***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: Eng K , Ranson JHC , Localio SA . Resection of the perforated segment : a significant advance in treatment of diverticulitis with free perforation or abscess . AmJr Surg 1977;133:67 - 72 . ' Pledger HG , Buchan R. Deaths in children with acute appendicitis . Br MedJ 1969;iv : 466 - 70 . 5 Tagart REB . General peritonitis and haemorrhage complicating colonic diverticular disease . Ann R Coll Surg Eng 1974;55:175 - 83 . 6 Barabas AP . Perforated diverticulitis . Br MedJ ' 1970;iii : 767 - 8 . 7 Fielding LP , Stewart-Brown S , Blesovsky L. Large-bowel obstruction caused by cancer : a prospect i ve study . Br MedJ ' 1979;ii : 515 - 7 . 8 Stewart DJ . Antibiotic lavage in the prevention of intraperitoneal sepsis . Am R Coll Surg Eng 1978;60:240 - 3 . 9 Stewart DJ , Matheson NA .  Peritoneal lavage in faecal peritonitis  in the rat . BrJr Surg 1978;65 : 57 - 9 . 10 Hudspeth AS . Radical surgical debridement in the treatment of advanced generalised bacterial peritonitis  . Arch Surg 1975;110:1233 - 6 . 1 Munro A , Jones PF . Operative intubation in the treatment of complicated small bowel obstruction . BrJf Surg 1978;65:123 - 7 . 12 Burnett WE , Brown GR , Rosemond GP , Caswell HT , Buchor RB , Tyson RR . The treatment of peritonitis using peritoneal lavage . Ann Surg 1957;145 : 675 - 81 . 13 Noon GP , Beall AC , Jordan GL , Riggs S , De Baker ME . Clinical evaluation of peritoneal irrigation with antibiotic solution .  Surgery 1967;62 : 73 - 8 . 14 Stewart DJ , Matheson NA .  Peritoneal lavage in appendicular peritonitis . BrJ Surg 1978;65:54 - 6 . . 15 McKenna JP , Currie DJ , MacDonald JA , Mahoney LJ , Finlayson DC , Lanskail DJ . The use of continuous postoperative peritoneal lavage in the management of diffuse peritonitis . Surg Gynecol Obstet 1970;130 : 254 - 8 . 16 Neely J , Catchpole B. Ileus : the restoration of alimentary-tract motility by pharmacological means . Br3 ' Surg 1971 ; 58 : 21 - 8 BACKGROUND Despite the rapidly growing body of literature on health-related quality of life ( HRQoL ) . placing the results in a context that is meaningful to clinicians and patients is often overlooked . OBJECTIVE This study sought to quantify the impact of irritable bowel syndrome ( IBS ) on HRQoL by comparing the Medical Outcomes Study 36-item Short-Form Health Survey ( SF-36 ) scores of IBS patients with normative US data and with the scores of patients having other chronic gastrointestinal ( GI ) and non-GI disorders . METHODS Two IBS reference groups were identified from the published literature : a largely untreated community sample of health maintenance organization ( HMO ) members ( N = 92 ) and a sample of patients with IBS recruited through clinics and in the community ( N = 140 ) . SF-36 scores for these groups were compared with published US population norms ( N = 2474 ) and with published scores for 3 other IBS sample s ( N = 464 ) ; a sample with other chronic GI disorders ( dyspepsia [ N = 126 ] , gastroesophageal reflux disease [ GERD ] [ N = 516 ] ) ; and sample s with other chronic episodic disorders ( asthma [ N = 375 ] , migraine [ N = 303 ] , panic disorder [ N = 73 ] , rheumatoid arthritis [ N = 693 ] ) . RESULTS The scores of patients in both IBS reference groups were significantly lower on several SF-36 domains than those of the US normative population ( P < 0.003 ) . Scores on several SF-36 scales were also significantly lower in the IBS reference groups compared with the GERD , asthma , and migraine sample s ( P < 0.003 ) . Depending on the IBS sample used , scores did not differ or were higher compared with those in the sample with dyspepsia . Relative to the sample s with panic disorder and rheumatoid arthritis , the IBS groups had significantly higher scores on most SF-36 domains ( P < 0.003 ) . Scores for the HMO reference group were generally higher than those for the clinic/community reference group . CONCLUSIONS Based on the results of this analysis , IBS is associated with impairment of HRQoL relative to US population norms and to population s with GERD , asthma , or migraine . HRQoL appears to be greater in patients with IBS than in those with panic disorder or rheumatoid arthritis , although the relative symptom severity in these sample s was not known This study describes the results of a controlled clinical trial involving 44 7- to 14-year-old children with recurrent abdominal pain who were r and omly allocated to either cognitive-behavioral family intervention ( CBFI ) or st and ard pediatric care ( SPC ) .  