The following pre-referral guideline covers chronic abdominal pain or periumbilical pain without vomiting, for children from school age to adolescence.

Initial work-up

• Urinalysis
• FBE with diff
• ESR or CRP
• LFTs
• U&Es

Recommended pre-referral treatment

• H2 receptor drug (eg. Zantac 3mg/kg dose BD orally - syrup available).
• Maximum 150mg.

When to refer

• If symptoms persist after initial work-up and treatment with H2 receptor for 2 weeks, refer for further evaluation.

Resources

• Make a referral:Specialist Clinics
• Contacts
• RCH Primary Care Liaison (GP website)
• Kids HealthInfo (Parent information website)  

References and more reading

• Paediatric Handbook (2009). Gastrointestinal Conditions, Chapter 24 (pp369389) Mark Oliver and Lionel Lubitz. Eighth Edition, Blackwell Publishing. By the staff of the Royal Children's Hospital, Melbourne, Australia.
• Constipation and toileting issues in children. Anthony Catto-Smith. The Australian Medical Journal (2005).

Guideline developed by RCH Gastroenterology. First published Nov 2006. Updated Apr 2010. Please read  Copyright and Disclaimer