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Chronic abdominal pain in childhood: diagnosis and management

A M Lake1

  • 1Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

American Family Physician
|April 20, 1999
PubMed

Insights

Chronic abdominal pain affects over a third of children. Empiric medical management, guided by history and a symptom diary, is often more effective than extensive testing for conditions like functional abdominal pain.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Diagnostics

Background:

  • Over one-third of children experience abdominal pain lasting two weeks or longer.
  • Accurate diagnosis is crucial for effective management of pediatric abdominal pain.

Purpose of the Study:

  • To outline a diagnostic and management approach for chronic abdominal pain in children.
  • To emphasize the role of patient history and empiric treatment over extensive investigations.

Main Methods:

  • Detailed patient and parent history taking.
  • Physical examination.
  • Utilizing a symptom diary for active patient participation.
  • Empiric medical management for suspected functional abdominal pain, constipation, or peptic disease.

Main Results:

  • Empiric medical management shows greater value than multiple exclusionary investigations when functional abdominal pain, constipation, or peptic disease is suspected.
  • Symptom diaries enhance the child's role in diagnosis.
  • Management strategies include nutritional, pharmacologic, and psychologic support.

Conclusions:

  • A history-driven, stepwise diagnostic approach is recommended for pediatric abdominal pain.
  • Empiric treatment and symptom diaries are valuable tools.
  • Comprehensive management addresses nutritional, pharmacologic, and psychosocial aspects of pediatric gastrointestinal disorders.

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