Abdominal pain

Question 1

Abdominal pain red flags

Answer 1

• > 1 month
• Bilious vomiting
• Fullness/ masses/ hepatosplenomegaly
• Perianal/ rectal disease
• Tenderness over spine
• Weight loss
• Poor growth
• Delayed puberty
• Blood in stools
• Bilious vomiting
• Severe and chronic diarrhoea
• Fever
• RUQ/ LUQ pain
• First degree relative w/ IBD

Question 2

Non-abdominal causes of abdomina pain

Answer 2

• DKA
• Pneumonia (basal)
• UTI/ pyelonephritis
• Mesenteric adenitis
• Sick cell disease
• Migraine
• Psychological/ safeguarding
• Gonadal torsion
• Poisoning
• Malignancy
• Acute porphyria (liver disorder, porphyrins build up in body)

Question 3

Epidemiology of IBD

Answer 3

• 5-7 per 100,000 <16yrs
• Most common 12-16 yrs
• Delayed diagnosis as symptoms differ in paeds
• Growth failure and psych problems common

Question 4

Presentation of IBD in children

Answer 4

• Fever
• Anaemia
• Arthritis
• Weight loss
• Impaired growth (more common in Crohn’s)
• Pubertal arrest
• Vitamin/ mineral deficiencies
• Retarded bone development
• Psych problems

Question 5

Why is IBD diagnosed late in children?

Answer 5

• Low index of suspicion
• Predominance of extra intestinal symptoms
• GI symptoms may be subtle or non-specific
• Growth failure may precede other symptoms