1.6.1 Recurrent gastrointestinal disturbance

The patient is a twelve-year-old girl. She has now had the seventh such attack of abdominal pain her parents have documented over the last two years. Each episode brings sharp, cramping pain around the umbilicus lasting two to four hours, and on this occasion she also reported a pounding headache that began shortly before the tummy pain. Her abdomen has stayed soft and non-tender throughout every episode, with no rebound or palpable lump, even during the acute spell. There is no history of recurrent vomiting or diarrhoea between episodes, and her weight has stayed stable. A close look at her overall history has not turned up any other disorder responsible for the pattern.