Content Objective: Abdominal Pain

By the end of the Family Medicine Clerkship, the medical student will be able to:

1. Given a patient presenting with abdominal pain, perform a patient-centred interview and focused physical exam, list and interpret clinical findings. Then,:
   
   • Identify signs and symptoms of a surgical abdomen
   • Identify red flags of potential serious causes including referred pain from chest
   • Identify psychosocial factors associated with chronic and recurrent abdominal pain
   • Propose a relevant differential diagnosis that includes common causes of abdominal pain and less common but important causes of abdominal pain
2. For patients with acute abdominal pain, propose an initial management plan that includes appropriate and timely referral/investigation for potentially serious causes. Examples include:
   • Gastroenteritis
   • Diverticulitis
   • Appendicitis
3. For patients with chronic/recurrent abdominal pain, propose a management plan that highlights initial investigations and basic management. Examples include:
   • GERD, Dyspepsia, Peptic Ulcer Disease
   • IBS
   • Constipation
   • Anal/rectal bleeding

Mandatory Clinical Encounter

• Abdominal Pain
• Bleeding from Lower GI tract

Resources*

• Abdomimal Pain clinical card, LearnFM
• Cartwright S, Knudson M. Evaluation of Acute Abdominal Pain in Adults. Am Fam Physician 2008; Apr 1:77(7):971-978
• Diagnostic Imaging of Acute Abdominal Pain in Adults’ by AFP (2015 article)
• Acute Abdominal Pain in Children’ by AFP (2016 article)
• Fallone C, et al. Toronto Consensus for the Treatment of Helicobacter pylori Infection in Adults. Gastroenterology 2016; 151(1): 51-69.
• Alberta Health Services Primary Care Network Pathway: Dyspepsia
• Wilkins, T et al. Diagnosis and Management of IBS in Adults, Am Fam Physician 2012 Sept 1;86(5):419-426
• Evaluation of Acute Pelvic Pain in Women’ by AFP (2010 article)
• Please also refer to other general resources
  

* Where a specific resource is not listed for a particular objective, please refer to recommended general texts/websites. Resources have often been selected from the Clinical Practice Guidelines and Protocols in British Columbia and Alberta’s Towards Optimized Practice Clinical Practice Guidelines. These are often concise summaries of national guidelines.