Abdo pain and headache Flashcards
def. chronic abdo pain
long lasting intermittent or constant abdo pain that is functional or organic in nature
3 major DDx of chronic abdo pain
- organic GI disorders
- organic non-GI disorders
- Functional GI disorders
what are organic non-GI disorders
things that cause pain to be referred to the abdo
***RED flags for abdo pain
- weight loss
- oral ulcers
- bile or blood in vomit
- unexpalined fever
- pain at night
- melena
- hematochezia
- unexplained diarrhea
- acute abo - rebound, guarding
- anal tags/fissures
- joint Sx
- dysuria
- family Hx of GI disease
- dysphagia
- anemia
- hypoalbumenemia
*what is key to ROME III criteria for FGID
no evidence of an inflammatory, anatomic, metabolic, or neoplastic process that explains Sx
4 cats. of FGID
- IBS - pain with improvement of def.
- functional dyspesia - heart burn
- abdo migraine - has periods of intervening health
- functional abdo pain - insufficient crit for other 3
what is diff. between functional abdo pain and FAP SYNdrome
same crit. as pain, but in addition cause 25% of time:
- loss of function
- additional somatic symptoms
demographics of functonnal abdo pain
peak 10-12
- under 9 - M=F
- over 9 M
features of functional abdo pain
- periumbilical
- unrelated to meals,activity
- does not wake
- normal growth
- no findings
- inteferes with school
what tests for functional abdo
Hx and Px - if clear, then no other tests
important social Hx
- relationships, home and school
- family funct.
- school performance
- mood, anxiety in parents
3 general cats. of mgmt
- pharma - for pain
- CBT
- dietary
keys to mgmt
education! reassure
prognosis for abdo pain
most improve, 1/3 go on
epi of headache
- under 7 - 50% M>F
- over 7 - 70% F>M
4 patterns of headache
- acute
- acute recurrent
- chronic prog.
- chronic non-prog.
*** red flags for secondary headache
- under 3
- progressive
- increase with valsalva
- exposive or severe sudden
- systemic Sx
- suppressed, CA ,
- neuro Sx
- new or different severe headache
- sleep related
5 primary headache syndrome
1. migraine 2, migraine with aura 3. other migraine 4. tension 5. chronic
Sx of migraine
with or without aura
- attacks 30min -72hrs
- unilateral or bilateral
- moderate to severe
- nausea, photophobia
Sx of tension
- most common
- bilateral
- pressure or tightening
- nild-moderate
- not worse with act.
- no nausea
best test for ecurrent headache
Hx and Px
- imaging not reccomended for children with normal neuro exam
keays to headache mgmt
- reasssure
- headache diary
- ID and avoid triggers
- aerobic excercise
SMART headache magmt
Sleep Meals Activity Relaxation Trigger avoidance
migraine MGMT
- sleep in dark quiet room
- aceto or advil at onset
what is key to avoid rebound headache
limit ibu or aceto to 2-3 days per week
