Primary gastro-oesophageal reflux disease and irritable oesophagus syndrome as causes of recurrent abdominal pain in children.

Cases of two adolescents with recurrent abdominal pain, localized in the periumbilical area, due to primary oesophageal disorders are reported. Food allergy or intolerance, as well as other paediatric causes, were not involved in the pathogenesis of recurrent abdominal pain in these two patients. Case 1 was affected by primary gastro-oesophageal reflux disease: upper endoscopy with biopsies and oesophageal 24-hour pH-monitoring showed mild oesophagitis and pathological reflux index, respectively. Case 2 was affected by "irritable oesophagus syndrome": upper endoscopy with biopsies was normal and oesophageal 24-hour pH-monitoring showed a close correlation between gastro-oesophageal reflux and recurrent abdominal pain episodes. Both patients were successfully treated with cisapride (0.2 mg/kg t.i.d.) and ranitidine (2.5 mg/KG b.i.d.). These reports suggest that primary gastro-oesophageal reflux disease and irritable oesophagus syndrome may cause recurrent abdominal pain in children.