Navigating recurrent abdominal pain through clinical clues, red flags, and initial testing.
Recurrent abdominal pain is a common chronic complaint that presents to your office. The constant challenge is one of detecting those with organic disease from the majority who have a functional pain disorder including functional dyspepsia, irritable bowel syndrome, functional abdominal pain, and abdominal migraine. Beginning with a detailed history and physical exam, you can: 1) apply the symptom-based Rome III criteria to positively identify a functional disorder, and 2) filter these findings through the diagnostic clues and red flags that point toward specific organic disease and/or further testing. Once a functional diagnosis has been made or an organic disease is suspected, you can initiate a self-limited empiric therapeutic trial. With this diagnostic approach, you should feel confident navigating through the initial evaluation, management, and consultation referral for a child or adolescent with recurrent abdominal pain.
Noe
Joshua D
JD
Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, W1 53226, USA.
Li
B U K
BU
D015746:Abdominal Pain / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D001466:Barium Sulfate; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D016145:Endoscopy, Digestive System; D005243:Feces; D006801:Humans; D008487:Medical History Taking; D010372:Pediatrics / Q000379:methods; D010808:Physical Examination; D017410:Practice Guidelines as Topic; D012008:Recurrence
D015415:Biomarkers; D003287:Contrast Media; D001466:Barium Sulfate