Talk:Abdominal pain

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Dear Nunh, I'm pleased to find you reverting my work again. Could you please argue why abdominal pain is not a gastroenterological disease? Yeah, family doctors and especially gynaecologists see lots of them. But the main causes of abdominal pain are handled by surgeons (acute) or gastroenterologists (chronic). I'm reintroducing the box, and await your argumentation.
JFW | T@lk 03:05, 25 Apr 2004 (UTC)

I'm not so pleased to find you defacing mine. Abdominal pain is not a GI disease because [1] it's not a disease, it's a symptom, and [2] it's caused by many other things than GI disease. The box misrepresents this, falsely making abdominal pain [1] medical rather than surgical [2] specifically GI rather than a symptom that involves many organ systems. - Nunh-huh 03:08, 25 Apr 2004 (UTC)

Allright, it's a symptom, not an actual disease. So are some others in my cherished box (nausea, vomiting, diarrhea). It would be a lovely job to make seperate boxes for symptoms and others for diseases, but IMHO this clouds the issues.
Indeed, when I'm finished doing all these boxes (see WikiDoc), this article might well have a box from gastroenterology and surgery. Episodic or chronic abdominal pain is not surgical. It's a gastroenterologist's job to determine whether this patient needs to be worked up for rare diseases such as FMF and C1-esterase deficiency.
JFW | T@lk 03:16, 25 Apr 2004 (UTC)

  • No, in most cases it will be a family medicine, gynecological or internal medicine practitioner that decides whether a gastroenterologist's particular expertise is needed, not the reverse. The box is pretty but misleading, and not particularly useful. A list of GI diseases can stand on its own: it doesn't need to be here. - Nunh-huh 03:25, 25 Apr 2004 (UTC)

The purpose of these boxes is to link together as much medicine as possible, preferably with as little linking as possible. There is inevitably some overlap between specialisms; will we have the same argument over allergic rhinitis? This is treated mainly by family doctors, although it's an ENT diagnosis.
Could you suggest which specialism is best suited to link to "abdominal pain"?
JFW | T@lk 03:29, 25 Apr 2004 (UTC)

  • My point is that abdominal pain "belongs" to no particular specialty, and to discourage the suggestion that it belongs to one more than any other. A doctor who thinks of one particular organ system when confronted with abdominal pain is a dangerous physician. - Nunh-huh 03:32, 25 Apr 2004 (UTC)

This is completely off the point. As I stated above, the end result of this exercise might well be that the "abdominal pain" page will be—as you call it—"defaced" by several horizontal linking elements, each for all the specialisms that might involve themselves with Jane Doe's recurrent abdominal cramps in the week before her period. I thought I'd made abundantly clear that I'm not forcing abdominal pain into any particular organ system!
If you don't like the horizontal linking, please just state this outright.
JFW | T@lk 03:38, 25 Apr 2004 (UTC)

  • It's precisely on point. The utility of linking abdominal pain to gyn, GI, general surgery, hepatology, emergency medicine, and every other specialty in which it may figure does in fact seems minimal to me, but at least it would avoid falsely suggesting that only one of them need be considered. Please wait until you can link them all, if you are intent on doing so, rather than linking only one. Though I do think Wikipedia would be much more improved by concentrating on content, rather than on a device for navigating between articles there is no particular need to navigate between. - Nunh-huh 03:48, 25 Apr 2004 (UTC)

I'll refrain from dropping lots of boxes on the page. Indeed, this would amount to overkill. I do not agree that Wikipedia would not benefit from the type of navigational element I've sought to introduce. The complete absence of hierarchical structure can cause a lot of confusion.
By the way, I don't need to be reminded of the need for wikipedia content.
JFW | T@lk 03:55, 25 Apr 2004 (UTC)

  • Imposition of a hierarchic structure where it does not occur naturally is misleading. Navigational elements are useful when used in moderation and where they grow out of the subject matter, but they are destructive when they proliferate and are used to impose a false order. - Nunh-huh 04:02, 25 Apr 2004 (UTC)

Great. May I suggest we provide links on the pages to the specialisms involved? I would recommend just five: surgery, family medicine, gynecology, internal medicine and gastroenterology. It would establish a vertical order without suggesting there's a horizontal one.
By the way, could you define "destructive" and "proliferate"?
JFW | T@lk 04:08, 25 Apr 2004 (UTC)

  • I have no problem with you putting a link to abdominal pain anywhere you think it's pertinent. My problem is with linking from abdominal pain to articles where abdominal pain is only peripherally related. Do you want to mention abdominal pain in the articles you enumerate? If not, I don't think they'd be useful links. I'm using "destructive" and "proliferate" in their usual senses. To elaborate on "destructive", the boxes are destructive in the same way that all overlinking it: it's distracting; linking to an article suggests that pertinent information is to be found there and is wrong if it isn't to be found there; boxes take up visual space allowing fewer on-screen words; mediawiki "menus" imply relationships between subjects that may be unduly narrow or even misleading, and their "premade" format enables rote insertion rather than thoughtful linking. As to "proliferate", I'd say that these boxes are multiplying faster than their utility is. Do you envision a box on every "medical" article? -- Nunh-huh 04:31, 25 Apr 2004 (UTC)

Do I envision that? The answer is probably "yes". I agree with you on the narrowness of menu structure; they can impose constraints where these are unwarranted. In this particular article, I agree that lots of boxes would seriously deface the page. There are undoubtedly other examples.
However, many cities, counties and personalities are linked by "blue boxes" just because they happen to have a form of spacial or temporal proximity. Wikipedia seems to be tolerating this quite well, without upsetting layout conventions—even if their structure is premade and quite rigid.
JFW | T@lk 04:39, 25 Apr 2004 (UTC)

Let's just say I don't share your vision<g>. If you want to add a "See also: surgery, family medicine, gynecology, internal medicine and gastroenterology" I'd have no objection. I don't think it's particularly pertinent, but it's less obtrusive. I think you'll find that as more and more of these mediawiki "menus" are used less and less appropriately, there will be more objections made, though I suspect it will be some time before serious consideration is given to their net effect and the fact that a pretty face is being used to conceal particular points of view in places not particularly amenable to editing. - Nunh-huh 04:50, 25 Apr 2004 (UTC)

Well, I'm finished arguing. My menu effort is certainly not aimed at pushing my (or anyone's) view, apart from creating some sense of unity in Wikipedia's medical segment. And Mediawiki messages can be edited by everybody, including you! Requires no privileges! The "serious consideration" will be given in wiki style: by consensus and debate. The matter of whether navigational elements should be introduced is something for admins and bureaucrats. JFW | T@lk 05:04, 25 Apr 2004 (UTC)

I think as long as people know that severe or sudden abdominal pain can be a medical emergency and seek treatment at their local emergency department, you could merely say on the site that abdominal pain can be a feature of a range of problems that relate to a number of fields including gastroenterology, gynaecology, and surgery, and could be appropriately treated in either an inpatient setting, in a hospital, or in the community, through your local GP. The point you make about recurrent abdominal pain in young women is helpful, because it allows such people an understanding of the various causes of abdominal pain that are relevant to them, even if they may be somewhat difficult for us to treat.

Almost everyone gets some form of abdominal pain, and everyone realises that there are many different levels, causes, and degrees of severity. The advise is simple, basic and useful, without frightening or concerning a patient. It presents information at a level that allows their doctor to help guide and explain through what they have learned, rather than confusing the doctor-patient relationship by providing excessive and therefore potentially misguiding advice. I was impressed with the page.