Chronic Abdominal Pain (CAP) is a common condition among children. It may occur in 9 to 15% of all children. Usually, it affects boys between the ages 5 to 6 years old, and in girls between 5 to 6 years old and 9 to 10 years old.

Children with CAP often complain of continuous abdominal pain, or recurrence of abdominal pain of at least once per week, for at least 2 months.

Fortunately, chronic abdominal pain is not a serious condition, and children who are affected recover without needing medical treatment. However, the pain does affect the quality of life of these children : causing school absentees, inability to participate in activities etc.

In most children who suffer from CAP, no underlying medical cause is detected despite extensive medical examination and investigation. These children are often diagnosed to have “Functional Abdominal Pain.

Worrying symptoms that may indicate presence of an underlying disease :

• Abdominal pain that wakes your child up from sleep.
• Vomiting, constipation, diarrhoea or abdominal distension.
• Bloody stools.
• Prolonged or recurrent fever.
• Loss of weight, or not growing well.
• Change of bowel habits – increase frequency, or soiling (unable to reach toilet in time).
• Pain during urination or blood in urine.

If your child has any of the symptoms above, you should consult a doctor.

Functional Abdominal Pain (FAP)

Functional Abdominal Pain is a condition in children whereby the abdominal pain is not caused by underlying medical illness. Other than abdominal pain, children who have FAP do not have the worrying signs listed above.

Usually, FAP is triggered when children undergo a period of stress or anxiety. For example, birth of a new sibling, illness in the family, school exams etc.

Although FAP is not caused by a disease, it is important to understand that the pain felt is real among the afflicted children, and not “made-up”.

Until now, science has not able to fully explain why a child suffers from FAP. It is believed that psychological factors are involved. Many of the nerves supplying the stomach and intestinal muscles are closely connected to the brain. Therefore, any emotional stress may cause the stomach and intestinal muscles to work harder or excessively. These contractions of stomach and intestinal muscles are believed to cause the feeling of “abdominal pain”.

Treatment

If your child suffers from abdominal pain, we encourage you to keep a pain diary. The pain diary should record the following details :

• When the pain occurs.
• How long is the pain.
• Location of the pain.
• Any triggers for the pain: (e.g. Food, activity, stress, etc).
• Whether it interferes with daily activities: (e.g. Schooling, sports).
• Any relieving factors.

During a medical consult, any underlying disease that is detected to cause the abdominal pain will be treated accordingly.

However, majority of children with abdominal pain has Functional Abdominal Pain.

The most common treatment for FAP revolves around relaxation techniques and behavioral therapy. The focus of treatment is to enable your child to return to her normal activity of daily living (e.g. schooling, sports etc).

Helpful advice or tips that may be useful include :

• Demonstrate to your child that you care about his well-being. (A simple way would be to use a warm and wet towel to wipe your child’s tummy to reduce the pain or discomfort). However, do not give excessive attention as this may cause the child to experience more frequent attacks or increase severity of pain, in an attempt to get more attention from you. Instead, focus on giving more attention during the period when your child has NO PAIN.
• “ALL work and NO play makes Jack a dull boy”. Your child may require more time to rest and play. Some children may be too stressed by a busy daily schedule (e.g. Schooling, extra-curricular activities, tuition, music lessons, etc.). Thus, this may indirectly contribute to the child’s abdominal pain.
• DO NOT complain about your child’s problem to other people IN YOUR CHILD’S PRESENCE.
• Encourage your child to talk and share his problems with you. Always make time available. Be a good listener – sometimes, all that your child wants is for somebody to listen to him.

Change in Diet

Occasionally, certain food can trigger abdominal pain. Example: milk, spicy food, coffee, chocolate, fatty food.

If you are able to identify a certain food trigger, it is best to avoid that particular food.

Medications

Your child may be given some medications to relieve the abdominal pain. However, it is vital that you consult your doctor before starting on any medication.