Functional Abdominal Pain in Children

Abdominal pain or tummy pain is a common symptom that children complain of. Most tummy pain is benign and not caused by pathology or disease. However, the pain is still real. We call tummy pain that is not caused by disease functional pain as opposed to organic pain which relates to disease/pathology.

Ads

What is Functional Tummy Pain (or FAP)?

FAP refers to recurrent tummy pain in children that is not caused by any disease process. Pain that is caused by a disease process is called organic pain rather than functional pain.

Organic causes of pain in the abdomen include:

  • infection, such as:

Another common cause of tummy pain in children is constipation, so if your child does not have regular soft formed bowel motions, go to the constipation page. For an overview of what causes tummy pain in children, click here.

Advertisement

On the other hand, FAP (functional pain in the abdomen) in children includes the following:

  • functional dyspepsia - functional pain or discomfort in the upper abdomen
  • irritable bowel syndrome - functional pain with alteration in bowel habit
  • abdominal migraine - functional tummy pain with the features of migraine - (pallor, nausea, vomiting and a family history of migraine headaches)

Back to list

Who gets functional abdominal pain?

Functional pain in the abdomen is seen in children from the age of 3 to 4 years. There is no serious underlying cause and few investigations are required.

Back to list

Is the pain real?

Yes. The pain is real. It just isn't caused by any disease process. Headaches are very real, as you will be aware, but there is no disease process causing them - just some people are prone to them. The same is true of functional pain in the abdomen.

Back to list

What are the features of functional pain in the abdomen?

Functional tummy pain is non-specific pain that is not associated with any alarming symptoms or signs. The following signs and symptoms would be considered alarming and so a search for another cause of pain should be sought:

  • weight loss (involuntary)
  • deceleration of height
  • blood loss from the gut - so blood in the stool (you may not be able to see the blood and a special test may be required)
  • significant vomiting
  • chronic severe diarrhea
  • persistent pain on the right side (either upper or lower abdomen)
  • unexplained fever
  • family history of inflammatory bowel disease
  • other abnormal or unexplained physical findings

Back to list

Advertisement

How is functional abdominal pain diagnosed?

Your doctor will take a history of the pain and associated features and do a physical examination. Some baseline investigations may be performed, such as a stool test looking for occult blood, a blood count, kidney and liver function, inflammatory markers (ESR and CRP). These tests will not diagnose functional tummy pain but will reassure if they are normal.

Back to list

How is functional pain in the abdomen treated?

There is no specific treatment that will work all the time. Sometimes, all that can be achieved is ensuring your child's life is affected as little as possible due to the pain.

For functional dyspepsia, anti-acid medication may be tried.

For irritable bowel syndrome, agents that affect bowel habit may be tried. If your child is constipated, you can read more by clicking here.

For abdominal migraine, pizotifen might be tried. This has been shown in one small study to reduce the frequency of painful episodes and reduce the severity of pain when the child gets it. You might also want to look for trigger factors - read more..

There have been studies looking at dietary changes, such as fiber supplements and lactose-free diets, but these have not shown conclusive benefits.

One study looking at probiotics, did show that Lactobacillus rhamnosus (Lactobacillus GG) when given to children with functional pain in the abdomen, did reduce frequency of the pain and more children were thought to have successful treatment of their tummy pain compared to those taking a dummy medication (placebo).

Probiotics are relatively safe and I advise parents of children with functional abdominal pain to try them.

Back to list


Advertisement
Ads

References

  • AAP. Chronic abdominal pain in children. Pediatrics 2005 Mar;115(3):812-5
  • Huertas-Ceballos A, Macarthur C, Logan S. Dietary interventions for recurrent abdominal pain (RAP) in childhood. In Cochrane library. CD003019. DOI: 10.1002/14651858. CD003019
  • Huertas-Ceballos A, Macarthur C, Logan S. Pharmacological interventions for recurrent abdominal pain (RAP) in childhood. In Cochrane library. CD003017. DOI: 10.1002/14651858. CD003017
  • Gawronska A, Dziechciarz P, Horyath A, Szajewska H. A randomized double-blind placebo-controlled trial of Lactobacillus GG for abdominal pain disorders in children. Aliment Pharmacol Ther 2007 Jan;25(2):177-84

To go to the top of the Functional Abdominal Pain, click here

To go to the Pain page, click here

To return to the Home page, click here


Last reviewed 17 May 2011

HONcode accreditation seal. We comply with the HONcode standard for health trust worthy information:
verify here.

Dr Maud MD

Dr Maud MD (MBChB, FRACP, FRCPCH), a specialist pediatrician, provides health information and medical advice for parents of babies and toddlers. Read more about Dr Maud.



Special Offer
A must have for new parents

Baby sleep

Essential Baby Sleep
By Dr Maud


We're so excited to announce our first Children Book

The Special and Talented Dog Show
To order click here

The second book published is called

Flying Things

This is aimed at a pre-school audience and is a rhyming story.  You can buy by clicking here

To read more about our children's books, click here



We comply with the HONcode standard for trustworthy health information: verify here.


Visitors Say

Thanks for your "straight to the point" advice! I am very happy that you decided to add your wisdom to the internet for all to read. You made a very worrisome toddler's fever day into something a lot calmer.
Fred, Sweden

Excellent website. Plain english - reassuring and direct. Great resource - thank you.
David, Australia

Dear Dr.Maud, I had to write a thank you note for all the work you put into this site to make our life easier! We had many questions and worries but we found all the answers here very easily. You helped us to find a way to make our little boy eat again and calmed our worried minds when he was sick.. So much useful information, I recommend your website to all moms and dads I know. Thank you so much, you are fantastic! Have a wonderful day! :)
Sophie, Singapore

Thank you so much. I have taken ... to three different Dr.'s and you are the first to answer my questions in a manner that I can understand. You explained everything in English for once, and told me things that none of the other Dr.'s did. Thank you again. I really appreciate your help.
Machelle, United States