An 8-year-old boy is brought to your office with the complaint of abdominal pain. The pain is worse during the week and seems to be less prominent during the weekends. The patient's growth and development are normal. He has one soft stool a day, and does not complain of painful defecation. The physical examination is unremarkable, with no masses, no rebound tenderness, and no guarding. Laboratory screening, including stool for occult blood, CBC, urinalysis, and chemistry panel yields normal results. Which of the following is the best next step in the care of this patient?
Recurrent abdominal pain is a common complaint occurring in at least 10% of school-age children. In children older than 2 years, less than 10% of cases have an identifiable organic cause. Management of these children is difficult and frustrating for the physician and the family. Excessive testing and treatments are not typically useful. A thorough history and physical examination, including growth parameters, are frequently helpful in separating organic from nonorganic causes of abdominal pain. Any signs or symptoms of organic causes, such as growth failure, should be pursued. If nothing in the history or physical examination is found, as is likely in the case described, reassurance of the children and family members is indicated. Close follow-up for new or changing symptoms as well as further reassurance to the family is important.
Perform an upper GI series with small bowel follow-through
Perform CT of the abdomen with contrast
Administer a trial of a proton pump inhibitor
Observe the patient and reassure the patient and family
Gastro Intestinal System