emotional abdominal pain
Introduction
Introduction Former people think that only adults can suffer from emotional diseases, while children, especially infants and young children, are not sensible, and "heart disease" is not on their heads. But now medical research has found that "heart disease" can also be entangled in children. Mental pain is one of them. This kind of abdominal pain often occurs due to mood swings. Symptoms: There is no fixed part of abdominal pain, and there is no obvious tender point. It can last for several minutes to tens of minutes, and the degree can be light or heavy. Often accompanied by nervousness, insomnia, headache and other symptoms, mostly in infants and young children.
Cause
Cause
Mental RAP seems to be related to stress, anxiety or depression. Its pathophysiology is still unclear. The factors that cause stress are relative. Patients who are sensitive to RAP seem to be very nervous. They may be due to family matters (such as recent illness, economic problems, separation and loss) or school events (such as worrying about their performance, and teachers). Relationship with classmates). RAP itself is more nervous because of new problems (such as frequent absenteeism, being isolated by classmates) or mixed with previous problems (like the opposition between cells).
Examine
an examination
Related inspection
Laparoscopic blood routine
The medical history should be understood from the onset of the first pain, the frequency, nature, and location of the pain; the relationship with diet, defecation, and excretion; the results of various treatments (such as changing posture, family therapy, OTC or prescription medication). Information obtained from parents (or other caregivers) is also helpful. Their disagreement about the onset of abdominal pain and how it occurs can help to observe the impact of family status on the child and can help provide a way to treat the abdominal pain that is also satisfactory to the parents. Emphasize the potential role of parents in participating in pain bursts, persistence, and overcoming.
Mental RAP lacks persistent intestinal symptoms, fever, weight loss or growth retardation. However, these performances are not specific. Common related symptoms are headache, dizziness (non-vertigo), pale and sweaty. Fatigue, anorexia, nausea, vomiting, diarrhea, constipation and limb pain are also less common than organic or functional RAP. The psychosocial characteristics of psychosocial RAP include immature, over-reliance on parents, anxiety or depression, fear, tension and over-criticality. Often due to the special status of the child at home (such as the only child, the smallest of the compatriots, the only boy or girl among many compatriots) or due to disease problems (abdominal angina, feeding difficulties), parents often treat these children as special People look at it. Parents often care too much about their children, love them, listen to them, and fully satisfy their demands. Attention should be paid to any possible causes (such as illness, family disharmony, parental separation or death, stress caused by school attendance); benefits of the first episode (due to pain avoided by the child) or benefits of recurrence (due to illness) Evidence of psychosocial gains; and the personality traits of children. School records can reveal the impact of pain on daily activities in the class.
Family history often has chronic physical discomfort or pain, peptic ulcer, headache, "nervous" or depressed patients. Family history should also include family members, especially related diseases or similar problems that parents have had at a similar age. Most sick children do not have signs at the beginning. Before making a diagnosis, adequately observe and check for bloating during the onset of pain to avoid any signs of organic disease. In addition to umbilical discomfort during palpation, there are often no other signs. For younger children, a full physical examination should be carried out with the presence of parents and a careful and thorough impression of them. If it is the discomfort of adolescents or older children, parents with the same gender should be examined.
At the initial visit and subsequent follow-up, the child and parent should record any pain, including its nature, strength, duration, triggering factors; diet; excretion; and any treatment performed and its outcome. These records often reveal inappropriate behaviors and exaggerated manifestations of pain and contribute to diagnosis. Once the diagnosis is confirmed, repeated examinations should be avoided to prevent the sick child from paying special attention to or exaggerating those signs, or suggesting that the doctor lacks confidence in the diagnosis.
Organic RAP, if in doubt, should be properly examined. Peptic ulcers are often missed because the special relationship between eating and upper abdominal pain in adult patients is rare in children (see peptic ulcer below). UTI, if not subjected to special tests, will also be missed because the main complaint is from the abdomen or pelvis without referring to the flank or urethra.
Functional RAP is best diagnosed by detailed medical history to determine relevant symptoms or triggering factors (for example, reviewing a 24-hour diet to determine whether food allergies or improper diet is the cause of pain, menstrual history, etc.). Functional RAP identification includes: improper diet, inadequate toilet training, use of general toilets (may be too large, children afraid to fall) leading to constipation or fecal retention and fecal incontinence, dysmenorrhea, menstrual pain, and patients in 10~ The physiological decline in lactase activity occurring between the ages of 20 is secondary to lactose intolerance. Since pain occurs 2 hours after feeding or dairy products, lactose intolerance is often not suspected at first.
Diagnosis
Differential diagnosis
Differential diagnosis of emotional abdominal pain:
1. Chronic abdominal pain: Chronic abdominal pain is a kind of abdominal pain that is relatively slow onset, has a long course of disease, or is secondary to acute abdominal pain. Its positioning is relatively accurate.
2. Abdominal pain after violent action: Abdominal pain after violent action is one of the symptoms of liver rupture. Liver rupture is a common disease in abdominal trauma, and right liver rupture is more than left liver.
3, exercise abdominal pain: some people who do not exercise regularly, exercise less than 15 minutes will feel abdominal pain, and even some people will have abdominal pain in the rush to go quickly, rest for a while naturally improved. What is going on here? In fact, most people have this kind of abdominal pain in the early stage of exercise. Sports medicine is called "abdominal pain during exercise". The medical history should be understood from the onset of the first pain, the frequency, nature, and location of the pain; the relationship with diet, defecation, and excretion; the results of various treatments (such as changing posture, family therapy, OTC or prescription medication). Information obtained from parents (or other caregivers) is also helpful. Their disagreement about the onset of abdominal pain and how it occurs can help to observe the impact of family status on the child and can help provide a way to treat the abdominal pain that is also satisfactory to the parents. Emphasize the potential role of parents in participating in pain bursts, persistence, and overcoming.
