Assessment and management of recurrent abdominal pain in the emergency department

Jo Daniels, Mark Griffiths, Emma Fisher

Research output: Contribution to journalReview article

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Abstract

Recurrent abdominal pain accounts for a significant proportion of attenders and high impact users in the emergency department. Due to the heterogeneity of presentation and the broad spectrum of possible causes, abdominal pain presents as a significant clinical challenge within the emergency department, particularly as distress and pain are commonly elevated. Patients in this group are routinely prescribed opiate-based interventions and repeated investigations in a 'better safe than sorry' culture which saturates the field of persistent physical symptoms. This approach is contributing to the growing problem, and fuelling a cycle of repeated attendance and failure to resolve. This article reviews the current clinical and psychophysiological understanding of recurrent abdominal pain, critiquing guidelines and approaches to diagnosis and management. We offer an alternative evidence-based biopsychosocial approach using the mnemonic 'ERROR', recommending five steps to assessment and clinical management of recurrent abdominal pain in the emergency department.

Original languageEnglish
JournalEmergency Medicine Journal
Early online date6 Dec 2019
DOIs
Publication statusE-pub ahead of print - 6 Dec 2019

Keywords

  • abdomen
  • analgesia/pain control
  • pain management

ASJC Scopus subject areas

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

Projects

ED frequent attenders

Daniels, J.

Royal United Hospitals Bath NHS Foundation Trust

9/04/1830/09/19

Project: Central government, health and local authorities

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