Functional Abdominal Pain – What Is It and What Can We Do About It?

There’s nothing like chronic pain to knock you off your feet.  Now imagine being just a kid with chronic pain that no one can fully explain.  As if you don’t have enough going on with growing your body, dealing with hormonal changes, navigating family dynamics and peer pressure, and looking for yourself and your place in the world, now you have unrelenting pain.  Fortunately we are learning more and more about it.

So just what is this Functional Abdominal Pain?  It is…

1. More common than you think: About 30% of school aged kids may experience recurrent pain
2. Not explained by any diagnosed condition such as Inflammatory Bowel Disease (IBD), acute infection, or a blockage
3. Possibly triggered by constipation, infection, or stress
4. Very disruptive – it is not uncommon for kids to start missing school or struggle to attend
5. Believed to be caused by nerves that are so sensitive that they react to normal intestinal activity

It is not…

1. All in your head
2. Easy to treat
3. Dangerous: affected children are generally healthy and maintain normal growth

How is Functional Abdominal Pain Diagnosed?

Your doctor will ask lots of questions, including information about the type and frequency of pain and family history of similar symptoms.  Depending on the history, your doctor may order tests:

1. Urinalysis: rules out a urinary tract infection
2. X-Ray: rules out blockage and constipation
3. Blood tests, stool tests and other imaging: rule out other conditions such as IBD and acute infection

How is Functional Abdominal Pain Treated?

There are lots of treatment options to try; they won’t all work for every child.  Any child suffering from Functional Abdominal Pain should be managed by one primary care physician, who should coordinate and supervise all treatment approaches.  It is important to enter treatment with an open and hopeful mind balanced by reasonable expectations (think maintenance of daily activities rather than 100% lack of pain).

1. Diet Diaries / Food Allergy and Intolerance Testing to detect food reactions (a lot of abdominal pain is caused by lactose intolerance, but people react to every food under the sun, so the possibilities are endless).  For more information about how to detect food allergies/sensitivities check out our e-book How To Do An Elimination/Challenge Diet. 
2. Psychosocial Interventions:  Cognitive Behavioral Therapy, Biofeedback, Hypnotherapy, Family Therapy, Meditation, Guided Imagery.
3. Body work: Craniosacral Therapy, Visceral Manipulation, massage, and others.  For more information on abdominal massage check out our blog post Tummy Massage for Every Body
4. Traditional Chinese Medicine: acupuncture or acupressure with the possible addition of Chinese herbs.
5. Naturopathic Medicine: herbs and supplements to improve digestion, calm the nerves, reduce pain, etc.
6. Homeopathic Medicine: controversial as it is, practitioners and patients alike swear by it.  For more information about the controversy in Homeopathy check out our blog post What Is Homeopathy? (Insert Controversy Here)
7. Pharmaceuticals: there are a variety of drug classes that may be considered, particularly if all else fails.

Resources:

Merck Manual

GI Kids

Seattle Children’s Hospital Pain Clinic