ABSTRACT

The classic definition of recurrent abdominal pain has been based on the work of Apley and Naish,1

who described children who presented with intermittent episodes of abdominal pain occurring for at least 3 months without any identifiable cause and interfering with daily activities. The term ‘chronic abdominal pain’ is often used interchangeably with ‘recurrent abdominal pain’. Chronic abdominal pain is abdominal pain that is continuous, persistent, or intermittent over a period of a few months. The pain may wax and wane, with some days being better than others.2

On occasions, relatively short asymptomatic periods may be interposed with ‘painful periods’, but the episodes of wellness rarely last long, generating a condition that profoundly distresses the daily life of children and their families. It is important to emphasize that recurrent abdominal pain represents a description and not a diagnosis. Many conditions can cause abdominal pain that is recurrent, but in clinical practice most children and adolescents presenting with this symptom have a functional disorder without any evidence of organic disease. They are considered to have ‘functional abdominal pain’. In this chapter we discuss conditions associated with functional alterations of the gastrointestinal (GI) system, called functional bowel disorders, and we only briefly describe those organic diseases causing abdominal pain (in the section dedicated to the differential diagnosis).