Recurrent
abdominal pain is one the challenging problems which we face in our practice.
First thing one must understand is that the child is not telling any lie. It is a genuine pain.
It may have a psychological basis, but the suffering is true. we have to acknowledge it.
I have found the following method working in South Indian children
A.
Seven questions pointing to a possible medical problem
1.
Vomiting 2.
Fever. 3. Motion consistency change 4. Once in six months deworm the child or is there a history of passing worms. 5. Urine pain 6. brown colour urine. 7. Any cold cough
ear pain skin rash
B.
1. Any outside oil food intake 2. Unboiled water intake 3. Any chance of hand dirt going inside. These boys may play outside & eat without washing hands
C.
Do basic urine and motion examination. Reassure the family
D.
Still if the pain persisits do a simple abdomen ultrasound
E.
If still pain persists tell the parents that this may have psychological basis.
Coming to your child with
white spots in stools, verify the history of outside food intake.
This can cause some digestion disturbance.
Frankly asking him about his fears will be rewarding