Sir.—What causes recurrent abdominal pain in children? And what should pediatricians do about it?
If a comprehensive battery of the usual studies (such as a complete blood cell count, urinalysis, ESR, examination of the stool for ova and parasites, and gastrointestinal (GI) roentgenograms show no abnormalities, what then? Should the patient be referred for psychiatric counseling because nothing "organic" has been found? Or should he undergo even more extensive testing and study, including EEG, rectal biopsy, sigmoidoscopic examination, or exploratory laparotomy?
Or could there be a simpler answer for a child's problem? A simpler diagnostic test, such as the elimination diet?
In the past 17 months, two separate articles with the identical title, "Recurrent Abdominal Pain," have appeared in the Journal (131:1340-1344, 1977 and 133:486-489, 1979). One study consisted of a review of the management of 19 patients, while the other was a long-term follow-up study of 161 children. In