9: Peds Recurrent Abd Pain

Question 1

What are the 3 categories of recurrent abd pain?

Answer 1

1. Organic cause
2. Psychogenic cause
3. Neither clearly 1 or the other

Question 2

How does recurrent abdominal pain differ from chronic abdominal pain?

Answer 2

Recurrent has periods of wellness between episodes of pain.

Question 3

T/F Lab values will be normal in recurrent abdominal pain.

Answer 3

True for psychogenic. Potentially false for organic.

Question 4

7 management goals for psychogenic recurrent abd pain.

Answer 4

1. Validate pain
2. Reassure that no physical danger
3. Discuss stress and emotional issues
4. Encourage normalization of lifestyle
5. Increase dietary fiber
6. Restrict sorbital and caffeine
7. Address underlying psychological issues

Question 5

What are 11 red flags that the abd pain is organic and not psychogenic?

Answer 5

1. Localization of pain away from the umbilicus
2. Diarrhea, constipation or nocturnal bowel movements associated w/ pain
3. Pain awakens at night
4. Repeated vomiting, especially bilious
5. Age < 4 years old
6. Loss of weight or height velocity
7. Organomegaly
8. Localized tenderness, especially not at umbilicus
9. Perirectal abnormalities
10. Joint swelling, redness, heat
11. Hernias

Question 6

This type of recurrent abd pain has an unclear cause, but the pain is genuine. Could be caused by functional abd pain, intestinal dysmotility, family or temperament, maternal depression, overprotectiveness, or poor conflict resolution.

Answer 6

Psychogenic (nonorganic)