Recurrent Abdominal Pain
Recurrent Abdominal Pain
Exclusion of organic disease if clinically indicated
Definition: Recurrent abdominal pain for which no cause can be found occurring at least monthly for 3 consecutive months with severity that interferes with routine function of the child. Typically periumbilical pain associated with belching, bloating with negative findings on clinical evaluation and no response to acid-blocking medication. Note: pain below the umbilicus accompanied by abdominal cramps, bloating and distension and with and altered bowel pattern are consistent with Irritable Bowel Syndrome, but first exclude organic disease with appropriate investigations. Where the diagnosis is strongly suspected in the presence of a normal clinical evaluation excessive investigation should be avoided.
Exclusion of organic disease if clinically indicated:
- UTIs / Urinary Tract anomalies / Renal disease
- GIT infection, infestation or inflammation
- Chronic infections (such as TB abdomen)
- Abdominal masses such as tumours
- Gall bladder disease
- Pancreatic disease
General measures
Appropriate management of psychological stressors, anxiety or depression – where present. Reassurance of child and family. Counselling to avoid the reinforcement of the symptoms with secondary gain. With irritable bowel syndrome type condition ensure adequate dietary fibre.
Medicinal treatment
Manage any organic disease as indicated. Treat constipation where present as per protocol. Appropriate management of anxiety or depression if considered co-morbid condition.