When belly pain won't go away

March 03, 2010

Does your child have belly pain that won’t go away but doesn’t come with fever, vomiting, diarrhea or constipation? He or she may have FAP, functional abdominal pain, a common complaint in children ages 4 to 14. It is one of the top reasons for visits to school nurses and pediatricians during the school year.

FAP symptoms

  • Pain in the belly, usually around the belly button, but the pain can occur at any place in the belly.
  • Children describe it as "shooting" or "stabbing" pain.
  • The pain may be severe enough to cause the child to leave school or be doubled over in pain.
  • If the pain occurs with a fever, vomiting, diarrhea or burning during urination, a different cause may be to blame.

FAP tends to worsen under stress, peaking during the start of a new school year, a move, or divorce, said Dr. Rina Sanghavi, a gastroenterology specialist at Children’s Medical Center and assistant professor of Pediatric Gastroenterology and Nutrition at UT Southwestern.

What causes FAP?

It is not known exactly why some children get FAP, but the theory is that there is a genetic component and that the nerves of the child’s gut are sensitive. Stress and irritable nerves are likely causes.

FAP treatment options

See your child’s pediatrician, who can diagnose FAP. He or she may refer your child to a pediatric gastrointestinal specialist to help diagnose this condition. There is no definitive diagnostic test to confirm the condition, Dr. Sanghavi said, so physicians must conduct a thorough medical history and do a physical exam on the child.

Medications may calm the nerves of the gut. A counselor or psychologist also may teach the child relaxation techniques. Most children with FAP will recover in a few weeks to a few months, Dr. Sanghavi said.

Children with FAP should continue to go to school. Missing school increases stress and may aggravate the pain. Avoid pain-relieving medication unless recommended by your child’s doctor.

To learn more, contact the Pain Management Center at Children’s at 214-456-8131.

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