Chronic Functional Abdominal Pain

Samantha A. Scanlon, Madhusudan Grover, Amy E. Foxx-Orenstein, Douglas A. Drossman

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Functional abdominal pain syndrome (FAPS) is a less common functional gastrointestinal disorder characterized by abdominal pain which is not related to food intake and defecation. It accounts for significant health care impact and has a high comorbidity with psychiatric disorders. Its etiology is incompletely understood, however, it relates primarily to dysfunction of central pain modulatory systems. The diagnosis of FAPS is primarily based on positive symptom criteria defined by Rome III; in the absence of alarm symptoms an extensive work-up is not required. Medical evaluation must include a careful physical examination, psychosocial assessment and a cost-effective approach to rule out an alternative or co-existing diagnosis. Effective treatment approaches hinge on the principles of biopsychosocial medicine with emphasis on the doctor-patient relationship and negotiating reasonable treatment goals. These include the use of centrally acting pharmacological and psychological therapies that focus more on adaptive coping rather than complete cure. Antidepressants (tricyclic, selective serotonin reuptake inhibitors) are the mainstay of pharmacotherapy which also aims to target associated psychiatric comorbidities. A multidisciplinary pain clinic approach and combination therapies are often helpful at the severe, refractory end of the spectrum of FAPS.

Original languageEnglish (US)
Title of host publicationPractical Gastroenterology and Hepatology
Subtitle of host publicationSmall and Large Intestine and Pancreas
PublisherWiley-Blackwell
Pages461-469
Number of pages9
ISBN (Print)9781405182744
DOIs
StatePublished - Aug 31 2010

Keywords

  • Biopsychosocial model
  • Chronic abdominal pain
  • Cognitive behavioral therapy
  • Functional abdominal pain
  • Functional pain syndrome
  • Selective serotonin reuptake inhibitors
  • Tricyclic antidepressants

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Scanlon, S. A., Grover, M., Foxx-Orenstein, A. E., & Drossman, D. A. (2010). Chronic Functional Abdominal Pain. In Practical Gastroenterology and Hepatology: Small and Large Intestine and Pancreas (pp. 461-469). Wiley-Blackwell. https://doi.org/10.1002/9781444328417.ch62