Recurrent abdominal pain

v.djabatey
Mind Map by v.djabatey, updated more than 1 year ago
v.djabatey
Created by v.djabatey about 6 years ago
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Description

Paediatrics (Gastroenterology & nutrition) Mind Map on Recurrent abdominal pain, created by v.djabatey on 01/07/2014.

Resource summary

Recurrent abdominal pain
1 definition
1.1 pain sufficient to interrupt normal activities
1.2 duration
1.2.1 at least 3 months
2 may become part of a vicious cycle of anxiety
2.1 w/ escalating pain
2.2 anxiety may -> altered bowel motility
2.2.1 child may perceive this as pain
3 epidemiology
3.1 10% of school age kids
4 characteristically umbilical
5 child otherwise well
6 can be a manifestation of stress
7 3 distinct sx constellations arising from functional abnormalities of gut motility or enteral neurones
7.1 irritable bowel syndrome
7.1.1 most common
7.2 abdominal migraine
7.3 functional dyspepsia
7.4 many ppl will have one of these 3
8 Mx
8.1 aim: ID any serious cause w/o unnecessary ix
8.2 o/e
8.2.1 inspect perineum
8.2.1.1 for anal fissures
8.3 urine microscopy and culture
8.4 abdominal ultrasound
8.4.1 to exclude gall stones and pelvic ureteric junction obstruction
9 long-term prognosis
9.1 about 1/2 of affected children rapidly become free of sx
9.2 in 1/4, sx take some months to resolve
9.3 in 1/4, sx continue or return in adulthood as migraine, IBS or functional dyspepsia
10 cause
10.1 > 90% no structural cause IDed
10.2 gastrointestinal
10.2.1 irritable bowel syndrome
10.2.2 constipation
10.2.3 non-ulcer dyspepsia
10.2.4 abdominal migraine
10.2.5 gastritis and peptic ulceration
10.2.5.1 epigastric pain @ night, haematemesis (duodenal ulcer)
10.2.6 inflammatory bowel disease
10.2.6.1 diarrhoea
10.2.6.2 weight loss
10.2.6.3 blood in stools
10.2.7 malrotation
10.2.7.1 bilious vomiting
10.2.7.2 abdo distension
10.3 gynaecological
10.3.1 dysmenorrhoea
10.3.2 ovarian cysts
10.3.3 pelvic inflammatory disease
10.4 psychosocial
10.4.1 bullying
10.4.2 abuse
10.4.3 stress
10.5 hepatobility/pancreatic
10.5.1 hepatitis
10.5.1.1 jaundice (liver disease)
10.5.2 gallstones
10.5.3 pancreatitis
10.5.3.1 vomiting
10.6 urinary tract
10.6.1 UTI
10.6.1.1 dysuria
10.6.1.2 secondary enuresis
10.6.2 pelvi-ureteric junction obstruction
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