Functional abdominal pain refers to recurrent abdominal pain and is one of the most common childhood and adolescent complaints. It is true pain that can be quite severe. The vast majority of children and adolescents with recurrent abdominal pain have functional abdominal pain or “non-organic” pain, which means the pain is not caused by physical abnormalities.
Patients usually fall into one of four categories:
- Chronic functional abdominal pain. This is pain without other symptoms.
- Irritable bowel syndrome (IBS). This is abdominal pain with abnormal bowel movements (diarrhea, constipation or both).
- Functional dyspepsia. This is pain in the upper abdomen that is associated with symptoms of indigestion.
- Abdominal migraine. This is a sudden attack of severe abdominal pain that is associated with migraine-type symptoms such as paleness, sweating and light sensitivity.
Most pediatric gastroenterologists believe that abnormal contractions in the intestines and overly sensitive nerves in the gastrointestinal (GI) tract cause the abdominal pain. The perception of pain is thought to involve input from both the nerves in the GI tract and the processing of these signals from the brain. As a result, psychological stress, anxiety or depression may provoke pain episodes. The pain may also occur without an obvious cause.
Symptoms of functional abdominal pain include:
- Pain at or around the belly button
- No additional warning signs
If a physical abnormality is causing your child's recurrent abdominal pain (organic abdominal pain), he or she may experience the following symptoms:
- Blood in the stool
- Multiple episodes of diarrhea a day
- Recurrent fevers higher than 100 degrees Fahrenheit
- Waking up at night because of pain or to have a bowel movement
- Weight loss
Diagnosis of Functional Abdominal Pain
Children with symptoms of recurrent abdominal pain do not often require additional testing. However, a pediatric specialist may perform the following tests to make a diagnosis:
- Ultrasound. Abdominal ultrasound is an imaging test used to examine the liver, gallbladder, spleen, pancreas and kidneys as well as the blood vessels connected to them.
- Blood tests. Blood tests that may be performed include complete blood count (measures red blood cells, white blood cells, platelets and other components of the blood) and erythrocyte sedimentation rate (looks for signs of inflammation).
- Computed tomography (CT). Computed tomography creates detailed photos of the body’s internal structures.
- Upper endoscopy. Endoscopy tests use a tube equipped with a camera to visualize and take biopsies of the gastrointestinal system.
- Stool tests. Stool tests detect blood in the stool that cannot be seen with the naked eye and verify the presence of bacteria and parasites that cause infection.
- Fluoroscopy. Upper gastrointestinal (UGI) fluoroscopy is an imaging test that takes a video X-ray of the esophagus, stomach and duodenum (first part of the small intestine).
- Urinalysis. Urinalysis measures the different components of urine such as protein, blood or bacteria.
- X-ray. X-ray creates images of internal body structures and can detect stool blockages and other abdominal issues.
Functional abdominal pain is treatable and causes no long-term health problems. Treatments include:
- Reassurance and education. Simply explaining to your child that his or her pain is not caused by a serious medical problem often results in improvement by easing worry.
- Dietary modifications. Adequate fiber in the diet is important, as is the avoidance of foods that can irritate the GI tract such as:
- Fried foods
- Gas-producing vegetables (beans, broccoli, cabbage, cauliflower, etc.)
- Greasy foods
- High-fat foods
- Spicy foods and seasonings
- Tomato-based products (ketchup, pizza sauce, spaghetti sauce, etc.)
- Stress reduction. Stressors at home and school may contribute to pain. Pediatric specialists work with you to address these situations.
- Medicines. Antispasmodics help decrease abnormal contractions in the GI tract and may be prescribed to prevent pain or relieve pain once it has occurred.
If your child has organic abdominal pain, treatment will involve managing the underlying condition.
Key Points to Remember
Key Points to Remember
- Functional abdominal pain refers to recurrent abdominal pain.
- The majority of children and adolescents with recurrent abdominal pain have functional abdominal pain, which means the pain is not caused by physical abnormalities.
- Organic abdominal pain is caused by a physical abnormality.
- Functional abdominal pain is treatable and causes no long-term health problems.
Support Services & Resources
Support Services & Resources
Visit the websites below to find support groups and services and learn more about functional abdominal pain.
Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.
The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition operates this website for parents, children and teens and provides information on living with functional abdominal pain.
In addition to our primary hospital location at the Academic Health Center in Indianapolis, IN, we have convenient locations to better serve our communities throughout the state.
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