For a school-age child with recurrent stomach pain and a normal exam, what is an appropriate step?

For a school-age child with recurrent stomach pain and a normal exam, what is an appropriate step?

• A. Order Extensive Radiologic and Laboratory Tests
• B. Encourage Diary Keeping of Pain and Related Factors
• C. Diagnose a Somatic Illness and Start Treatment
• D. Refer Immediately to Counseling Without Attempting Non-Medical Strategies

Answer: (B)

When a school-age child has recurrent abdominal pain but a normal physical exam, the best first step is to have the family start keeping a pain diary that records when the pain occurs, its location and intensity, what the child was doing or eating before the pain, bowel habits, sleep, stressors, and mood. This simple, noninvasive tool helps reveal patterns and potential triggers, often pointing toward functional abdominal pain rather than an organic disease. Tracking these factors gives you practical insight for management without jumping to extensive testing. It supports nonmedical strategies such as regular meals and hydration, adequate sleep, regular activity, and coping techniques. It also helps determine whether there are red flags that would warrant further testing or a referral. Without red flags, delaying invasive tests is appropriate, and this approach avoids prematurely labeling the pain as a somatic illness or rushing to counseling; the diary can guide whether and when to pursue additional help like behavioral strategies if needed.

When a school-age child has recurrent abdominal pain but a normal physical exam, the best first step is to have the family start keeping a pain diary that records when the pain occurs, its location and intensity, what the child was doing or eating before the pain, bowel habits, sleep, stressors, and mood. This simple, noninvasive tool helps reveal patterns and potential triggers, often pointing toward functional abdominal pain rather than an organic disease.

Tracking these factors gives you practical insight for management without jumping to extensive testing. It supports nonmedical strategies such as regular meals and hydration, adequate sleep, regular activity, and coping techniques. It also helps determine whether there are red flags that would warrant further testing or a referral. Without red flags, delaying invasive tests is appropriate, and this approach avoids prematurely labeling the pain as a somatic illness or rushing to counseling; the diary can guide whether and when to pursue additional help like behavioral strategies if needed.