Gastro - Abdominal Pain in Children Flashcards
How is abdominal pain categorised?
Non-organic causes
Medical causes
Surgical causes
What is non-organic or functional abdominal pain?
No disease process found to explain the pain
What is the most common cause of abdominal pain in children?
Constipation
What are the medical causes of abdominal pain?
Constipation
UTI
Pyelonephritis
Henoch-schonleine purpura
Coelaics
IBD
IBS
Mesenteric adenitis
Abdominal migraine
Infantlie colic
Tonsilitis
Diabetic ketoacidosis
What are some additional causes of medical pain in adolescent girls?
Dysmenorrhoea (period pain)
Mittelschmerz (ovulation pain)
Ectopic pregnancy
PID
Ovarian torsion
Pregnancy
Ovarian cyst
What are some surgical causes of abdominal pain?
Appendicitis
Intussusception
Bowel obstruction
Testicular torsion
What are the signs in intussusception?
Non-specific colicky abdominal pain
Redcurrant jelly stools
What are the red flags for serious abdominal pain?
RED FLAGS
Rectal bleeding
Emesis- bilious or persistent
Dysphagia
Fever
Loss of weight
Abdominal tenderness
Growth faltering
Severe chronic diarrhoea
Night-time pain
What initial investigations should be done in abdominal pain?
FBC
- Anaemia, can indicate IBD or coeliacs
ESR and CRP
- IBD
Anti-TTG or anti-EMA
- Coeliacs disease
Faecal calprotectin
- IBD
Urine dipstick
- UTI
What is a diagnosis of recurrent abdominal pain?
Child presents with repeated episodes of abdominal pain with no identifiable underlying cause
How is recurrent abdominal pain described?
Non-organic or functional
What implications can recurrent abdominal pain have?
Psychosocial problems
- Missed days at school
- Parental anxiety
What is linked to recurrent abdominal pain ?
Stressful life events
- Loss of relatives
- Bullying
What is the pathophysiology of recurrent abdominal pain?
Increased sensitivity and inappropriate pain signals from visceral nerves in response to normal stimuli
How is recurrent abdominal pain managed?
Careful explanation and reassurance
- Distract child from pain with other activities
- Encourage parents not to ask about pain
- Sleep advice, regular meals, health diet, hydration, exercise and stress reduction
- Probiotics, helps IBS symptoms
- Avoid NSAIDs
- Address psychosocial triggers
- School support from counsellor or psychologist
