This pilot study will investigate the efficacy of SAM-e for the treatment of recurrent
abdominal pain in a total of 30 children. This will be an open-labeled study and all
participants will receive SAM-e therapy. Given that SAM-e has been demonstrated to
improve symptoms of depression and pain with minimal side effects as compared to other
antidepressant therapy, we hypothesize that SAM-e will reduce pain symptoms among children
with recurrent abdominal pain.
- 8 to 22 years old
- Diagnosed with RAP as verified by a physician, and having at least twice weekly
episodes of abdominal pain which cause the patient to withdraw from normal
- At least one month trial on a high fiber diet without resolution of abdominal pain.
- Focal abdominal pain by history or physical exam, unless a negative (including
endoscopic) evaluation has been performed
- Current diagnosis of inflammatory bowel disease, pancreatitis (acute or recurrent),
peptic ulcer disease, gastrointestinal infection (unresolved), or ongoing
- Current or recent (within the past year) pregnancy and/or current breastfeeding.
- Current diagnosis of nephropathy or genitourinary disease.
- Blood in stools or emesis (EXCEPTION: blood in the stool secondary to hemorrhoids is
not an exclusion criterion).
- Unintentional loss of over 10% body weight over the past 3 months or weight < 100%
ideal body weight.
- Recurrent fevers (T>100F) at least once a week or with abdominal pain episodes.
- Recurrent dehydration with abdominal pain episodes requiring intravenous rehydration.
- Current personal diagnosis of depression or report of suicidality, mania or bipolar
- Family history of mania or bipolar disorder.
- Current use of opiates or other prescription pain medications and/or refusal to
remain off opiate/prescription pain medications during the study period.
- Currently receiving additional therapies besides diet for recurrent abdominal pain
and/or refusal to remain off such therapies during the study period, including but
not limited to anticholinergic medications, antidepressant medications, biofeedback
therapy, cognitive behavioral therapy.
- Hypersensitivity to SAM-e.
- Inability of child to provide assent and/or inability of parent/custodian to give
Jeannie Huang, MD, MPH
University of California, San Diego