Evaluation of S-adenosyl Methionine (SAM-e) for Recurrent Abdominal Pain in Children

Inclusion Criteria: * 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 activities. * At least one month trial on a high fiber diet without resolution of abdominal pain. * Ambulatory Exclusion Criteria: * 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 gastrointestinal inflammation. * 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 disorder. * 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 consent.