Download PDFPDF
Assessment and management of recurrent abdominal pain in the emergency department
Compose Response

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g.
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Statement of Competing Interests


  • Responses are moderated before posting and publication is at the absolute discretion of BMJ, however they are not peer-reviewed
  • Once published, you will not have the right to remove or edit your response. Removal or editing of responses is at BMJ's absolute discretion
  • If patients could recognise themselves, or anyone else could recognise a patient from your description, please obtain the patient's written consent to publication and send them to the editorial office before submitting your response [Patient consent forms]
  • By submitting this response you are agreeing to our full [Response terms and requirements]

Vertical Tabs

Other responses

Jump to comment:

  • Published on:
    Pain is a central consideration
    • Paul Tanto, EM registrar Chelsea & Westminster Hospital

    A timely and interesting read if for no other reason colleagues and I were discussing / bemoaning recurrent abdominal pain presentations only last week. Many of the features that act as obstacles were well recognised and omnipresent.

    The solutions are an excellent mixture of skills and I can see much utility, I can also foresee the care pathways being highly personalised in our healthcare institutions (Daniels et al allude to this by describing one the ED consultants with an interest in HIU) and once that person moves job the pathway crumbles.

    To an extent excluding medical emergency (the 1st E in ERROR) does require medicalisation whether it be vitals being taken or the initial bloods including lactate. I can see the purpose and benefit of not repeating unnecessary blood tests and I suspect not doing tests will be a feat more easily achieved with seniority, There is benefit in letting HIUs be seen exclusively by such.

    I was surprised that Daniels and the other authors claim that "pain is not a central consideration in RCEM guidelines...". The college guidelines page ( lists at east 3 where pain is most certainly the central consideration, or was this in relation to abdominal pain only?


    Show More
    Conflict of Interest:
    None declared.