A large percentage of children with rheumatic heart disease exhibit a group of frequently unrecognized gastro-intestinal symptoms as the only manifestation of an active rheumatic phase.
Digestive symptoms, especially abdominal pain in children, have been observed in various conditions apart from rheumatic infection.
Heiman and Cohen1 reported instances of abdominal pain in children between the ages of 4 and 12 years due to enterospasm. The characteristic features of this pain are its frequent recurrence and the fact that it is usually referred to the region of the umbilicus. A chance finding in these cases is a spastic intestine, which feels cordlike and rolls easily on palpation. Atropine affords ready and prompt relief. The German writers term this condition Nabelkolik. Roentgenograms show a spasm of the intestine, usually in the ileocecal region or in the colon.
Frazer2 attributed this condition to a functional neurosis in the gastro-intestinal tract. He
WOLFFE JB, BRIM CJ. THE ABDOMINAL SYNDROME OF RHEUMATIC DISEASE IN CHILDHOOD. Am J Dis Child. 1936;52(2):296–302. doi:10.1001/archpedi.1936.04140020039004
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