Childhood Abdominal Pain

What Causes Abdominal Pain in Children?

Dozens of conditions, known as disorders of gut-brain interaction (DGBI), can cause chronic abdominal pain. DGBI is also known as functional gastrointestinal disorder (FGID) and functional abdominal pain. 

When a child has a DGBI, there’s a disconnect between their gut and brain. Depending on the condition, a DGBI may affect:

• Brain signals that help control how food moves through the intestines (intestinal motility)
• Nerves in the intestines that aid intestinal motility

When a medical treatment or condition, such as inflammatory bowel disease (IBD), causes stomach pain, the pain is a symptom or secondary condition. It’s different from having a DGBI.

DGBIs That Cause Abdominal Pain in Children

Common disorders that cause chronic abdominal pain in children include:

• Abdominal migraine
• Functional dyspepsia 
• Irritable bowel syndrome (IBS)

What Are the Signs and Symptoms of Childhood Abdominal Pain? 

Abdominal pain affects every child differently, depending on the cause.

Abdominal Migraine Symptoms

An abdominal migraine often comes on and ends suddenly. The stomach pain may last one hour or up to 72 hours. Your child may have:

• Mild to severe pain around their belly button area
• Headache
• Loss of appetite
• Migraine symptoms, such as sensitivity to light or noise
• Nausea and vomiting
• Pale skin

Functional Dyspepsia Symptoms

Functional dyspepsia is chronic indigestion that causes symptoms that can be mistaken for gastroesophageal reflux disease (GERD). Your child may have:

• Upper abdominal pain
• Bloating and gas pain
• Burning pain in their chest that’s similar to heartburn or GERD
• Fullness after eating little food
• Loss of appetite 

IBS Symptoms

IBS affects the large intestine. Your child may have:

• Lower abdominal pain that eases after a bowel movement
• Bloating
• Constipation, diarrhea or both

How Is Childhood Abdominal Pain Diagnosed?

Pediatric gastroenterologists are experts in digestive or gastrointestinal (GI) disorders. But not all GI doctors are familiar with DGBIs. At Lurie Children’s, your child receives care from pediatric gastroenterologists with deep expertise in diagnosing and managing DGBIs that cause chronic stomach pain.

After your child has a physical exam, both your child and you will participate in interviews to help our care team learn more about your child’s symptoms and medical history. Our team refers to diagnostic criteria established by the Rome Foundation, a nonprofit organization dedicated to the diagnosis and treatment of DGIBs, to aid the diagnosis.

In some cases, a child has chronic abdominal pain and other symptoms that don’t fit the Rome criteria for a DGBI. This is known as functional abdominal pain, not otherwise specified (FAP-NOS).

Some children need additional tests to rule out other conditions and aid diagnosis. These tests may include:

• Colonoscopy to examine the large intestine (colon)
• Motility tests to see how food moves through the digestive tract
• Upper endoscopy to view the esophagus, stomach and first part of the small intestine (duodenum) 
• X-rays to check for constipation 

How Is Childhood Abdominal Pain Treated?

Chronic abdominal pain can be challenging to treat. Depending on your child’s needs, they may see a pediatric gastroenterologist at Lurie Children’s for treatment or receive more advanced care at our Comprehensive Chronic Abdominal Pain Program. 

Treatments vary depending on your child’s unique symptoms and diagnosis. We offer comprehensive therapies to relieve stomach pain.

Medications

Depending on your child’s symptoms and diagnosis, your child’s GI doctor may recommend over-the-counter or prescription medications to:

• Calm the nervous system
• Ease abdominal pain, bloating, gas and nausea
• Help move food through the intestines
• Reduce stomach acid
• Treat constipation or diarrhea

Behavioral health therapies

Every child who receives care at our Comprehensive Chronic Abdominal Pain Program sees a GI health psychologist who helps them cope with chronic pain. This specialist evaluates behavioral, emotional and social factors that can contribute to abdominal pain and affect a child’s response to pain. 

Your child may benefit from:

• Care for mood disorders, such as anxiety and depression, that can worsen pain
• Gut-focused hypnotherapy to improve the gut-brain connection and help your child manage chronic pain
• Meditation and mindfulness exercises to ease pain, anxiety and stress, as well as improve sleep

Nutritional Counseling

Stomach pain can affect your child’s appetite, leading to poor nutrition and growth. We offer nutritional counseling to ensure your child gets the nutrients they need. Our registered dietitians may: 

• Recommend healthy foods that are easier to digest and less likely to cause stomach pain
• Educate your child and family about foods and drinks to avoid due to stomach upset
• Provide tips, such as eating smaller portions more frequently throughout the day, to ensure your child gets the right amount of calories, nutrients and more 
• Suggest supplements like higher-calorie drinks or vitamins to boost nutrition

What Is Lurie Children’s Approach to Caring for Children With Chronic Abdominal Pain?

Lurie Children’s is the only pediatric center in the region offering integrated care for children with DGBIs that cause chronic abdominal pain. Our experts partner with your family to ease your child’s pain and help them enjoy life more fully. 

Your child benefits from:

• Dedicated care team: Your child’s care team may include a gastroenterologist, health psychologist, nutritionist and other experts. These experts work with your family to help your child feel better.
• Nationally recognized care: Our gastroenterology and behavioral health programs are among the best in the country, as rated by U.S. News & World Report.
• Advanced care for motility issues: Specialists at our Neurointestinal and Motility Program offer advanced diagnostic tests and treatments for intestinal motility disorders that cause abdominal pain. Intestinal motility refers to the muscular movements of the GI tract that push digested matter through the body. 
• Research and clinical trials: We’re active in national research and clinical trials to find new ways to prevent and treat disorders that cause abdominal pain in children. Your child may benefit from promising new therapies still in development.

Lurie Children’s Comprehensive Chronic Abdominal Pain Program

At the Lurie Children’s Comprehensive Chronic Abdominal Pain Program, we provide thorough medical, psychological and nutritional services for children with chronic abdominal pain. Your child benefits from a personalized treatment plan that improves pain, so they eat better, feel better, thrive and learn along with their peers. 

Learn more about our Comprehensive Chronic Abdominal Pain Program.