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Abdominal Pain

Abdominal Pain Abstract 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 References 1. Duke WW: Food allergy as a cause of abdominal pain . Arch Intern Med 28:151-165, 1921.Crossref 2. Rowe AH: Gastrointestinal allergy . JAMA 97:1440-1444, 1931.Crossref 3. Rowe AH: Roentgen studies of patients with gastrointestinal food allergy . JAMA 100:394-400, 1933.Crossref 4. Fries JH, Zizmor J: Roentgen studies of children with alimentary disturbances due to food allergy . Am J Dis Child 54:1239-1251, 1937. 5. Fries JH, Mogil M: Roentgen observations on children with gastrointestinal allergy to foods . J Allergy Clin Immunol 14:310-321, 1943. 6. Fries JH: Roentgen studies of allergic children with disturbances of the pylorus resulting from food sensitivity . J Allergy Clin Immunol 23:39-47, 1952. 7. Pollard HM, Stuart GJ: Experimental reproduction of gastric allergy in human beings with controlled observations on the mucosa . J Allergy Clin Immunol 13:467-473, 1942. 8. Gray I, Harten M, Walzer M: Studies in mucous membrane hypersensitiveness: IV. The allergic reaction in the passively sensitized mucous membranes of the ileum and colon in humans . Ann Intern Med 13:2050-2056, 1940.Crossref 9. Speer F: Allergic tension-fatigue in children . Ann Allergy 12:168, 1954. 10. Rapp DJ: Allergies and Your Family . New York, Sterling Publishing Co Inc, 1980. 11. Soothill JF: Elimination diets in childhood . Br Med J 280:401-402, 1980.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Abdominal Pain

Abstract

Abstract 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...
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Publisher
American Medical Association
Copyright
Copyright © 1980 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1980.02130220074026
Publisher site
See Article on Publisher Site

Abstract

Abstract 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 References 1. Duke WW: Food allergy as a cause of abdominal pain . Arch Intern Med 28:151-165, 1921.Crossref 2. Rowe AH: Gastrointestinal allergy . JAMA 97:1440-1444, 1931.Crossref 3. Rowe AH: Roentgen studies of patients with gastrointestinal food allergy . JAMA 100:394-400, 1933.Crossref 4. Fries JH, Zizmor J: Roentgen studies of children with alimentary disturbances due to food allergy . Am J Dis Child 54:1239-1251, 1937. 5. Fries JH, Mogil M: Roentgen observations on children with gastrointestinal allergy to foods . J Allergy Clin Immunol 14:310-321, 1943. 6. Fries JH: Roentgen studies of allergic children with disturbances of the pylorus resulting from food sensitivity . J Allergy Clin Immunol 23:39-47, 1952. 7. Pollard HM, Stuart GJ: Experimental reproduction of gastric allergy in human beings with controlled observations on the mucosa . J Allergy Clin Immunol 13:467-473, 1942. 8. Gray I, Harten M, Walzer M: Studies in mucous membrane hypersensitiveness: IV. The allergic reaction in the passively sensitized mucous membranes of the ileum and colon in humans . Ann Intern Med 13:2050-2056, 1940.Crossref 9. Speer F: Allergic tension-fatigue in children . Ann Allergy 12:168, 1954. 10. Rapp DJ: Allergies and Your Family . New York, Sterling Publishing Co Inc, 1980. 11. Soothill JF: Elimination diets in childhood . Br Med J 280:401-402, 1980.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Oct 1, 1980

References

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