Pediatric Medicine

Answer 3 Ask the patient to keep a pain diary. Functional abdominal pain is the most common cause of isolated chronic abdominal pain in children, and a detailed history, including a detailed psychosocial history, is critical to the diagnosis. A pain diary, including time of onset, duration, relation to food, and aggravating factors, is often a useful part of this history. Although a plain abdominal radiograph may be considered during an episode of pain, other diagnostic modalities are generally not helpful unless specifically suggested by additional history or physical examination findings. Acid reflux is generally not the underlying cause for this type of pain; thus, ranitidine would not be useful in this patient. Although dietary manipulation may be considered once further history is obtained, lactose restriction is generally reserved only for those with documented lactose malabsorption. SUGGESTED READING Behrman RE, Kliegman RM, Jenson HB, editors. Nelson textbook of pediatrics. 17th ed. Philadelphia: Saunders; 2004. Click here to return to the questions

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