Abdominal Pain (Functional)
What is functional abdominal pain and why has my child got it?
Functional abdominal pain (FAP) is common in children or teenagers. The word functional means that there is no physical blockage, infection, inflammation or disease causing the pain.
FAP can be very upsetting for children and their families. It is a type of chronic pain. Chronic means lasting more than a few weeks. It is a condition where children and young adults experience frequent periods of abdominal (tummy) pain over an extended period.
Like all pain, abdominal pain can affect your thoughts, feelings, and behaviour in many situations.
What are the signs and symptoms?
Children with FAP complain of recurrent tummy pain, usually around their belly button, which goes on for at least two months.
They have no other signs of serious illness, such as fever, weight loss, persistent vomiting or blood in their poo.
Sometimes, the pain may happen at the same times as episodes of diarrhoea and constipation, or vomiting, but this is not the cause of the pain.
FAP is often linked with other symptoms such as headache, limb pain and difficulty sleeping.
It can have a big effect on your child’s day and can become a reason for missing school or activities. It is made worse by stress, anxiety or low mood.
What Causes Functional Abdominal Pain?
Although FAP has been studied, the exact cause is not known.
It is likely that several factors play a part in the development of FAP.
It may be due to overly sensitive nerves in the gut. The gut has a huge network of nerves which sends signals to the brain to say we are hungry, full or ill. Sometimes things outside the gut can affect these messages and they are misinterpreted by the brain. For example, it is common not to feel hungry on the morning of an important test or big performance, or to visit the toilet many times, or even vomit.
The symptoms are real and are especially difficult to manage in situations that cause stress or anxiety. It is important to remember that they are not caused by a physical disease.
Does my child need any tests to confirm the diagnosis?
At your first visit, the doctor will ask you lots of questions about the stomach pain and other things such as diet, bowel habits and general health.
They will also look at your child’s growth.
Depending on the answers and the doctor’s assessment, they may arrange for some blood tests to rule out serious, less common conditions. They may also ask for a sample of urine or poo.
What treatments are available?
Your child should understand that there is no serious physical problem causing their pain and they should try not to let the pain become central in their life.
Everyone focusing on the pain or worrying about a possible underlying disease will make it worse. This does not mean you should ignore the pain, as it is real and can be very bad.
Try to reassure and distract your child from the pain and not reinforce it.
Try not to allow the pain to change your child’s social activities or to become a reason for missing school.
It may help a younger child to explain to them that their tummy is very sensitive and sometimes hurts as the food goes round the bends. An older child may be able to understand the information and examples given in this leaflet.
Research shows that medicines are unlikely to prevent or reduce FAP. Distraction works best, for example a game, gentle exercise or something else your child finds fun or relaxing. In older children, yoga and active relaxation or hypnotherapy may help and there are apps you can get to help with this.
What happens if my child does not get treatment?
FAP tends to improve with time and most children eventually grow out of it, without any specific treatment other than distraction.
Is there anything I can do to help my child?
You can try to remove known irritants from your child’s diet, for example sorbitol (an artificial sweetener), fizzy drinks and caffeine.
Keeping a food diary for a week or two may help find any food which triggers your child’s pain. This does not mean food allergy is the cause.
Children and young people who are a normal healthy weight, eat a balanced healthy diet with plenty of fruit and vegetables and get regular exercise have healthier guts.
There is some evidence that taking a daily probiotic can help gut health. These are not medicines, so cannot be prescribed. A reputable health food shop can advise you.
Other pain resources
- Pain Concern is a charity working to support and inform people with pain
- The Pain Toolkit helps people self manage persistent pain. It includes a useful collection of resources
- Great Ormond Street NHS Foundation Trust has information on chronic pain