ABDOMINAL PAIN, CHRONIC - Flourish Paediatrics

Starship Children’s Health Clinical GuidelineNote: The electronic version of this guideline is the version currently in use. Any printed version cannot be assumed to be current. Please remember to read our disclaimer.ABDOMINAL PAIN, CHRONICManagement of specific conditions causing chronic abdominal painConstipation:• Laxatives (e.g. Lactulose, bulking agents)• Increase dietary fibre• Regular toileting (5 minutes on toilet 20 minutes after breakfast and evening meal)• Star chart for younger childrenIrritable Bowel Syndrome – Explanation• Avoiding /managing psychosocial triggers• High fibre dietPeptic Ulcer Disease• H 2 blockers• Proton pump inhibitorsChronic Inflammatory Bowel Disease• Nutritional support• Anti-inflammatory /immunomodulatory drugsPrognosisMost studies show that organic disease is rarely missed in children with chronic abdominal pain.Thirty to fifty percent of children with chronic abdominal pain settle within 6 weeks with the resttaking somewhat longer. Factors associated with a poorer prognosis are shown in Table 2.Table 2: Prognostic Indicators in Children with Chronic Abdominal PainFactor Better prognosis Worse prognosisFamily No family history of chronic pain Family members with chronic painGender Girls BoysAge Of Onset Older than 6 years Younger than 6 yearsDuration of pain beforeTreatmentLess than 6 monthsMore than 6 monthsAdults who as children had chronic abdominal pain are at increased risk of having functionalabdominal pain (as well as headaches and backpain) but in the vast majority of cases this does notinterfere with their daily activities.Author: Dr Ralph Pinnock Service: General PaediatricsEditor: Dr Raewyn Gavin Date Reviewed: August 2008Abdominal Pain, Recurrent in Childhood Page: 6 of 7