564 No evidence for drug treatments for recurrent abdominal pain in children

December 02, 2017

written by Brian McAvoy

Clinical question
How effective are pharmacological interventions for recurrent abdominal pain in children of school age?

Bottom line
There was no evidence for the use of medications to improve symptoms or the child’s quality of life. Studies were conducted in 7 countries, and follow-up ranged from 2 weeks to 4 months. Medications included tricyclic antidepressants, antibiotics, 5-HT4 receptor agonists, antispasmodics, antihistamines, histamine H2-receptor antagonists, serotonin antagonists, selective serotonin reuptake inhibitors, a dopamine receptor antagonist and melatonin.

Although some single studies reported treatments were effective, all of these studies were either small or had key methodological weaknesses with a substantial risk of bias. None of these “positive” results were reproduced in subsequent studies. The evidence of effectiveness was of low quality.


Between 4% and 25% of school-aged children, at some stage, complain of recurrent abdominal pain of sufficient severity to interfere with their daily lives. When no clear organic cause is found, the children are managed with reassurance and simple measures; a large range of pharmacological interventions have been recommended for use in these children.

Cochrane Systematic Review

Martin AE et al. Pharmacological interventions for recurrent abdominal pain in childhood. Cochrane Reviews, 2017, Issue 3. Art. No.: CD010973.DOI: 10.1002/14651858. CD010973.pub2. This review contains 16 studies involving 1024 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.