Chronic functional abdominal pain: Difference between revisions

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Latest revision as of 20:57, 29 July 2020

Abdominal pain Microchapters

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Patient Information

Overview

Classification

Pathophysiology

Causes

Diffuse Abdominal Pain
Left Upper Quadrant
Left Flank
Left Lower Quadrant
Epigastric Quadrant
Umbilical Region
Pelvic Region
Right Upper Quadrant
Right Flank
Right Lower Quadrant
Intraperitoneal
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Differentiating Abdominal pain from other Diseases

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Natural History, Complications and Prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Chronic functional abdominal pain (CFAP) is the ongoing presence of abdominal pain for which there is no known medical explanation. It is quite similar to, but less common than, irritable bowel syndrome (IBS), and many of the same treatments for IBS can also be of benefit to those with CFAP. The fundamental difference between IBS and CFAP is that in CFAP, unlike in IBS, there is no change in bowel habits such as constipation or diarrhea. Bowel dysfunction is a necessary diagnostic criteria of IBS.

Pathophysiology

CFAP is characterized by chronic pain, with no physical explanation or findings (no structural, infectious, or mechanical causes can be found). It is theorized that CFAP is a disorder of the nervous system where normal nerve impulses are amplified "like a stereo system turned up too loud" resulting in pain. This visceral hypersensitivity may be a stand-alone cause of CFAP, or CFAP may result from the same type of brain-gut nervous system disorder that underlies IBS. As with IBS, low doses of antidepressants have been found useful in controlling the pain of CFAP.

Causes

Common Causes

Treatment

Medical Therapy

Non-pharmaceutical approaches to CFAP also overlap with treatments for irritable bowel syndrome. This includes enteric coated peppermint oil capsules, which act as anti-spasmodics to relax the gut and also have pain-killing properties due to the methyl salicylate that naturally occurs in peppermint. Gut-directed hypnotherapy or self-hypnosis can also mitigate the hyperreactive nervous system of CFAP, and help alleviate abdominal pain.

References

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