By F.C. Oglesby
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Additional resources for An Examination of a Decision Procedure
FAP is still real pain. However, the response to pain can be subjective and understood through life experience. The treatment may therefore be a combination of psychotherapy, pharmacology, dietary, or alternative medicine techniques. It must always begin with educating the child and parent about the cause of the pain and the treatment plan. This approach not only improves the adherence to the treatment plan but also has been shown to aﬀect the outcome. 28 X MANAGEMENT A discussion of FAP as a real entity that is a product of an alteration in the brain-gut axis makes understanding the cause of the pain easier for parents.
Recurrent abdominal pain in childhood. Pediatrics. 1970;45:732 17. Boyle JT. Pediatric gastrointestinal disease. In: Walker WA, ed. Pathophysiology, Diagnosis, Management. 4th ed. Hamilton, Ontario, Canada: BC Decker; 2004 18. Song AH, Advincula AP. Adolescent chronic pelvic pain. J Pediatr Adolesc Gynecol. 2005;18:371–377 19. Constipation Guideline Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Evaluation and treatment of constipation in infants and children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition.
The concept of referred pain is especially relevant when discussing acute abdominal pain in children. A complete history may provide crucial information that suggests the abdominal pain may originate outside the abdomen. For example, a 3-year-old who has pneumonia may have inﬂammatory irritation of the diaphragm, resulting in acute abdominal pain as the presenting complaint. In addition, perihepatitis (Fitz-Hugh–Curtis syndrome) can produce acute abdominal pain, and the physician should be sensitive to an adolescent girl’s possible reluctance to spontaneously disclose a history of sexual intercourse.
An Examination of a Decision Procedure by F.C. Oglesby