Consultant Corner: Chronic Abdominal Pain
The patient presenting with chronic abdominal pain presents difficulties in both diagnosis and management. The incidence of serious missed diagnoses increases with age. Referral to a gastroenterologist for follow-up within approximately 2 weeks is recommended for patients with chronic abdominal pain after evaluation in an acute care setting has ruled out urgent etiologies. Colitis, malignancy, functional abdominal pain syndromes/irritable bowel syndromes, and adhesions from prior surgical procedures are commonly established diagnoses with specific therapeutic options. Magnetic resonance imaging (MRI) is a valuable option in patients who may have already accumulated a high burden of radiation exposure due to multiple prior CT scans. Analgesia for chronic abdominal pain can be a challenge but is best guided by understanding the underlying cause.