Stomach pain in children

“I’ve got a pain in my stomach.” “My stomach hurts.” Every parent is likely to have heard these words. Stomach pain is very common in children and adolescents. In fact, it is believed that up to 38 per cent of children experience stomach pain every week. Stomach pain is one of the most common clinical symptoms that pediatricians see in their day-to-day practice and one of the most common reasons why children visit the emergency room. For most children, the pain disappears by itself. However, for some, stomach pain becomes a problem that interferes with school or day care and with social and family life. It can 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 episodic or continuous stomach pain without any organic cause. The pain is not caused by a physical or physiological change in some tissue or organ. Usually, the pain is located around the belly button, but the pattern or location of stomach pain is not always predictable. 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 and is more common among girls than boys. One peak usually occurs from 5 to 7 years, when the child starts school, and a second peak during 8 to 12 years. It is estimated that 10 to 20 percent of school children suffer from functional pain disorders.

Why does functional abdominal pain hurt?

The exact cause of functional abdominal pain is unclear, but it seems to be an interplay between genetic, physiological and psychological factors. One possible mechanism may be a disturbed function of 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.

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How it impacts a child’s life

Stomach pain can impact many areas of a child’s life, making 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. 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 clinical efficacy and the underlying mechanisms. If you would like to know more or if the pain doesn’t seem to be improving, speak to your doctor. The goal is, of course, to reduce the pain so that your child can resume normal 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 return to school and social activities as soon as possible. Getting back to a normal routine with regular school attendance, normal sleep patterns and participation in sports and other activities is important.
  • Displaying worry and anxiety can adversely affect treatment outcomes. Remain positive and encouraging.

Asking the right questions

The following questions may be helpful in clarifying details of 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 – did you go as normal today?
  • Stool form – Was it like a sausage or was it soft, fluffy or watery?