GASTROENTEROLOGY ARTICLE OF THE WEEK
April 14, 2005
Drossman DA. Functional abdominal pain syndrome. Clin Gastro Hepatol 2004;2:353-65
FAPS = Functional Abdominal Pain Syndrome
1. Diagnostic criteria for FAPS include:
a. Pain lasting minutes to 1 hour, relieved by fasting or defecation
b. Nearly continuous abdominal pain
c. Some loss of daily function
d. Association with physiologic events such as eating or defecating
e. Typical findings for IBS
True or False
2. One of the clinical characteristics of FAPS is the association between pain and bowel function.
3. Patients with FAPS have more severe symptoms and disability than IBS patients, but usually respond to therapies used in IBS
4. Pain in FAPS is usually diagnosed in emotional terms rather than descriptive terms
5. FAPS is more common than IBS.
6. Allodynia is usually present in patients with FAPS.
7. The Carnett’s test is often positive in patients with FAPS even though there is no abdominal wall pathology.
8. Patients with FAPS usually associate worsening of pain with increased stress.
9. Benzodiazepines are useful as they increase the pain threshold.
10. NSAID’s are a useful adjunct for the therapy of pain in patients with FAPS
11. Patients should be asked to keep a detailed diary of symptoms, these diaries should be forwarded to Dr. Clark for careful analysis and interpretation
12. Patients with FAPS usually present to the ED with severe pain but no hypertension or tachycardia reflecting severity of pain.
13. Closed eye sign (eyes closed with the abdomen is palpated) is often found in FAPS, in contrast, patients with severe organic abdominal pail usually keep their eyes open in anticipation of a painful exam.
14. The role of SSRI’s in the treatment of FAPS is mainly to treat co-existent anxiety of phobic symptoms, their value in the treatment of pain is not yet proven.
15. The use of desipramine or nortriptyline may be associated with fewer side effects compared to amitriptyline or imipramine