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Biopsychosocial approach to functional abdominal pain
  1. E Crushell,
  2. M Rowland
  1. Department of Paediatrics, University College Dublin, The Children’s Research Centre, Our Lady’s Hospital for Sick Children, Dublin, Republic of Ireland; ellencrushell.com

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We read with interest the article by Lindley and colleagues1 outlining their concerns about consumerism in health care focusing on the potential detrimental effects on the child with functional abdominal pain (FAP). All of the children had extensive investigations carried out by the authors according to in house clinical service guidelines for the management of children with abdominal pain.

While this is surprising in itself, it is even of more concern when it is noted that most children already had extensive investigations in other centres. Clinical service guidelines should take into account the fact that children referred with abdominal pain to a tertiary referral practice have a high probability of having a functional disorder. Rather than embark on an extensive, expensive, and traumatic list of procedures, protocols should encompass a biopsychosocial approach to the management of abdominal pain. We are potentially doing a great disservice to children if we first resort to invasive investigations while failing to make a positive diagnosis of FAP.

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