Saturday, July 24, 2004

Does your child R.A.P. ?

This article does NOT refer to the musical preferences of today's kids. Rather it deals with another common problem that almost 10-20% of school-going children have.. RAP or Recurrent Abdominal Pain.
Does my child have it?
Almost all kids have abdominal pain at some point of time, however RAP is defined as 3 episodes of abdominal pain over 3 months or more, interfering with daily activities like going to school etc.
What causes RAP?
Only around 10 % of RAP are caused by organic (physical) causes, the rest 90% are functional. This means that once the physical examination & basic lab tests are normal, you can be pretty confident that there is nothing wrong in the child's abdomen.
It is interesting to note that an Indian study has shown that children with functional RAP are likely to belong to a nuclear family, have history of marital fights between parents, irritable bowel syndrome and chronic painful disorders and maternal dysmneorrhoea in the family. School tantrums (before going to school) , absenteeism and punishments in shchool were more common among these children too. Generally sleep was not afffected in these kids. There was however no difference in school performance from their peers. All this indicates that family and school stressors may play a significant role in causing RAP.
What tests are needed to confirm the diagnosis?
In most cases only complete blood count, Stool & urine examination (three times each), and maybe an X ray/ Ultrasound abdomen will suffice to confirm the diagnosis. More expensive & invasive tests are not indicated routinely.
What is the treatment?
Reassurance is the KEY for the parents (and the child). Telling them that there is nothing wrong physically with the child is very important. Of course this does not mean that the child is lying, the pain is real, but the cause is not in the abdomen. Sometimes, simple distraction by telling the child that the parent has been 'taught' how to take care of the problem (like blowing on the abdomen) can bring about wonderful results. A psychological evaluation for stressors maybe useful. Medicine use should be avoided as far as possible.

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