University of Oklahoma Health Sciences Center

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Author/s:

Chanchlani, Neil, Walters, Thomas D., Russell, Richard K.

Date Added:

December 7, 2020

Journal/Publication:

Canadian Medical Association Journal

Publication Date:

November 30, 2020

Issue:

Volume:

192

Pages:

1639-1640

URL:

Managing nonspecific abdominal pain in children and young people

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1503/cmaj.202555

PMID (1):

33257330

Keywords

children

Emergency Care

MeSH

gastrointestinal microbiome

RPR Commentary

A concise review of what is known about the diagnosis and management of chronic abdominal pain in children. James W. Mold, MD, MPH

Abstract

KEY POINTS

• Children present frequently to primary and emergency care with nonspecific abdominal pain.

• Only a few treatment options exist to manage colicky, undifferentiated pain; however, most children will not present more than once or twice to health services for this problem.

• Undifferentiated abdominal pain is poorly understood but likely multifactorial, arising from a combination of sensitizing medical events, psychosocial events and visceral hyperalgesia.

• Among children who seek health care for this problem, 20%–25% go on to be diagnosed with a disorder of the brain–gut axis, “a functional gastrointestinal disorder,” for which international guidelines exist to guide management.

• At first consultation, it is important to establish a positive therapeutic relationship between the clinician and the child and their parents, focusing on optimizing symptom control over unnecessary investigation and medicines.

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