Recurrent abdominal pain

Description

Paediatrics (Gastroenterology & nutrition) Mind Map on Recurrent abdominal pain, created by v.djabatey on 07/01/2014.
v.djabatey
Mind Map by v.djabatey, updated more than 1 year ago
v.djabatey
Created by v.djabatey about 10 years ago
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Resource summary

Recurrent abdominal pain
  1. definition
    1. pain sufficient to interrupt normal activities
      1. duration
        1. at least 3 months
      2. may become part of a vicious cycle of anxiety
        1. w/ escalating pain
          1. anxiety may -> altered bowel motility
            1. child may perceive this as pain
          2. epidemiology
            1. 10% of school age kids
            2. characteristically umbilical
              1. child otherwise well
                1. can be a manifestation of stress
                  1. 3 distinct sx constellations arising from functional abnormalities of gut motility or enteral neurones
                    1. irritable bowel syndrome
                      1. most common
                      2. abdominal migraine
                        1. functional dyspepsia
                          1. many ppl will have one of these 3
                          2. Mx
                            1. aim: ID any serious cause w/o unnecessary ix
                              1. o/e
                                1. inspect perineum
                                  1. for anal fissures
                                2. urine microscopy and culture
                                  1. abdominal ultrasound
                                    1. to exclude gall stones and pelvic ureteric junction obstruction
                                  2. long-term prognosis
                                    1. about 1/2 of affected children rapidly become free of sx
                                      1. in 1/4, sx take some months to resolve
                                        1. in 1/4, sx continue or return in adulthood as migraine, IBS or functional dyspepsia
                                        2. cause
                                          1. > 90% no structural cause IDed
                                            1. gastrointestinal
                                              1. irritable bowel syndrome
                                                1. constipation
                                                  1. non-ulcer dyspepsia
                                                    1. abdominal migraine
                                                      1. gastritis and peptic ulceration
                                                        1. epigastric pain @ night, haematemesis (duodenal ulcer)
                                                        2. inflammatory bowel disease
                                                          1. diarrhoea
                                                            1. weight loss
                                                              1. blood in stools
                                                              2. malrotation
                                                                1. bilious vomiting
                                                                  1. abdo distension
                                                                2. gynaecological
                                                                  1. dysmenorrhoea
                                                                    1. ovarian cysts
                                                                      1. pelvic inflammatory disease
                                                                      2. psychosocial
                                                                        1. bullying
                                                                          1. abuse
                                                                            1. stress
                                                                            2. hepatobility/pancreatic
                                                                              1. hepatitis
                                                                                1. jaundice (liver disease)
                                                                                2. gallstones
                                                                                  1. pancreatitis
                                                                                    1. vomiting
                                                                                  2. urinary tract
                                                                                    1. UTI
                                                                                      1. dysuria
                                                                                        1. secondary enuresis
                                                                                        2. pelvi-ureteric junction obstruction
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