Chronic Abdominal Pain in Children

More than one-third of children complain of abdominal pain lasting at least two weeks, according to the American Academy of Family Physicians. While some abdominal pain is enough to cause one child to simply feel "under the weather," another child may experience so much pain that he ends up missing multiple days of school. The way a physician diagnoses and decides to treat the chronic abdominal pain depends on its source.

Types

• There are two categories used to describe chronic abdominal pain in children. Organic disorders are related to abnormalities within the organs (e.g. the gastrointestinal system). Functional disorders are disorders that cannot be confirmed by tests, though they still cause a child pain. A child with chronic abdominal pain may have both an organic and a functional disorder. For example, he may have an organic disorder and develop stress, which then contributes to a functional disorder.

Organic Disorders

• Organic disorders are disorders that can be tested and identified. Constipation is one common organic disorder that causes children chronic abdominal pain. Other organic disorders include parasitic infections, ulcers, lactose intolerance, and acid indigestion (heartburn). A child with an organic disorder may not have an issue directly in his gastrointestinal system. In fact, he may be experiencing pain in his abdominal muscles or bones. He may also have abdominal tenderness, bloody stool or weight loss, or noteworthy amounts of vomiting, diarrhea, bloating or gas.

Functional Disorders

• Though functional disorders cannot be identified by tests, a physician may be able to diagnose them by taking note of common signs and symptoms. Functional dyspepsia (upset stomach), abdominal migraine (which may present alongside a headache and light sensitivity) and irritable bowel syndrome (IBS) are three common functional disorders.

Functional Abdominal Pain

• Some children are classified as having functional abdominal pain if they have abdominal pain but do not have organic disorders, abdominal migraine, IBS or functional dyspepsia. The pain usually lasts for less than an hour and it is often unrelated to bowel movements, activity or meals. Functional abdominal pain may be difficult to describe, but may include nausea, fatigue and dizziness. It is also commonly aggravated by anxiety or stress.

Diagnosis

• A healthcare provider will determine the cause of a child's chronic abdominal pain by asking the child and/or his parents to describe symptoms, by gathering a health history, and by examining the child's body. Sometimes the health-care finds it necessary to conduct lab tests or occasionally an imaging test, such as an X-ray. He may also ask the child to write in a pain journal in order to determine the time, severity and duration of the abdominal pain.

Treatment

• The treatment plan for a child's chronic abdominal pain depends on the cause. An organic disorder may, for example, be treated with medication and dietary changes, such as the removal of lactose for a child who is lactose-intolerant. A functional problem, on the other hand, may require a treatment plan that includes dietary changes, relaxation techniques, parental education (such as learning to soothe a stressed-out child), or even behavioral therapy for the child.