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Published on: February 3, 2016
Functional abdominal pain disorders in children
Swarna Gajendran1, Jay Sharma2, Ajay Sharma3
1BBiomedSc, MD (UWA), Intern, Fiona Stanley Hospital, Perth, WA.
Insights
Paediatric functional abdominal pain disorders (FAPDs) are common and challenging to diagnose. A structured clinical assessment is key to effective management in primary care.
Area of Science:
- Pediatrics
- Gastroenterology
- Psychology
Background:
- Paediatric functional abdominal pain disorders (FAPDs) represent a heterogeneous group of conditions characterized by chronic abdominal pain without a clear organic cause.
- Diagnostic challenges in FAPDs necessitate a structured approach to patient assessment.
- FAPDs significantly impact children's quality of life and healthcare utilization.
Purpose of the Study:
- To summarize the clinical assessment, investigations, and management of paediatric patients with chronic abdominal pain suggestive of FAPDs.
- To emphasize the importance of a biopsychosocial approach in managing FAPDs.
- To outline a recommended assessment and management strategy for primary care settings.
Main Methods:
- Literature review of current guidelines and evidence-based practices for FAPDs.
- Synthesis of information on diagnostic criteria and red flag features.
- Development of a primary care-focused management framework.
Main Results:
- A thorough clinical assessment is often sufficient for diagnosing FAPDs, minimizing the need for extensive investigations.
- Identifying 'red flag' symptoms is crucial to rule out serious underlying organic conditions.
- A biopsychosocial approach, integrating medical, psychological, and social factors, is recommended for comprehensive management.
Conclusions:
- Accurate diagnosis and management of FAPDs in children can often be achieved in primary care through a structured clinical approach.
- Minimizing unnecessary investigations reduces patient and family anxiety and healthcare costs.
- Early identification and management of FAPDs improve patient outcomes and well-being.
Background:
Paediatric functional abdominal pain disorders (FAPDs) encompass a heterogenous group of medical conditions characterised by chronic abdominal pain that cannot be fully explained by another medical condition. It is important to have a structured approach to assessing patients as FAPDs can pose diagnostic challenges.
Objective:
This article summarises the clinical assessment, investigations and management of paediatric patients presenting with chronic abdominal pain suggestive of FAPDs. It discusses the importance of a biopsychosocial approach to FAPDs, outlining the recommended approach to assessing and managing patients in a primary care setting.
Discussion:
A diagnosis of FAPD can often be made from a thorough clinical assessment without the need for extensive investigations or referrals that can perpetuate the anxiety of patients and their family. However, it is important to identify the presence of red flag features that raise the possibility of more serious causes that must not be missed.
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