Stomach pain in children

“I’ve got a pain in my tummy!” Or, “My tummy aches!” Most parents have heard these words from their children. It is completely normal, because stomach pain is very common among children and adolescents. Up to 38 per cent experience stomach pain every week. It is also one of the most common clinical symptoms that pediatricians meet in their day-to-day clinical practice and one of the most common reasons for children to visit the emergency room. For most children, the pain disappears by itself. But for some, the stomach pain becomes a problem that interferes with school and daycare, and with social and family life. It may even cause emotional stress. When this happens, it is time to seek medical advice. In some cases, the stomach pain could be functional abdominal pain (FAP).

 

What is functional abdominal pain?

Functional abdominal pain is an episodic or continuous stomach pain without any organic cause. This means the pain is not caused by a physical or physiological change to some tissue or organ. Usually, the pain is located around the belly button, but the pattern and location of stomach pain are not always predictable. The pain may occur suddenly, or slowly increase. It may be constant or vary in severity. The child, however, appears well and grows normally.

Functional abdominal pain affects children from 4 to 18 years of age, with one peak at 5 to 7 years, when the child starts school, and another peak at 8 to 12 years. Among school children it is estimated that 10 to 20 per cent suffer from functional pain disorders. Functional abdominal pain is more common among girls.

 

Does my child have functional abdominal pain?

According to the Rome IV criteria a child suffers from functional abdominal pain if the following criteria are fulfilled at least 4 times per month for the last 2 months prior to diagnosis:

  • Episodic or continuous abdominal pain
  • Insufficient criteria for other functional GI disorders
  • Not explained by another medical condition
 

Why does it hurt?

The exact cause of functional abdominal pain is still unclear, but it seems to be an interplay between genetic, physiological and psychological factors. One possible mechanism may be a disturbed function of the gut motility. Moreover, our brain and gut are connected by an extensive network of neurons and a highway of chemicals and hormones that constantly communicate. A change in this communication may cause the gut to be more sensitive to triggers that normally do not cause significant pain. In some cases, children previously suffering from stress or anxiety may show an exaggerated pain response. Functional abdominal pain is not a serious disease, but can sometimes be difficult to diagnose because of its multifactorial nature. Taking a thorough history is of most importance.

Read more about our gut bacteria

 

What are the treatments for functional abdominal pain?

Stomach pain impacts many areas of a child’s life, because it can make the child feel sick, worried, sad or tired. Stomach pain is the second most common cause of absence from school. It also interferes with sleep, participation in sports, social activities and family life. So, children’s stomach pain matters for your child, for your family and for society. There is no standard treatment for children with functional abdominal pain. The current treatment options are dietary or psychosocial interventions, medical treatments and non-pharmaceutical treatments such as probiotics. In recent years, the interest in probiotics in functional abdominal pain has grown, both in terms of research on the clinical efficacy and the underlying mechanisms. If you would like to know more, or your child does not get better, talk to your doctor to find the right treatment for your child. The overall treatment goal is to reduce the pain so that the child can go back to normal functioning and life again.

 

What can you do to help?

  • Show support and empathy, and reassure your child that Functional abdominal pain is not a serious disease.
  • Encourage your child to resume school and social activities as soon as possible. Getting back to a lifestyle as normal as possible with regular school attendance, a normal sleep pattern and participation in sports and other activities is very important for your child’s quality of life.
  • Showing too much worry and anxiety might adversely affect treatment outcomes in children with stomach pain. Show your child that you care, but try to stay positive and encouraging.

Stomach pain questions

The following questions may be helpful in clarifying details of the abdominal pain and possible triggering factors, such as specific foods or stressors. They can also be valuable when discussing your child’s condition and treatment with your doctor.

  • Food – what did you eat today?
  • Sleep – did you sleep well? Did you have any nightmares?
  • School/daycare – how was school/daycare today?
  • Leisure time – what did you do in your leisure time today?
  • Sport – have you done any sport or other physical activity today?
  • Did anything special or remarkable happen today?
  • Toilet habits – normal or unnormal today?
  • Stool form – for example hard lumps, like a sausage, soft, fluffy or watery?