Gastrointestinal Disorders, Developmental Aspects Of

Jay A. Perman & Ramasamy Manikam & Kathleen M. Schoemer & Elsie Stines

Pediatric gastroenterologists are trained in the medical model to identify, assess, and treat organic disease. Organic disease is generally accepted as having identifiable tissue changes in the form of inflammatory, infectious, or structural abnormality. Yet it is not uncommon for gastroenterologists to encounter patients with functional gastrointestinal symptoms (medically unexplained gastrointestinal symptoms). According to Wilhelmsen (2002), nearly half the patients in a gastroenterologist's office are diagnosed as having a functional disorder without any biological markers or endoscopic findings. Medically unexplained physical symptoms are common in children and adolescents (Garralda, 1996). Functional abdominal pain, recurrent abdominal pain, and functional constipation constitute the majority of cases referred to the pediatric gastroenterologist. Many of these children and adolescents do not have organic disease. At the present time, patients with psychological, developmental, and social attendant illness are inadequately served through conventional medical management. Pediatric gastroenterologists must recognize how children's developmental aspects and their mind-body ...

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