PEDIATRICS Vol. 40 No. 1 July 1967, pp. 84-89
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DIAGNOSIS AND TREATMENT: PSYCHOGENIC, RECURRENT, ABDOMINAL PAIN

Morris Green M.D.1

1 Department of Pediatrics, Indiana University School of Medicine

RECURRENT abdominal pain represents a frequent cause for medical consultation. At least 1 school child in 10 suffers from this complaint. Slightly more common in girls than in boys and unusual before the age of 5, recurrent abdominal pain has its greatest incidence in children 9 to 10 years of age. In 1,000 unselected school children Apley found the complaint to occur more frequently in girls (12.3%) than in boys (9.5%); more than one fourth of all girls at age 9 were affected.

Both organic and psychogenic etiologic possibilities need be considered together in each such case. The present discussion will be largely concerned with the latter. It is intended that a subsequent article will be concerned with organic abdominal pain.

CHARACTERISTICS OF PSYCHOGENIC, RECURRENT, ABDOMINAL PAIN

About one half of the children whose pain is psychogenic will have been symptomatic less than 1 year at the time of consultation; others will have had complaints for 1 to 5 years. Some children experience six or seven episodes a day while others one a week or one a month. Although this symptom may be related directly to stressful situations, this relationship is uncommon. A temporal relation to meals is rare, and the pain almost never awakens the child from sleep. Individual attacks are usually 5 to 30 minutes in length but may persist for hours.

Episodes usually began gradually rather than abruptly. The pain is generally constant and mild or moderate rather than colicky and severe. Descriptions are vague: "It just hurts," "It feels funny," or "I don't know."




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