A prospective study of patients with uncharacteristic abdominal disorders.

A prospective study was carried out in 51 patients admitted for abdominal complaints of at least 1 year's duration. Despite previous hospitalization for the same complaints, no certain diagnosis had been established. After systematic diagnostic procedures in the Medical Dept., Rikshospitalet, 33 patients were given a psychosomatic and 18 patients an organic primary diagnosis. The organic diseases were three cases of Crohn's disease, two of cancer, two of duodenal ulcers, one of gastric ulcer, two of gastroduodenitis, five of postresection syndrome, one of lactose intolerance, one of hyperthyroidism, and one of degeneration of the columna. The patients' condition was registered after 1 year of individual treatment. There was a significant decrease in the number of symptoms, in the psychosomatic score of anxiety, depression, and stress, and in days on sick leave and consultation with physicians in connection with the second compared with the first hospitalization for the whole group, for the psychosomatic group, and for the patients with upper gastrointestinal disease. Increased vitality based on muscular testing was also indicated in the same groups of patients. The study suggests that patients with uncharacteristic abdominal disorders may need a thorough examination at least once in the course of their illness; on the one hand, this may help patients with psychosomatic disease to cope better with their problems, and, on the other hand, primary organic lesions may be difficult to diagnose on the grounds of simple screening procedures.