Practical guidance for the diagnosis and management of functional abdominal cramping pain

The expert panel suggested a definition for FACP as “the sudden occurrence of mild-to-moderate, undulating, and recurring cramping pain in any part of the abdomen, lasting for seconds to minutes or up to a few hours, in the absence of any ‘red flag’ signs/symptoms of structural organic disease or any strong association with defecation (which might indicate IBS), and typically not significantly interfering with daily activities” [3].

For FACP diagnosis, it is recommended to initially recognise and exclude ‘red flags’ (alarm symptoms) (Fig. 1) indicative for a structural organic disease, followed by a detailed investigation of family history, medication, pain characteristics and dietary/defecation habits. Physical examination, laboratory tests, psychosocial assessment and abdominal ultrasound may be required in some cases.

The algorithm suggested for physicians’ use focuses on the optimal diagnosis and management of FACP in a primary care setting. The recommendations suggested for pharmacists and patients (Fig. 2) support raising awareness for ‘red flag’ symptoms and highlight alternative treatment approaches and may serve as a source of education for pharmacists and patients thus enabling effective self-management of FACP.

_{Acknowledgements: The authors thank Paula Fontanilla, PhD, for critically reviewing the scientific content of this manuscript and Debayan Goswami, an employee of Sanofi, for providing writing and editorial support.}

_{Conflict of interest: D. Marquez, H. Weigmann and R. Lange are employees of Sanofi.}

_{Disclosure: Sanofi funded medical writing and publication of this manuscript.}