Pediatric Abdominal Pain (Chronic)

Pediatric Abdominal Pain (Chronic)



Chronic abdominal pain is a stomachache that reoccurs for long periods of time and caused by one of several known or unknown conditions.

Expanded Overview

Pediatric chronic abdominal pain can be caused by unknown reasons (idiopathic), or by one or more conditions affecting a child’s abdominal region (lower chest to upper pelvis area). It becomes a chronic pain issue when it’s a consistent problem that reoccurs (repeats) for days or even years.


There are two types of chronic abdominal pain:

  • Functional abdominal pain (non-organic abdominal pain) — This type is idiopathic, meaning there isn’t an immediate, identifiable reason. This commonly happens with children, as it can be hard for them to accurately describe the pain or where it’s located.
  • Explained pain This type means there is a specific reason for the pain that can be identified. 


Each condition has its own cause and average age of diagnosis, as outlined below.

Unexplained pain or functional abdominal pain

Unexplained abdominal pain can be the result of an offset nerve or referred pain (also known as reflective pain). This occurs when the pain begins in one area, but the child feels it another region.

Explained pain

Chronic abdominal pain typically occurs for a specific reason, including those listed below.

  • Abdominal epilepsy — seizures that occur in the abdomen (a rare condition).
  • Abdominal migraines — pain symptoms in the abdomen similar to migraines.
  • Acid reflux (GERD) – digestive enzymes that come back up into the throat.
  • Cancer — any cancer that occurs in the abdominal region, including colon, liver, ovarian and stomach.
  • Chronic appendicitis — the appendix can swell multiple times and not burst, causing pain during flare-ups.
  • Crohn’s disease — a disorder in which the immune system attacks healthy tissue in the digestive tract.
  • Endometriosis — tissue that normally lines the uterus grows outside of it and causes pain.
  • Food allergies — pain can be caused by allergies like Food Protein-Induced Enterocolitis.
  • Gallbladder inflammation — also known as chronic cholecystitis, this is a swollen gallbladder that can also have gallstones.
  • Hernia – an organ or tissue bulges through the abdominal muscle.
  • Irritable bowel syndrome (IBS) – a group of gastrointestinal (GI) symptoms.
  • Ischemic bowel disease – an artery (blood vessel) becomes blocked or narrowed.
  • Ovarian cyst – a solid or fluid-filled sac on one or more of a girl’s ovaries.
  • Lead poisoning– a buildup of toxic lead in the system.
  • Parasitic infection – intestinal infection typically from parasites called giardia and cryptosporidium.
  • Sickle cell anemia –a type of anemia that creates irregular, crescent-shaped red blood cells.
  • Ulcers – sores that develop in the abdominal region.
  • Ulcerative colitis – ulcers and inflammation in the lining of the colon and rectum.


Symptoms will vary, depending on the location and source of condition, and include:

  • Ascites (swelling)
  • Abdominal mass (lump)
  • Abdominal pain
  • Blood in bowel movement or urine
  • Fatigue
  • Fever
  • Jaundice
  • Weight loss

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