When In Rome Use the Criteria
Discussion
Functional gastrointestinal diseases are very common problems throughout the lifespan. Estimates vary but around 13-38% of children and adolescents have weekly abdominal pain and 24% have chronic abdominal pain that last more than 8 weeks. Chronic abdominal pain was extensively studied by John Apley in the 1950′s and since then newer criteria have been developed for distinguishing various types of abdominal pain. See Learning Point below.
A thorough history and physical examination is needed to distinguish these different types of abdominal pain and to evaluate for organic causes. Warning signs of potential organic disease includes:
Growth problems and unintentional weight loss
Significant GI complaints including emesis, diarrhea and blood in the stool
Pain that is not periumbilical (or radiates) or pain at night
Systemic symptoms – fever, rash, joint pain, urinary symptoms, apthous ulcers
Family history of gastrointestinal organic disease – inflammatory bowel disease, ulcer, celiac disease
Abnormal laboratory testing – elevated inflammatory markers, anemia, etc.
Basic laboratory testing may include a basic metabolic panel, complete blood count, C-reactive protein or erythrocyte sedimentation rate, urinalysis and urine culture and stool guaiac. Additional testing may be indicated based on the patient’s history such as stool for ova and parasites with a history of travel or animal exposure, stool C. difficile after antibiotics or br...
Source: PediatricEducation.org - Category: Pediatrics Authors: Donna M. D'Alessandro, M.D. Tags: Uncategorized Source Type: news
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