Functional abdominal pain: what clinicians need to know
Edward Thomas Andrews1, R Mark Beattie2, Mark P Tighe3
1Department of Paediatrics, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Archives of Disease in Childhood
|March 11, 2020
Summary
Functional abdominal pain in children is common, often without a clear cause. Management focuses on understanding visceral hypersensitivity and involving families in treatment, with psychological therapies showing the most promise.
Area of Science:
- Pediatrics
- Gastroenterology
- Psychology
Background:
- Childhood abdominal pain is a frequent concern in healthcare settings.
- Recurrent abdominal pain significantly impacts children's daily lives.
- Most cases lack identifiable organic pathology, suggesting functional origins.
Purpose of the Study:
- To explore the mechanisms of functional abdominal pain, including visceral hypersensitivity.
- To review the link between parental anxiety and pediatric symptoms.
- To provide guidance on investigating and managing childhood functional abdominal pain.
Main Methods:
- Literature review on functional abdominal pain mechanisms and treatments.
- Evidence-based discussion of diagnostic approaches (celiac screen, inflammatory markers, fecal calprotectin).
- Evaluation of pharmacological, psychological, and complementary therapies.
Main Results:
- Visceral hypersensitivity is a key mechanism in functional abdominal pain.
- Parental anxiety can influence symptom presentation.
- Psychological interventions (CBT, hypnotherapy) and complementary therapies (yoga) show efficacy.
- Pharmacological options are limited, with probiotics and peppermint oil having some support.
Conclusions:
- A rational, one-stop investigation approach is recommended in the absence of red flags.
- Management requires addressing family expectations and accepting multifactorial etiology.
- Positive outcomes depend on child and family acceptance of contributing factors.
Related Concept Videos
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
466
Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
466
01:22Appendicitis-I: Introduction
1.9K
The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
1.9K
01:30Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
666
Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
666
01:30Acute Pancreatitis II: Clinical Manifestations and Management
639
Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
639
01:24Chronic Pancreatitis I: Introduction
616
The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
616
01:19Abdominal Regions and Quadrants
15.4K
To promote clear communication, for instance, about the location of a patient's abdominal pain or a suspicious mass, anatomists and clinicians typically use imaginary lines to categorize the abdominopelvic cavity into either four quadrants or nine regions to identify organs in the cavity.
The simpler quadrants approach, which is more commonly used in medicine, subdivides the cavity with one horizontal and one vertical line that intersects at the patient's umbilicus (navel). The four...
The simpler quadrants approach, which is more commonly used in medicine, subdivides the cavity with one horizontal and one vertical line that intersects at the patient's umbilicus (navel). The four...
15.4K