What is functional abdominal pain?
Functional abdominal pain refers to chronic or recurrent abdominal pain for which there is no known medical cause. The term “functional” means that after many tests, there's no clear medical explanation or disease that accounts for the pain. The pain is not caused by an infection, irritation or blockage. But the pain is real.
Functional abdominal pain is the most common type of chronic abdominal pain: About 10 to 15 percent of school-aged children experience this symptom. Functional abdominal pain that is accompanied by diarrhea, constipation or both is called irritable bowel syndrome (IBS).
What causes functional abdominal pain?
Functional abdominal pain is believed to be caused by abnormalities in the nervous system that create an oversensitivity to physiological stimuli. There's some evidence that functional abdominal pain may be associated with visceral hyperalgesia—a decreased threshold for pain in response to changes in the body.
Functional abdominal pain also can be influenced by a person’s increased sensitivity and physical response to psychosocial stressors. Psychological factors do not cause functional abdominal pain, but they can make the pain experience worse.
How is Functional Abdominal Pain Treated?
You can help your child most by consistently encouraging the use of good coping skills, such as using relaxation techniques or engaging in daily activities, during a pain episode. Research shows that children experience lower levels of pain and disability when their parents encourage them to use their coping skills rather than focusing on children’s pain or providing lots of attention or sympathy. You can further aid your child by providing small rewards or extra time together when you see your child coping adaptively with pain.
Some patients find that medication helps reduce functional abdominal pain, and others find that physical methods such as massage, acupuncture, Reiki or a Transcutaneous Electrical Nerve Stimulation unit (TENS) help. Addressing common triggers of pain episodes, such as stress or particular foods, is usually quite useful for pain management. Most often, these treatments work best when used in combination with cognitive behavioral psychological treatments aimed at helping patients to gain more control over their pain.
Your child should continue to attend school and participate in academic and social activities. Your child is improving when you see an increase in day-to-day functioning. For most of our patients, the pain diminishes after the child is functioning normally.
You and your child should be reassured that the abdominal pain is not caused by a serious undiagnosed problem. Continuing to search for a medical explanation for your child’s pain may inadvertently prolong the pain episodes. Being positive about getting better helps send the message to your child that the pain can be treated.
Adapted in part from the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Guidelines on Functional Abdominal Pain