Therapy goals
- Symptomatic therapy
- Diagnosis finding
Therapy recommendations
- Acute abdominal pain: analgesia (pain management) according to WHO staging scheme until definitive therapy when diagnosis is confirmed:
- Non-opioid analgesic: paracetamol, first-line agent for acute abdominal pain.
- Low-potency opioid analgesic (e.g., tramadol) + non-opioid analgesic.
- High-potency opioid analgesic (eg, morphine) + non-opioid analgesic.
If necessary, butylscopolamine (spasmolytic).
- Chronic abdominal pain: analgesia according to WHO staging scheme until definitive therapy when diagnosis is confirmed:
- Non-opioid analgesic: metamizoleNote: In chronic abdominal pain, do not administer acetaminophen (because of hepatotoxicity!) and coxibe (potential cardiac side effects).
- Low-potency opioid analgesic (eg, tramadol) + non-opioid analgesic: caveat for constipation!
- High-potency opioid analgesic (e.g., morphine) + non-opioid analgesic.
If necessary, butylscopolamine (spasmolytic).
- Neuropathic pain – opioid analgesics, anticonvulsants, antidepressants(treatment option for 4-12 weeks); in patients with neuropathic tumor pain who respond only partially to opioid analgesics, amitriptyline, gabapentin, or pregabalin should be considered.
- Infantile colic/infantile colic (“three-month colic”):
- Phytotherapy (plant therapy): peppermint + fennel oil.
- Probiotics → reduction of colic symptoms; Lactobacillus (L.) reuteri may be able to reduce crying duration
