CLIPP 27: 8 year old with abdominal pain Flashcards
Most common cause of abdominal pain in school-aged children?
Functional abdominal pain
What causes functional abdominal pain?
Functional Abdominal pain is defined as pain that is “without demonstrable evidence of a pathologic condition such as an anatomic, metabolic, infectious, inflammatory, or neoplastic disorder.” In functional abdominal pain the enteric nervous system, which envelops the gut, is thought to be in crisis with the central nervous system. This dysregulation can result in the pain. Further thought has been given to the idea that those with functional abdominal pain may have abnormal bowel reactivity to physiologic stimuli (meal, gut distension, hormonal changes), noxious stressful stimuli (inflammatory processes), or psychological stressful stimuli (parental separation, anxiety). These stimuli may interact with the enteric nervous system and result in dysregulation.
tx for functional abdominal pain?
Reassurance
Two most useful studies in diagnosis of IBD?
Upper Endoscopy
Colonoscopy
Extraintestinal symptoms associated with Crohn’s?
fever, rash, joint pain, aphthous ulcers, or dysuria
Crypt abscesses are common in…?
UC
Which IBD is more likely to cause a fistula?
Crohn’s- due to transmuralinflammation
What tools helps classify the severity of IBD in pediatric populations?
Paris classification system
General first therapy for newly diagnosed IBD?
Corticosteroids to try and induce remission.
Enteral nutrition therapy as well
Extraintestinal involvement in Crohn’s?
arthritis, uveitis, renal involvement (kidney stones), hepatic involvement, and pyoderma gangrenosum
Most sensitive and specific test for celiac?
IgA tissue transglutaminase antibodies
First line treatment for Crohn’s?
Mesalamine
