Journal List > Korean J Pediatr Gastroenterol Nutr > v.14(1) > 1043512

Korean J Pediatr Gastroenterol Nutr. 2011 Mar;14(1):26-32. Korean.
Published online March 31, 2011.  https://doi.org/10.5223/kjpgn.2011.14.1.26
Copyright © 2011 The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
Diagnostic Approaches to Chronic Abdominal Pain in Children
Jae Hong Park, M.D.
Department of Pediatrics, School of Medicine, Pusan National University, Busan, Korea.

Corresponding author (Email: jhongpark@pusan.ac.kr )
Received February 27, 2011; Revised March 15, 2011; Accepted March 17, 2011.

Abstract

Chronic abdominal pain (CAP) is a common complaint encountered in pediatric clinics and a great concern for patients and their caretakers as well as health care professionals. A constant challenge is detecting individuals with organic diseases or psychosomatic disorders from the majority of patients who have a functional disorder including functional dyspepsia, irritable bowel syndrome, functional abdominal pain, and abdominal migraine. Beginning with a detailed history and physical examination, physicians must determine a differential diagnosis of CAP by applying the symptom-based Rome III criteria to positively identify a functional disorder. These findings should then be further analyzed based on diagnostic clues and red flags that indicate the presence of specific organic diseases and/or the need for further testing. Once a functional diagnosis has been made or an organic disease is suspected, physicians can initiate an empiric therapeutic trial. Since psychological distress accompanies both organic and non-organic abdominal pain in children, a cooperative diagnostic approach involving pediatricians and psychiatrists is recommended.

Keywords: Abdominal pain; Chronic; Diagnosis; Child

Tables


Table 1
Currently Used Definitions to Describe Childhood Abdominal Pain
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Table 2
Initial Approach to Treating Children with Recurring Abdominal Pain
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Table 3
Findings That Suggest Recurrent Abdominal Pain due to Organic Disease
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Table 4
Rome III Functional Gastrointestinal Disorders in Children and Adolescents
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Table 5
Functional Gastrointestinal Disorders (FGID)
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Table 6
Differential Diagnosis of RAP Based on the Presenting Symptoms Complex
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Table 7
Alarm Symptoms for Organic Causes of RAP
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Table 8
Findings and Testing
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Table 9
Key Diagnostic Features
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Table 10
Pediatric Gastroenterology Referral
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