Noe Joshua D, Li B U K
Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, W1 53226, USA.
Pediatr Ann. 2009 May;38(5):259-66.
Recurrent abdominal pain is a common chronic complaint that presents to your office. The constant challenge is one of detecting those with organic disease from the majority who have a functional pain disorder including functional dyspepsia, irritable bowel syndrome, functional abdominal pain, and abdominal migraine. Beginning with a detailed history and physical exam, you can: 1) apply the symptom-based Rome III criteria to positively identify a functional disorder, and 2) filter these findings through the diagnostic clues and red flags that point toward specific organic disease and/or further testing. Once a functional diagnosis has been made or an organic disease is suspected, you can initiate a self-limited empiric therapeutic trial. With this diagnostic approach, you should feel confident navigating through the initial evaluation, management, and consultation referral for a child or adolescent with recurrent abdominal pain.
复发性腹痛是一种常见的慢性病症，常出现在你的诊室。持续面临的挑战之一是，从大多数患有功能性疼痛障碍（包括功能性消化不良、肠易激综合征、功能性腹痛和腹型偏头痛）的患者中，识别出患有器质性疾病的患者。从详细的病史和体格检查入手，你可以：1）应用基于症状的罗马III标准来明确诊断功能性疾病，以及2）通过指向特定器质性疾病和/或进一步检查的诊断线索和警示信号来筛选这些检查结果。一旦做出功能性诊断或怀疑患有器质性疾病，你就可以启动一个自限性的经验性治疗试验。通过这种诊断方法，你应该有信心对患有复发性腹痛的儿童或青少年进行初步评估、管理以及会诊转诊。
