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Difficulties in the Diagnosis and Management of Functional or Recurrent Abdominal Pain in Children
Insights
Recurrent abdominal pain in children often stems from functional gastrointestinal disorders. A thorough evaluation and understanding of the psychosocial pain model aid diagnosis and management.
Area of Science:
- Pediatric Gastroenterology
- Functional Gastrointestinal Disorders
Background:
- Recurrent abdominal pain is common in pediatric gastroenterology.
- Most cases involve functional gastrointestinal disorders.
- Diagnosis often relies on history, exam, and minimal testing.
Purpose of the Study:
- Discuss challenges in diagnosing pediatric abdominal pain.
- Outline diagnostic and therapeutic strategies.
- Emphasize the psychosocial model of pain.
Main Methods:
- Focused medical history.
- Comprehensive physical examination.
- Minimal diagnostic testing.
Main Results:
- Functional disorders are the most frequent cause of abdominal pain.
- Red flag symptoms (e.g., rectal bleeding, bilious vomiting) guide further plans.
- Absence of red flags allows for education on pathophysiology and psychosocial pain models.
Conclusions:
- Effective management involves accurate diagnosis and family education.
- The psychosocial model is crucial when red flags are absent.
- Addressing anxiety is key in managing pediatric abdominal pain.
Abstract:
Recurrent abdominal pain is a frequent pathology seen in the pediatric gastroenterology practice. In fact, most children with abdominal pain symptoms have functional disorders of the gastrointestinal tract. A focused medical history, comprehensive physical examination, and minimal testing are often enough to establish the diagnosis. The presence of red flags such as rectal bleeding, bilious vomiting, fever, and arthralgia should alert providers as well as direct further diagnostic and therapeutic plans. When patients show no red flags after a complete physical examination, providing the family with information about the pathophysiology and explaining the psychosocial model of pain can help to decrease anxiety around the pain symptoms. This article discusses the challenges in diagnosing and managing abdominal pain in children. [Pediatr Ann. 2016;45(11):e388-e393.].
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