Functional Abdominal Pain
All children have the occasional stomachache, but some have them more frequently. While stomach pain can be caused by a serious illness, it may also be the result of a condition called functional abdominal pain. If your child has complained about stomach pain repeatedly for two months or more, they could have this condition.
The term “functional” means that while the pain is real, there is no infection, inflammation or blockage causing it. The exact cause is not known. One theory is that the pain comes from overly sensitive nerves in the digestive tract. These nerves send pain signals to the brain during normal bodily processes, such as the stretching of the stomach after a meal or bloating from gas.
Functional abdominal pain is very common, and nearly a quarter of all children who go to the doctor for stomach or intestinal problems are diagnosed with it.
Symptoms
The main symptom of this condition is pain near the belly button, though it can occur anywhere between the chest and the pelvis. The pain may begin slowly or suddenly and may be intermittent.
Other symptoms include:
Nausea and vomiting
A feeling of fullness after eating just a few bites
Pain with bowel movements
Upset stomach
Increased stool frequency >2-3 a day especially when persistent
Diarrhea
While functional abdominal pain is common and not life-threatening, children should see their doctor if they have any of these symptoms:
Weight loss
Blood in the stools or vomit
Fever
Joint pain
Trouble swallowing
Pain with urination
Pain that wakes them up at night or keeps them from their typical activities, such as going to school or playing with friends
Diagnosis
Your child’s doctor will do a physical exam and ask:
When the pain started
Where the pain is located
The number of times your child feels pain each week
How long the pain lasts
In most cases, your child’s doctor can make the diagnosis based on the symptoms and physical exam. If tests are needed to rule out a more serious condition, they may include:
Blood tests. These are used to check for infections and other conditions that can cause abdominal pain.
Stool culture. This test can find bacteria, viruses and small amounts of blood in the stool.
Ultrasound. This test uses sound waves to take real-time pictures of the abdomen.
CT scan. This test creates pictures of the interior of the abdomen with X-rays.
Barium study. For this test, your child swallows a chalky liquid called barium, which is then tracked through the upper part of their digestive system with X-rays. This test is also called an upper GI.
Upper endoscopy. During this test, your child is sedated and the doctor passes a thin, flexible tube with a camera into their stomach through their mouth. This test can show inflammation, infection, ulcers and other problems.
Stool studies to rule out infection and inflammation. Contrast studies instead of barium.
Treatments
Your child’s doctor can explain ways to manage pain, such as breathing techniques and relaxation exercises. Some children with functional abdominal pain do well with medications such as acid suppressors, laxatives or anti-spasmodic medicines for pain during bowel movements. These strategies also can help:
Avoid triggering foods whether spicy, citrusy, food that can induce gas such as cabbage, beans or greasy food
Eating slowly
Medications can be offered to relieve episodes of pain. Some other medications may be offered on daily basis. In some cases, behavioral therapy is warranted
Nearly half of children with functional abdominal pain recover with these treatments in a few weeks to several months. It’s important to stay positive and support your child so they can have a good attitude and heal.
Next Steps
While functional abdominal pain isn’t a serious disease, we use all our resources to ensure that your child has the best possible recovery. From diagnosis through treatment and follow-up care, the doctors, nurses and other team members at Orlando Health Children's Arnold Palmer Hospital Center for Digestive Health and Nutrition work together to treat each child as an individual and each family as the most important members of the care team.
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