Abdominal Pain, Constipation & Gastrointestinal Disease
Distinguish functional symptoms from surgical and inflammatory warning signs.
Quick revision ↓ Medical Dictionary
01Acute pain
Assess stability, pain location, vomiting, stool pattern and urinary symptoms. Appendicitis can present atypically in younger children. Guarding, bilious vomiting, distension or shock needs urgent review. Include testicular assessment where relevant because torsion can present with abdominal pain.
02Intussusception
Intermittent severe distress with vomiting, pallor or lethargy can suggest intussusception. A classic bloody stool may be late or absent, so do not wait for the full textbook triad. Prompt imaging and specialist management are needed when the clinical picture raises concern.
03Constipation assessment
Ask about stool frequency, consistency, painful defecation, withholding and soiling. Overflow soiling can occur around retained stool and is not necessarily deliberate behaviour. Delayed meconium, growth concerns, neurological findings or severe distension require assessment for an underlying disorder before labelling symptoms functional.
04Management and review
Functional constipation often needs an agreed disimpaction and maintenance plan with education and follow-up. Diet and toilet routines support treatment but may not replace required medicines. Avoid punishment for soiling and explain that sustained treatment may be needed to restore comfortable bowel habits.
05Chronic gastrointestinal symptoms
Persistent diarrhoea, blood, weight loss, poor growth or nocturnal symptoms can suggest inflammatory or malabsorptive disease. Consider coeliac disease in the appropriate context; testing can be affected by starting a gluten-free diet beforehand. Choose investigations and referral based on the whole pattern rather than one isolated symptom.
High-Yield Revision
- Do not wait for every classic intussusception sign.
- Overflow soiling is not necessarily intentional.
- Investigate gastrointestinal symptoms with growth or bleeding concerns.
Common Pitfalls
- Ignoring testicular torsion in abdominal pain.
- Starting a gluten-free diet before an agreed diagnostic plan.
References & Further Reading
Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.
Reference review: 28 September 2026. Consult current local protocols for prescribing, procedures and escalation.