Deepa Kattail, MD MHS FAAP
Assistant Professor
McMaster University

12 year old female with a diagnosis of functional dyspepsia has been referred to your pediatric chronic pain program for management of pain. She complaints of constant throat and stomach pain for the last 1 year. She has had extensive work-up by the gastroenterologists, including endoscopy, esophageal manometry and MRI of her abdomen that have all shown normal findings. She missed approximately 2 full days of school per a week, due to abdominal pain, thus prompting her parents to keep her at home. Her mother describes her as being quite anxious, in fact she was unable to sleep last night due to today’s appointment and was crying before entering the room to see you today. Last year, prior to onset of her pain, she was able to competitively dance, but this has now been put on hold. In addition to multidisciplinary approach to chronic pain management, including psychosocial support, pain education and assessment by physiotherapy, which medication would be appropriate and evidence based for first line treatment?