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Chapter-049 Chronic Abdominal Pain

BOOK TITLE: Ramamurthy's Decision Making in Pain Management: An Algorithmic Approach

Author
1. TT Lai
2. Clinical Assistant Professor, Department of Anesthesiology UT Health San Antonio, San Antonio, TX, USA
ISBN
9789386261458
DOI
10.5005/jp/books/14128_50
Edition
3/e
Publishing Year
2018
Pages
4
Author Affiliations
1. Uniformed Services University of the Health Sciences, Bethesda, MD, USA
Chapter keywords
Chronic abdominal pain, endoscopic retrograde cholangiopancreatography, ERCP, SNRI, NSAID, gastrointestinal disorder, functional abdominal pain syndrome, FAPS, narcotic bowel syndrome, NBS

Abstract

This chapter basically talks about the chronic abdominal pain. Abdominal pain is one of the most common complaints from patients, and this is often a challenge for physicians to evaluate and ultimately treat. The causes of abdominal pain can be numerous, so it is important to have an organized approach when evaluating these patients. An astute clinician can often narrow the differential with a thorough history of the abdominal pain. Imaging and laboratory studies should be reviewed. Pain originating from an organic cause can sometimes be visualized on computed tomography (CT), magnetic resonance imaging (MRI), or ultrasound imaging. Treatment can be focused on stretching and physical therapy, along with serotonin-norepinephrine reuptake inhibitors (SNRIs), nonsteroidal anti-inflammatory drugs (NSAIDs), and muscle relaxants. Trigger point injections, either with local anesthetics or dry needling, can also be helpful and can be performed under ultrasound guidance to avoid entry into the peritoneum.

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