Abdominal pain, acute vs. chronic and organic vs. functional

Answer 1

• organic: abnormality of the structure or function of an organ
  
  • peptic ulcer disease
  • pancreatitis
• functional: symptoms but very few if any physical findings; lab work is normal; endoscopy is normal; imaging is normal
  
  • hard to diagnose & treat
  • IBD

Question 2

What are the 3 types of abdominal pain classifications?

Answer 2

1. Visceral pain
   
   1. tender in one area
2. Somatoparietal pain
   
   1. vague and nonspecific most of the time
3. Referred pain

Question 3

When a person comes in with a complain of pain, what information should you ask for?

Answer 3

• location
• character
  
  • functional pain does not occur overnight
• aggrevating and alleviating factors
  
  • postitional changes
  • meals
  • bowel movements
  • stress

Question 4

Things to consider while performing the physical exam?

What should you look for?

Answer 4

• General position in bed, posture, degree of discomfort and facial expression
• vital signs
  
  • people in sever pain will have rapid heart rate, high blood pressure & sweating
• abdomen should be inspected for distetion, scars, hernias, muscle rigidity, splinting durign respiration, ecchymoses, and visible hyperperistalsis

Question 5

What tests should you order on someone who comes in with a chief complaint of abdominal pain?

Answer 5

• Laboratory CBC, LFT (liver function test), ABG, Amylase
• Radiological
• Pain abdominla series
• CXR

Question 6

What are special circumstances that may make an exam of abdominal pain more difficult?

Answer 6

• extremes of age difficult history
  
  • minimal physical
  • increased mortality
• pregnancy
  
  • organs are all pushed around

Question 7

What percent of adolescents/young adults meet the diagnostic criteria for irritable bowel syndrome?

female to male ratio?

percent of adults will see a practicioner or chronic or intermittent abdominal pain?

Answer 7

• 75% meet it
• female to male 6:1
• 34% of adults

Question 8

Describe the pathophysiology of Functional abdominal pain

Answer 8

Question 9

What are “red flags” that point to organic abdominal pain?

Answer 9

Question 10

What are “red flags” on a physical abdominal exam that point to organic abdominal pain?

Answer 10

Question 11

Historical components of functional abdominal pain?

Answer 11

Question 12

If preliminary labs are normal, what should you do?

Answer 12

stop

very low likelihood of finding significant organic pahtology with normal physical exam, no red flags and normal lab work and imaging

Question 13

What are the most common etiologies of functional abdominal pain?

Answer 13