Abdominal Pain

Sir.—I would like to comment regarding Dr Lebenthal's article "Recurrent Abdominal Pain in Childhood" (Journal 134:347-348, 1980). As a clinician, I am repeatedly distressed to find that so many physicians who discuss abdominal pain find solace in the medical scrap basket called psychosomatic illness. I am sure that such problems are at times psychosomatic, but I believe that this diagnosis is made too frequently to mask our own inadequacies in diagnosis. The literature has shown repeatedly that foods can cause dramatic, observable effects on the gut and that these problems are real.^1-8 Not all food-related reactions are IgE-mediated. The fact that a physician cannot always understand why a food causes symptoms cannot be equated to the fact that a food does cause symptoms. Unfortunately, although careful clinicians see many children who respond favorably to dietary manipulation, scientific documentation is not always possible or practical. Parents who have been told