27- abdominal pain Flashcards
most common cause of abdominal pain in school-age children
Functional abdominal pain
Functional abdominal pain
pain that is “without demonstrable evidence of a pathologic condition such as an anatomic, metabolic, infectious, inflammatory, or neoplastic disorder
CNS/mind interaction
concerning signs in pediatric abdominal pain
Involuntary weight loss
Deceleration of linear growth
Gastrointestinal blood loss
Significant vomiting
Chronic severe diarrhea
Persistent right upper or right lower quadrant pain
Unexplained fever
Family history of inflammatory bowel disease
Abnormal or unexplained physical findings
tests to confirm IBD
upper endoscopy
colonoscopy
red flags for crohns
Pain that awakens the child at night
Pain that can be localized
Involuntary weight loss or growth deceleration
Extraintestinal symptoms (e.g., fever, rash, joint pain, aphthous ulcers, or dysuria)
Sleepiness after attacks of pain
Positive family history of inflammatory bowel disease (although only positive in about 30% of patients)
Abnormal labs such as guaiac-positive stool, anemia, high platelet count, high ESR, hypoalbuminemia
Abnormalities in bowel function (e.g., diarrhea, constipation, incontinence)
Vomiting
Dysuria
single greatest risk factor for the development of IBD
having a first-degree relative who has the disease:
first-line treatment for Crohn’s disease
Meselamine in the past
corticosteroids and immunomodulators
labs to evaluate abdominal pain + bloody stools
CBC- anemia? inflammation? ESR and CRP LFTs IgA transglutaminase- celiac? Stool ova and parasite Stool culture
Differential for abdominal pain + bloody stool
IBD Celiac disease bacterial gastroenteritis giardia peptic ulcer disease HSP
presentation of celiac
between 6 and 24 months of age
chronic abdominal pain, abdominal distention, diarrhea, anorexia, vomiting, and poor weight gain.
