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Pediatric Chronic Abdominal Pain and Irritable Bowel Syndrome

What is chronic abdominal pain?

Abdominal pain is a common complaint in children. Recurrent or chronic abdominal pain is when abdominal pain occurs several times per week for greater than one month.

Estimates show that up to 20 percent of school-age children may experience recurrent abdominal pain. Chronic abdominal pain in children frequently accounts for missed school days and for missed work by parents. There may be associated symptoms including reflux, nausea and vomiting, as well as bowel movement changes such as constipation and diarrhea. 

There are numerous causes of abdominal pain. The job of the pediatric gastroenterologist is to determine if there are “red flags” or warning symptoms that will guide testing and evaluation.

Examples of warning symptoms include weight loss, pain that moves away from the center of the belly, blood in stool and/or diarrhea, vomiting and waking at night with abdominal pain, swallowing problems, and fever. 

Causes can often be separated into categories such as dietary, infectious, inflammatory, anatomic abnormalities and functional GI disorders. There are many potential diagnoses in each category. An example of dietary cause would be lactose intolerance or food allergy. An inflammatory example would be Crohn’s disease or celiac disease.

In the end, however, most of the chronic abdominal pain seen by the gastroenterologist is functional. 

Functional GI disorders represent conditions where an individual has chronic complaints of pain and other symptoms in the absence of other identifiable disease. Examples including Irritable bowel syndrome, functional abdominal pain syndrome, abdominal migraines, non-ulcer dyspepsia. These disorders are related to dysfunction in the nervous system of the intestinal tract and are often influenced by diet, life stressors, and likely our own gut bacteria.

What are symptoms associated with chronic abdominal pain?

  • Abdominal pain
  • Nausea
  • Constipation
  • Diarrhea
  • Appetite changes
  • Fever
  • Blood in stool 
  • Weight loss
  • Swallowing problems 

How are chronic abdominal pain disorders diagnosed?

  • Evaluation by the Pediatric Gastroenterologist
  • Blood tests
  • Stool tests
  • Radiology tests
  • Endoscopy

How are chronic abdominal pain disorders treated by Golisano Pediatric Gastroenterology?

Treatment of chronic abdominal pain in children ultimately depends on the diagnosis. The pediatric gastroenterologist can help guide the patient and family on treatment options for inflammatory, infectious, dietary or anatomic causes of chronic abdominal pain. 

Treatment of the more common functional gastrointestinal disorders such as irritable bowel syndrome functional abdominal pain syndrome, abdominal migraines, and non-ulcer dyspepsia focuses on reducing dietary, life and environmental stimuli that further disrupt the dysfunctional hypersensitive intestinal nervous system.

This often focuses on dietary changes and coping skills, but can include medications (over-the-counter, natural and prescription) that directly target the hypersensitive nervous system. 

Ultimately the goal of treatment is improvement or resolution of the abdominal pain and return to normal quality of life for the child and family.

Our specialists are dedicated to finding the best treatment options and to work with you to help improve the abdominal pain problems affecting your child’s life.

Our specialists also work together with our colleagues at Golisano Children’s Hospital of Southwest Florida including nutritional specialists, psychologists, radiologists,  and surgeons in the diagnostic and treatment process.