45231 - DR.KANUPRIYACHATURVEDI 1 1.TERMINOLOGYANDDEFINITION

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DR. KANUPRIYA CHATURVEDI 1
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1.TERMINOLOGY AND DEFINITION PATHOPHYSIOLOGY      3.EVALUATION AND DIAGNOSIS 4.MANAGEMENT 5.PROGNOSIS 6. SUMMARY  2
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Chronic and recurrent abdominal pain are common  symptoms in children and adolescents . Chronic abdominal pain can be organic or nonorganic,  depending on whether a specific etiology is identified.  Nonorganic abdominal pain or functional abdominal  pain refers to pain without evidence of anatomic,  inflammatory, metabolic, or neoplastic abnormalities. Overlap between chronic and recurrent abdominal  pain exists, and the terms are sometimes used  synonymously. 3 SOURCE: J.APLEY
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Chronic abdominal pain — Chronic abdominal pain is  defined by pain of at least three months' duration, although  some clinicians consider pain of more than one to two  months' duration to be chronic . Recurrent abdominal pain — Recurrent abdominal pain is  one of the most common recurrent pain syndromes in  childhood. The classic definition is based upon four  criteria : History of at least three episodes of pain Pain sufficiently severe to affect activities Episodes occur over a period of three months No known organic cause   4 Source:Hyams et.al 1996.
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Chronic abdominal pain Long-lasting intermittent or constant abdominal pain that is  functional or organic (disease based) Functional abdominal pain Abdominal pain without demonstrable evidence of pathologic  condition, such as anatomic metabolic, infectious,  inflammatory or neoplastic disorder. Functional abdominal pain  can manifest with symptoms typical of functional dyspepsia,  irritable bowel syndrome, abdominal migraine or functional  abdominal pain syndrome. Functional dyspepsia Functional abdominal pain or discomfort in the upper abdomen 5
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Irritable bowel syndrome Functional abdominal pain associated with alteration in  bowel movements Abdominal migraine Functional abdominal pain with features of migraine  (paroxysmal abdominal pain associated with anorexia,  nausea, vomiting or pallor as well as maternal history of  migraine headaches) Functional abdominal pain syndrome Functional abdominal pain without the characteristics of  dyspepsia, irritable bowel syndrome, or abdominal  migraine. 6
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The American Academy of Pediatrics (AAP) and North  American Society for Pediatric Gastroenterology, Hepatology,  and Nutrition (NASPGHAN) guidelines for the evaluation and  treatment of children with chronic abdominal pain recommend  that the term "recurrent abdominal pain" should not be used  as a synonym for functional, psychological, or stress-related  abdominal pain . As discussed below, functional abdominal 
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45231 - DR.KANUPRIYACHATURVEDI 1 1.TERMINOLOGYANDDEFINITION

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