🩺 Chronic Abdominal Pain · Pediatric Workup

Schwartz Clinical Handbook — Chapter 10 · Functional pain · IBS · Celiac · IBD · Abdominal migraine · Organic red flags

Select symptoms, age group, and alarm features to distinguish functional from organic causes. Based on Rome III criteria, AAP guidelines.
⚠️ Red flags: weight loss, growth delay, nocturnal pain, persistent right upper/lower quadrant tenderness, vomiting, fever → prompt investigation.

📋 Step 1 — Pain characteristics & alarm features
📌 Diagnostic impressions
📖 Schwartz Ch 10 approach

Select clinical features above → system generates hypotheses for functional abdominal pain (FAP), irritable bowel syndrome (IBS), celiac disease, IBD, constipation, or abdominal migraine.

✔️ Rome III criteria for FAP, IBS, functional dyspepsia.
✔️ Alarm signs = organic etiology (celiac, IBD, PUD, UPJ obstruction).
✔️ Chronic pancreatitis, pelvic pathology in adolescents.
📘 Schwartz pearls (Chapter 10)
• Functional pain: normal growth, no alarm signs, pain typically periumbilical, resolves within 1 hour.
• Celiac disease: consider with iron deficiency, short stature, diarrhea.
• IBD: perianal disease, nocturnal diarrhea, weight loss, elevated CRP/ESR.
• Abdominal migraine: paroxysmal, predictable episodes, family history of migraine.