Non-Specific Abdominal Pain



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Non-Specific abdominal pain in childhood is a common reason for acute hospital admissions. Thousands of school age children often end up missing classes.

While the exact cause of this disorder remains unknown, psychological and behavioural factors have been implicated.

The unset of often insidious and tends to be more during school term time.

Zoë, for example, a 9 year old girl develops gradual onset abdominal pain over the last three days.

Now she would not want to have anything to eat. She had her 9th birth day a few weeks ago. It could not have been what Zoë ate mum muttered.

Her teacher is quite uncomfortable with the situation. Zoë’s mum has been to the G.P twice with Zoë. She saw the G.P again who gave some neurofen suspension and referred Zoe to a paediatrician.

After a couple of days the pain is back. All investigations at the local district hospital to identify the possible cause of this nagging pain did not yield any findings.

Non- specific abdominal pain, NSAP, is the cause of belly ache in a vast number of persons attending the accident and emergency unit of hospitals. It is commoner in children, but by no means confined to that age group.

A UK study revealed that, of the 6097 patient admitted for abdominal pain and thoroughly investigated for possible cause, 43% had no identifiable cause of their pain.

You probably can then sympathise with experts if they can not pin-point the cause of your tummy ache.

It is very important however to rule out the other causes of abdominal pain before a label of non-specific abdominal pain is applied to any one case.

Most often, causes of abdominal pain are due to minor to moderate ailments. Serious or potentially fatal abdominal pain should not be missed.

Non-specific abdominal pain can therefore be defined as abdominal pain that can not be explained after all possible causes have been excluded by taking a detailed history and examination or plus investigation.


Causes of Non–Specific Abdominal pain


Non-specific abdominal pain is common in children, especially between 5 – 13 years age. It is also common in young women.

The causes of this type of pain frequently include:


Viral Enteritis / Infections

Abdominal Aortic Aneurysm

Abdominal Migraine Or Cyclic Vomiting Syndrome (CVS)

Non- Specific Mesenteric Lymphadenitis

Mittleschmerz or Mid-Cycle Pain

Mentrual Pain

Irritable Bowel Syndrome

Recurrent Abdominal pain Syndrome (raps)

Intestinal Obstruction (raps)

Of all the above causes of non-specific abdominal pain, appendicitis and intestinal obstruction were found to be the most frequent diagnoses eventually made in some patients who were initially thought to have non-specific abdominal pain.


Reference:


1. Gray, D. W. R. and Collin, J.: Non-specific abdominal pain as a cause of acute admission to hospital. Brit. J. Surg., 74: 239-242, 19872. Irvin TT. Abdominal pain: a surgical audit of 1190 emergency admissions. Br J Surg 1989; 76: 1121-1125 Non-specific abdominal pain? You can talk to a G.P now!




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