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Which Specialist Should Be Consulted For Chronic Abdominal Pain?
You are treating a 13-year-old female for chronic abdominal pain. You have ordered blood work and CT scans and all the workup of the patient has been negative so far. What will you do next for this patient? Which specialists will you send her to? What will you expect from their workup? Discuss.
Wed, 25 Feb 2015
Hi I am Dr. Shreyash Mehta, MD Community Medicine
I understood you concern and I hope my advise will solve your query.
As you asked about which specialist to consult for an adolescent girl aged 13 with a complaint of chronic abdominal pain with all blood test, CT scan and all other investigation negative.
I advise to consult your family physician.
Let him/her take proper history of the girl preferably it should be discreet so any psychiatric/ genital problem can be discussed. If there is psychological/psychosocial problem like school avoidance, depression, eating disorder, abuse and substance abuse it will be solved there itself.
There are various causes of chronic abdominal pain in whom blood investigation may be normal.
Ultrasound investigation may be needed for ruling out any etiology with female urogenital organs. At times some special investigation are needed by the gynecologist to come to a diagnosis.
So I advise you to consult gynaecologist after you family physician if he unable to diagnose
If need arises then he/she will refer your kid to a MD internal medicine/ MD psychiatrist/ Surgeon.
Various causes of chronic abdominal pain in your scenario
Gynecologic: endometriosis, pelvic inflammatory disease.
Urologic: kidney stones, urinary tract infection
Gastrointestinal: constipation, irritable bowel syndrome
Musculoskeletal: postural problems
Psychosocial: school avoidance, depression, eating disorder, abuse, substance abuse
I understood you concern and I hope my advise will solve your query.
As you asked about which specialist to consult for an adolescent girl aged 13 with a complaint of chronic abdominal pain with all blood test, CT scan and all other investigation negative.
I advise to consult your family physician.
Let him/her take proper history of the girl preferably it should be discreet so any psychiatric/ genital problem can be discussed. If there is psychological/psychosocial problem like school avoidance, depression, eating disorder, abuse and substance abuse it will be solved there itself.
There are various causes of chronic abdominal pain in whom blood investigation may be normal.
Ultrasound investigation may be needed for ruling out any etiology with female urogenital organs. At times some special investigation are needed by the gynecologist to come to a diagnosis.
So I advise you to consult gynaecologist after you family physician if he unable to diagnose
If need arises then he/she will refer your kid to a MD internal medicine/ MD psychiatrist/ Surgeon.
Various causes of chronic abdominal pain in your scenario
Gynecologic: endometriosis, pelvic inflammatory disease.
Urologic: kidney stones, urinary tract infection
Gastrointestinal: constipation, irritable bowel syndrome
Musculoskeletal: postural problems
Psychosocial: school avoidance, depression, eating disorder, abuse, substance abuse
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