Both treatment conditions result ed in significant improvements on measures of pain intensity and pain behavior . However , the children receiving CBFI had a higher rate of complete elimination of pain , lower levels of relapse at 6- and 12-month follow-up , and lower levels of interference with their activities as a result of pain and parents reported a higher level of satisfaction with the treatment than children receiving SPC . After controlling for pretreatment levels of pain , children 's active self-coping and mothers ' caregiving strategies were significant independent predictors of pain behavior at posttreatment Background and Objectives : The purpose of the present study was to evaluate the results of diagnostic laparoscopy in children with chronic recurrent abdominal pain .  Patients and Methods : Thirteen children with chronic recurrent abdominal pain were subjected to diagnostic laparoscopy .  Ages varied from 10 to 17 years . There were six males and seven females .  Abdominal pain was present from 3 weeks to 12 months ( mean , 2 months ) . Extensive laboratory and imaging studies did not contribute to the diagnosis . In all patients , the pain was disabling and severe enough to warrant repeated visits to the pediatrician , emergency room visits , or hospital admissions , as well as absence from school . Results : All children recovered uneventfully . Laparoscopic findings that identified the cause of abdominal pain were obtained in 12 of 13 patients . Laparoscopic appendectomy was done in all patients . There were no operative complications . One child presented three months later with incomplete small bowel obstruction , which resolved with conservative management . There were no other postoperative complications . Follow-up varied from six months to three years . Abdominal pain resolved in ten patients . One patient presented eight months later with biliary dyskinesia . She improved following laparoscopic cholecystectomy and later on sphincterotomy , but her pain has not yet completely resolved . One patient presented six months later with abdominal pain secondary to intestinal adhesions . Her pain completely resolved after laparoscopic lysis of adhesions . A third patient who developed lower abdominal pain six months after laparoscopy improved with conservative management and antibiotics for pelvic inflammatory disease . Conclusions : Diagnostic laparoscopy is a valuable procedure in the management of children with chronic recurrent abdominal pain .  In the present study , laparoscopic examination revealed the cause of abdominal pain in most patients , and this pain resolved in most cases . Based on our experience , we recommend diagnostic laparoscopy early in the course of debilitating chronic recurrent abdominal pain in children .  Appendectomy should be done when no other significant cause of abdominal pain has been identified , even if the appendix looks normal In a r and omized , double-blind controlled trial , 42 children with irritable bowel syndrome ( IBS ) were given pH-dependent , enteric-coated peppermint oil capsules or placebo . After 2 weeks , 75 % of those receiving peppermint oil had reduced severity of pain associated with IBS . Peppermint oil may be used as a therapeutic agent during the symptomatic phase of IBS AIM To look at the predictors of health-care consultation for recurrent abdominal pain among urban schoolchildren in Malaysia . METHODS Recurrent abdominal pain was defined as at least three episodes of abdominal pain , severe enough to affect a child 's activities over a period longer than 3 months . A health-care consulter  was defined as a child who had been brought to see a doctor regarding recurrent abdominal pain at least once in the past year . Children aged between 9 and 15 years were r and omly chosen from schools in the city of Petaling Jaya , given question naires to fill in and interviewed to determine whether they fulfilled the above criteria for having symptoms of recurrent abdominal pain and for being a consulter . Bivariate analysis and multiple logistic regression analysis were performed on the data obtained . RESULTS One hundred and forty-three ( 9.61 % ) children fulfilled the criteria for recurrent abdominal pain out of a total of 1488 schoolchildren interviewed . There were 65 ( 45.5 % ) consulters and 78 ( 54.5 % ) non-consulters . Among the consulters , the male to female ratio was 1:1.4 , while among the non-consulters , the ratio was 1:1.1 . On bivariate analysis , the Chinese had a significantly lower