Chronic vague abdominal pain is an extremely common complaint in children over 5 years, with a peak incidence in the 8 to 10 year group. In over 90 per cent of the cases no serious underlying organic disease will be discovered. Most disease states can be ruled out by a careful history, a meticulous physical examination, and a few simple laboratory tests such as urinalysis, sedimentation rate, hemoglobin, white blood count determination, and examination of a blood smear. If organic disease is present there are often clues in the history and the examination. The kidney is often the culprit--an intravenous pyelogram should be done if disease is suspected. Barium enema is the next most valuable test. Duodenal ulcers and abdominal epilepsy are rare and are over-diagnosed. If no organic cause is found, the parents must be convinced that the pain is real, and that "functional" does not mean "imaginary." This is best explained by comparing with "headache"--the headache resulting from stress and tension hurts every bit as much as the headache caused by a brain tumor or other intracranial pathology. Having convinced the patient and his parents that no serious disease exists, no further investigation should be carried out unless new signs or symptoms appear. The child must be returned to full activity immediately.
慢性非特异性腹痛在5岁以上儿童中极为常见，8至10岁年龄段发病率最高。超过90%的病例不会发现严重的潜在器质性疾病。通过详细的病史、细致的体格检查以及一些简单的实验室检查，如尿液分析、血沉、血红蛋白、白细胞计数测定和血涂片检查，大多数疾病状态可以被排除。如果存在器质性疾病，病史和检查中往往会有线索。肾脏常常是病因所在——如果怀疑患病，应进行静脉肾盂造影。钡剂灌肠是其次最有价值的检查。十二指肠溃疡和腹型癫痫很少见且常被过度诊断。如果未发现器质性病因，必须让家长相信疼痛是真实的，“功能性”并不意味着“想象出来的”。通过与“头痛”作比较能最好地解释这一点——由压力和紧张引起的头痛与脑肿瘤或其他颅内病变引起的头痛一样疼痛。在让患者及其家长相信不存在严重疾病后，除非出现新的体征或症状，否则不应进行进一步检查。必须让孩子立即恢复正常活动。
