***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract The objective of this study was to assess the impact of parent attention and distraction on symptom complaints by children with and without chronic functional abdominal pain . The water load symptom provocation task was used to induce visceral discomfort in pediatric patients with abdominal pain ( N = 104 ) and well children ( N = 119 ) , ages 8–16 years . Parents were r and omly assigned and trained to interact with their children according to one of three conditions : Attention , Distraction , or No Instruction . Children 's symptom complaints and parents ' responses were audiotaped and coded . Children completed a self‐report measure of gastrointestinal ( GI ) symptoms before and after interacting with their parents . Parents ' and children 's perceptions of their interaction were assessed . Compared to the No Instruction condition , symptom complaints by pain patients and well children nearly doubled in the Attention condition and were reduced by half in the Distraction condition . The effect of attention on symptom complaints was greater for female pain patients than for male patients or well children . Findings for self‐report GI symptoms were similar to those for audiotaped symptom complaints . Both pain patients and well children in the Distraction condition rated parents as making them feel better compared to ratings for the Attention condition . Parents of pain patients rated distraction as having greater potential negative impact on their children than attention . Parents ' responses to children 's symptom complaints can significantly increase or decrease those complaints . Girls with functional abdominal pain are particularly vulnerable to the symptom‐reinforcing effects of parental attention Background Because of the paucity of effective evidence -based therapies for children with recurrent abdominal pain , we evaluated the therapeutic effect of guided imagery , a well-studied self-regulation technique . Methods 22 children , aged 5 – 18 years , were r and omized to learn either breathing exercises alone or guided imagery with progressive muscle relaxation . Both groups had 4-weekly sessions with a therapist . Children reported the numbers of days with pain , the pain intensity , and missed activities due to abdominal pain using a daily pain diary collected at baseline and during the intervention . Monthly phone calls to the children reported the number of days with pain and the number of days of missed activities experienced during the month of and month following the intervention . Children with ≤ 4 days of pain/month and no missed activities due to pain were defined as being healed . Depression , anxiety , and somatization were measured in both children and parents at baseline . Results At baseline the children who received guided imagery had more days of pain during the preceding month ( 23 vs. 14 days , P = 0.04 ) . There were no differences in the intensity of painful episodes or any baseline psychological factors between the two groups . Children who learned guided imagery with progressive muscle relaxation had significantly greater decrease in the number of days with pain than those learning breathing exercises alone after one ( 67 % vs. 21 % , P = 0.05 ) , and two ( 82 % vs. 45 % , P < 0.01 ) months and significantly greater decrease in days with missed activities at one ( 85 % vs. 15 % , P = 0.02 ) and two ( 95 % vs. 77 % . P = 0.05 ) months . During the two months of follow-up , more children who had learned guided imagery met the threshold of ≤ 4 day of pain each month and no missed activities ( RR = 7.3 , 95%CI [ 1.1,48.6 ] ) than children who learned only the breathing exercises . Conclusion The therapeutic efficacy of guided imagery with progressive muscle relaxation found in this study is consistent with our present underst and ing of the pathophysiology of recurrent abdominal pain in children . Although unfamiliar to many pediatricians , guided imagery is a simple , noninvasive therapy with potential benefit for treating children with RAP Objectives Recurrent abdominal pain ( RAP ) is a common childhood complaint rarely associated with organic disease . Recently , the Pediatric Rome Criteria were developed to st and ardize the classification of pediatric functional gastrointestinal disorders ( FGIDs ) using a symptom-based approach . The authors tested the hypothesis that most patients with childhood RAP could be classified into one or more of the symptom subtypes defined by the Pediatric Rome Criteria . Methods Using a prospect i ve longitudinal design , new patients with RAP ( n = 114 ) were studied at a tertiary care children 's medical center . Before the medical evaluation , parents completed a question naire about their child , assessing symptoms defined by the Pediatric Rome Criteria . Results Of the 107 children for whom medical evaluation revealed no organic etiology for pain , 73 % had symptom profiles consistent with the Pediatric Rome Criteria for one of the FGIDs associated with abdominal pain ( irritable bowel syndrome , 44.9 % ; functional dyspepsia,15.9 % ; functional abdominal pain , 7.5 % ; abdominal migraine , 4.7 % ) Conclusions This study provides the first systematic empirical evidence that RAP , originally defined by Apley , includes children whose symptoms are consistent with the symptom criteria for several FGIDs defined by the Rome criteria . The pediatric Rome criteria may be useful in clinical research to ( 1 ) describe the symptom characteristics of research participants who meet Apley 's broad criteria for RAP , and ( 2 ) select patients with particular symptom profiles for investigation of potential biologic and psychosocial mechanisms associated with pediatric FGIDs The association of lactase deficiency with recurrent abdominal pain was investigated . One hundred three white children between the ages of 6 to 14 years with recurrent abdominal pain were evaluated . Sixty-nine underwent lactose tolerance tests and 26 had intestinal biopsies with lactase determinations ; 21 of 69 ( 30.4 % ) had abnormal lactose tolerance tests and eight of 26 ( 31 % ) were lactase deficient . However , 16 of 61 ( 26.4 % ) control subjects matched for age and ethnic background exhibited lactase deficiency . Thus , a similar prevalence of lactase deficiency was found in the control and the recurrent abdominal pain groups . Thirty-eight patients with recurrent abdominal pain completed three successive six-week diet trials conducted in a double-blind fashion . An increase above base line value in pain frequency was seen in ten of 21 ( 48 % ) lactose malabsorbers and four of 17 ( 24 % ) lactose absorbers . After a 12-month milk elimination diet , six of 15 ( 40 % ) malabsorbers and five of 13 ( 38 % ) absorbers had elimination of their pain . This result compared with improvement occurring in five of 12 ( 42 % ) absorbers with recurrent abdominal pain who received a regular diet for one year and suggests that the elimination of lactose will not affect the overall frequency of improvement in recurrent abdominal pain . In addition , the recovery rate from recurrent abdominal pain is similar in both lactose absorbers and nonabsorbers independent of dietary restrictions In order to evaluate the role of lactose malabsorption in children with recurrent abdominal pain , we performed a prospect i ve controlled double-blinded study in 40 children with RAP of at least three months ' duration . Children were studied for lactose malabsorption by breath hydrogen determinations after ingestion of lactose ( 2 gm/kg of body weight ; maximum 50 gm ) . Lactose malabsorbers were retested with 12.5 gm lactose ; lactose absorbers were retested with lactose for ability to produce hydrogen . All children underwent a dietary trial which included two lactose elimination periods . Although 12 children ( 30 % ) were lactose malabsorbers , only three malabsorbed part of the smaller , more physiologic , lactose load . Improvement rates of lactose malabsorbers and absorbers during lactose elimination were not significantly different as judged by their physicians and as determined by a 50 % or more decrease in pain frequency . These results suggest that lactose malabsorption is of little importance in children with RAP 
    Output:
    
This review provides weak evidence of benefit on medication in children with RAP .
The lack of clear evidence of effectiveness for any of the recommended drugs suggests that there is little reason for their use outside of clinical trials .