Many Causes Are Unknown
According to the article, chronic functional abdominal pain in children and adolescents is “not due to any organic cause.” As in this article, the entire medical literature maintains a separation between “organic” and “functional” (non-organic). However, functional disorders are pathologies whose etiologies and pathogeneses are not at all understood and for which causal therapeutic approaches are lacking to date. The idea that all medical problems that cannot be identified by using today’s methods are per se non-organic has to be incorrect. The foreseeable result of this attitude among medical professionals is that patients who have no organic illness will inevitably be perceived as mentally or at least psychosomatically ill. It is therefore not surprising that patients feel they are being labeled as hypochondriacs, although “there is no organic disease” (1).
Abolishing the antiquated separation between “functional” and “organic” (non-organic) is well overdue. Instead, a distinction between “organic” and “non-organic” should be made even for functional disorders. This may be diagnostically complicated, but it is urgently needed in view of the existing confusion, so that patients with functional disorders are not treated consciously or unconsciously as primarily mentally ill or psychosomatic patients.
Furthermore, awareness needs to be raised vis-à-vis the fact that many organic causes for functional abdominal pain are currently unknown. Initial pointers exist in the insights into irritable bowel syndrome, whose confirmed causes include chronic infections, or postinfectious causes, or dysbiotic causes (2). I hope that the coming years will bring substantial advances in our knowledge. Up until that time, the treatment of choice, as outlined in the otherwise well conceived article, is the best possible distraction from the symptoms.
Dr. med. Christoph Namislo
Conflict of interest statement
The author declares that no conflict of interest exists.
|1.||Bufler Ph, Groß M, Uhlig HH: Recurrent abdominal pain in childhood. Dtsch Arztebl Int 2011; 108(17): 295–304. VOLLTEXT|
|2.||Layer P, et al.: S3-Leitlinie Reizdarmsyndrom: Definition, Pathophysiologie, Diagnostik und Therapie. Z Gastroenterol 2011; 49: 237–93. CrossRef MEDLINE|