Carl R. Darnall Army Medical Center - Health Library

Functional Abdominal Pain—Child

(Centrally mediated abdominal pain syndrome, CAPS, Visceral hypersensitivity)

Definition

Functional abdominal pain is defined as one of the following:

  • Pain one or more times a week for 2 months
  • Continuous pain for 2 months

It often interferes with daily activity and school attendance.

Causes  ^

Food and gas put pressure on the walls of the intestine. You normally would not notice this pressure. People with functional abdominal pain appear to be very sensitive to this pressure. It may be caused by a change in the nerves that send information from the intestines to the brain.

Functional pain may also be associated with problems in how the bowels work.

Functional pain may also be connected to crossed pathways in the brain. Emotional events create new nerve pathways. It may be that these new pathways can cross areas of the brain that sense pain. This may make a connection between emotional stress and pain.

An infection with a parasite may also cause pain in a small number of children.

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Risk Factors  ^

Factors that may increase the risk of functional abdominal pain include:

Psychological factors include:

  • History of physical, sexual, or emotional abuse
  • Stressful life events plus difficulties with stress management
  • History of depression or anxiety
  • Passive or dependent personality
  • History of being bullied
  • Parent with a history of gastrointestinal problems

Physical factors may include:

  • Previous gastrointestinal infection
  • Repeated abdominal injury

Symptoms  ^

Symptoms vary widely among children. Pain may come and go or be steady. It may appear suddenly or slowly increase over time.

Other symptoms may include:

  • Pain near the belly button or anywhere in the belly
  • A burning sensation under the breastbone that is not associated with eating
  • A feeling of fullness after a few bites of food
  • Pain following bowel movements

Diagnosis  ^

You will be asked about your child’s symptoms and health history. A physical exam will be done. The doctor may suspect functional abdominal pain based on the type and pattern of pain. It will be helpful for the doctor to know how it has affected your child’s life. This will include missed activities and school.

Your child's stool will be tested for blood.

The doctor may want to do more tests to look for causes. Test options include:

  • Elimination diet—to see if specific types of foods are causing problems
  • Breath test—to look for certain disorders such as lactose intolerance
  • Blood tests
  • Urine tests
  • X-rays or an ultrasound—to look for any abnormal areas in the belly

Treatment  ^

The abdominal pain will often go away with time. The goal of treatment is to find and manage triggers of pain. The overall goal is to return your child to normal activity.

Part of the treatment plan may include keeping a journal of:

  • Frequency and duration of abdominal pain
  • Circumstances that may have triggered the abdominal pain
  • Amount of activities and school days missed

Share this information with your doctor. Your child’s doctor may also recommend:

Therapy

Emotions and stress can trigger abdominal pain or make it worse. Therapy will help you and your child with stress management. This is done with different relaxation techniques.

Behavioral therapy works on thought processes about pain. It can help your child better cope with pain.

Medicine

Medicine may be used to treat physical symptoms that occur with the abdominal pain. In most, medicine is often only used for a short time. It can help during the time it takes for therapy to work or for pain to pass on its own.

  • Acid reduction treatments
  • Intestinal muscle relaxers
  • Bulk laxatives or medicine to stop diarrhea
  • Probiotics
  • Antidepressants

Prevention  ^

The cause is not clear, so there are not prevention steps.

RESOURCES:

American College of Gastroenterology
http://patients.gi.org

Healthy Children— American Academy of Pediatrics
https://www.healthychildren.org

CANADIAN RESOURCES:

Canadian Association of Gastroenterology
https://www.cag-acg.org

Caring For Kids—Canadian Paediatric Society
https://www.caringforkids.cps.ca

REFERENCES:

Chiou E, Nurko S. Functional abdominal pain and irritable bowel syndrome in children and adolescents. Therapy. 2011;8(3):315-331.

Functional abdominal pain in children. American College of Gastroenterology website. Available at: http://patients.gi.org/topics/functional-abdominal-pain-in-children. Updated December 2012. Accessed December 21, 2017.

Functional abdominal pain in children. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115824/Functional-abdominal-pain-in-children. Updated September 15, 2016. Accessed December 21, 2017.

Functional abdominal pain syndrome. International Foundation for Functional Gastrointestinal Disorders website. Available at: https://www.iffgd.org/lower-gi-disorders/functional-abdominal-pain-syndrome.html. Updated August 22, 2017. Accessed December 21, 2017.

Gijsbers CF, Schweizer, Büller HA. Protozoa as a cause of recurrent abdominal pain in children. J Pediatr Gastroenterol Nutr. 2013;57(5):603-606.

Last reviewed December 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP  Last Updated: 12/21/2017