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centrally-mediated abdominal pain syndrome (CAPS)
Pathology:
- central sensitization with disinhibition of pain signals
History:
- history & physical examination diagnostic tools of choice [1]
Physical examination:
- history & physical examination diagnostic tools of choice [1]
Clinical manifestations:
- abdominal pain
- unrelated to food intake &/or defecation
- nearly constant or frequently recurring
- not localized
- musculoskeletal pain may be noted
- psychosocial issues & impairment in activities of daily living
Laboratory:
- fecal immunochemical testing
- ESR, serum CRP
Management:
- focus on setting appropriate goals & expectations
- combination of pharmaceutical & psychotherapy may be needed
- psycotherapy
- cognitive behavioral therapy
- psychodynamic-interpersonal therapy
- mindfulness-based therapy
- hypnotherapy
- pharmaceuticals
- tricyclic antidepressant
- SSRI or SNRI
General
central pain syndrome
References
- Medical Knowledge Self Assessment Program (MKSAP) 18, 19.
American College of Physicians, Philadelphia 2018, 2021