likelihood to consult a doctor ( P = 0.02 ) , while the other two races did not show any increase in consultation ( Malays , P = 0.08 ; Indians , P = 0.21 ) . Among those with severe pain , there was a significantly higher prevalence of consulters ( P < 0.01 ) . Furthermore , those whose sleep was interrupted by abdominal pain were more likely to consult ( P < 0.01 ) . Children who had consulted a doctor were more likely to be missing school because of abdominal pain ( P < 0.01 ) . Following multiple logistic regression analysis , ethnicity was no longer a significant predictor . CONCLUSIONS Approximately 45.5 % of schoolchildren with recurrent abdominal pain in an urban setting were brought to see a doctor . Predictors of recent health-care consultation were school absence , pain severity and interruption of sleep caused by abdominal pain Recurrent abdominal pain ( RAP ) affects 10 % to 18 % of school-age children and is caused by obvious organic pathology in fewer than 10 % of cases . Two recent studies do not support previous beliefs that most RAP is psychogenic . Studies have shown disorders of bowel motility in children with RAP similar to those of adult irritable bowel syndrome ( IBS ) ; controlled trials of additional dietary fiber in adult IBS have shown beneficial results . We did a r and omized , double-blind , placebo-controlled study in 52 children with RAP and demonstrated a clinical ly and statistically significant decrease in pain attacks ( at least 50 % fewer ) in almost twice as many children who were given additional fiber as placebo .  Compliance was excellent in both groups and side effects were few . Although the cause of RAP is poorly understood , it is hypothesized that the beneficial effect of added fiber is due to its effect on shortening transit time , as in IBS Objective The purpose of this study was to look at the correlation between recurrent abdominal pain and the presence of recent stressful life events among schoolchildren in a rural district in Malaysia . Method This is a cross-sectional study of schoolchildren aged 9–15 years based in Kuala Langat , a rural district located in the south-west of the Malaysian state of Selangor . Schoolchildren were selected r and omly and given question naires to fill in . This was followed by interview with the children on the same day by one of the authors ( CCMB ) to ensure consistency of response . Recurrent abdominal pain was defined as ‘ at least three episodes of abdominal pain , severe enough to affect their activities over a period longer than three months’[1 ] . The children were also asked to answer either ‘ yes ’ or ‘ no ’ to whether they had experienced various life events in the previous year . Results A sample of 1462 schoolchildren ( 722 boys and 740 girls ) aged between 9 and 15 years were included in the study . There were 768 Malays , 393 Chinese and 301 Indians . Of these 1462 children , 161 ( 11.0 % ) had recurrent abdominal pain . On performing multiple logistic regression analysis , two life events were significantly associated with recurrent abdominal pain : death of a family member ( P = 0.008 ; odds ratio 0.61 , 95 % CI 0.43–0.88 ) and a change in occupation of an immediate family member ( P = 0.003 ; odds ratio 0.53 , 95 % CI 0.35–0.81 ) . Conclusion This study suggests that recurrent abdominal pain in children is associated with recent stressful life events in the children 's lives AIM To look at predictors of consulting behaviour among children with recurrent abdominal pain in a rural community in Malaysia . SUBJECTS AND METHODS A sample of 1462 school-children aged between 9 and 15 years were r and omly selected from all schools in K 
    Output:
    
The presence of alarm symptoms or signs ( such as weight loss , gastrointestinal bleeding , persistent fever , chronic severe diarrhea and significant vomiting ) is associated with a higher prevalence of organic disease .
There was insufficient evidence to state that the nature of the abdominal pain or the presence of associated symptoms ( such as anorexia , nausea , headache and joint pain ) can discriminate between functional and organic disorders .
Although children with chronic abdominal pain and their parents are more often anxious or depressed , the presence of anxiety , depression , behavior problems or recent negative life events does not distinguish between functional and organic abdominal pain .
Most children who are brought to the primary care physician 's office for chronic abdominal pain are unlikely to require diagnostic testing .