Drawing the abdominal pain: A powerful tool to distinguish between organic and functional abdominal pain

ObjectivesAbdominal pain (AP) in children imposes a large economic burden on the healthcare system. Currently, there are no reliable diagnostic tools to differentiate between organic and functional disorders. We hypothesized from previous research that the analysis of patients' graphic expression of subjective symptoms as well as their interactional behavior adds new ways to differentiate between functional and organic AP.MethodsConversation analyses of physician-patient-encounters and graphical expression of AP-based pain were performed.ResultsTwenty-two interactions were recorded and analyzed. Fifteen children were diagnosed with organic AP and seven with functional AP. We found marked differences between children with organic and functional AP. For example, all 15 children with organic AP saw the task of drawing a picture of the pain during the interview as a duty, whereas the seven children with functional AP took this as an opportunity to provide detailed descriptions about the nature of the pain, the circumstances, and how the AP impaired their quality of life.ConclusionAnalysis of patients' interaction strategies in response to the painting task provides relevant clues as to whether AP is functional or requires further workup for organic causes. image What is Known Abdominal pain (AP) is common in children and teenagers. A significant effort is made to ensure that those few children who require medical treatment are not overlooked.The simple task of drawing their AP may be a valuable tool to distinguish functional AP from AP of organic origin. Children with organic AP tend to see the task as a duty that they fulfill in a brief time without adding further details whereas children with functional AP use the task as an opportunity to show their suffering and tell more symptoms.