Recurrent Abdominal Pain in Children or RAP /

Medication, Lactobacillus and Dietary Modification for RAP

01 In Brief

 Between 4% and 25% of school-age children complain of recurrent abdominal pain (RAP) of sufficient severity to interfere with daily activities. For the majority no organic cause for their pain can be found on physical examination or investigation and although most children are likely managed by reassurance and simple measures, a large range of interventions have been recommended. we present recent data about the effectiveness of Medication, dietary interventions and lactobacillus. A recent trials suggested some improvement with Lactobacillus

02 What Others Say

DIETARY MODIFICATION

Cochrane database Review 2009

 AUTHORS' CONCLUSIONS: There is a lack of high quality evidence on the effectiveness of dietary interventions. This review provides no evidence that fibre supplements, lactose free diets or lactobacillus supplementation are effective in the management of children with RAP.
Dietary Interventions for recurrent abdominal Pain and irritable bowel syndrome in childhood

PHARMACOLOGICAL INTERVENTION 

Cochrane database  2008

Medications trialled

  • pizotifen compared to placebo for children with abdominal migraine syndrome
  • peppermint capsules and placebo
  • famotide an anti acid preparation similar to ranitidine with placebo

AUTHORS' CONCLUSIONS: This review provides weak evidence of benefit on medication in children with RAP. The lack of clear evidence of effectiveness for any of the recommended drugs suggests that there is little reason for their use outside of clinical trials. Clinicians may choose to prescribe drugs in children with severe symptoms that have not responded to simple management. However, if using drugs as a "therapeutic trial", clinicians should be aware that, RAP is a fluctuating condition and any "response" may reflect the natural history of the condition or a placebo effect rather than drug efficacy
Pharmacological Intervention for recurrent abdominal Pain in children

03 I Want To Know More

NEWS;Francavilla R, Miniello V, Magista AM, et al. A randomized controlled trial of Lactobacillus GG in children with functional abdominal pain. Pediatrics. 2010 Dec;126(6):e1445-52. Epub 2010 Nov 15. (Original) PMID: 21078735

Conclusion: Lactobacillus rhamnosus GG significantly reduces the frequency and severity of abdominal pain in children with Irritable bowel syndrome ; this effect is sustained and may be secondary to improvement in the gut barrier


The information published here has been reviewed by Flourish Paediatrics and represents the available published literature at the time of review.
The information is not intended to take the place of medical advice.
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Last updated: 18/01/2011