Does your child often have stomach pain? Can't find a reason for it? (Functional Abdominal Pain)

Does your little one always say, "Mommy, my stomach hurts?" You probably feel a lot of fear when you say that, don't you? When you go to a doctor and they say, "This is what's wrong," or something else, it's even more distressing. That's how we're going to talk about stomach pain that the child really feels, even though no clear cause can be found. Doctors call this ``Functional Abdominal Pain.'' Sometimes it's also called ``Centrally Mediated Abdominal Pain Syndrome.'' Let's talk about this simply, in our language. What is Functional Abdominal Pain? Simply put, ``Functional Abdominal Pain'' is when a child has stomach pain, and a doctor examines it, but cannot find a specific physical cause (for example, an intestinal ulcer, worms, infection). However, this does not mean that the child is lying. The pain is really there. Imagine, doctors look for several symptoms like these to diagnose this condition:

• This stomach ache should come at least four times a month .
• It should continue like this for at least two months .
• Most of the time, this pain doesn't last more than an hour.
• This stomach ache doesn't seem to be particularly related to eating, running around, or going to the toilet.
• A child with this condition grows up to be very tall and healthy. Weight loss is not usually seen.
• However, sometimes this pain can increase when there is stress or anxiety .

The good news is that most children with ``Functional Abdominal Pain'' get better within a few weeks or months. It is rare for a major, long-term problem to develop.

What other symptoms are there besides stomach pain?

The main thing is the stomachache you mentioned. However, the child may also experience other discomforts such as:

• Nausea: This means feeling like you are going to vomit or your stomach is turning over.
• Headache: It is common for some children to have headaches along with stomach upset.
• Dizziness: A feeling of lightheadedness and spinning head .
• Feeling extremely tired: You may feel so tired that you can't do anything.

These symptoms do not occur in every child in the same way. Some children may only have an upset stomach, while others may have one or more of these additional symptoms.

Why does this Functional Abdominal Pain occur? What is the cause?

In fact, doctors still don't know 100 percent for sure what causes Functional Abdominal Pain. However, there are several theories. It is thought to be related to a sensitivity in the brain-gut axis, the nerve signal system between our brain and intestines . Simply put, some children's intestines are more sensitive than the average person to even simple stimuli (for example, when the stomach or rectum is stretched a little). Because of this visceral hypersensitivity, these children may experience pain even when they don't feel anything. The functioning of these nerve signals can be slightly different. This condition is usually seen in children between the ages of 4 and 16. Sometimes, this type of pain can also start after a previous intestinal infection. That is, even after a stomach bug has gone and healed, the sensitivity of the intestines may remain increased for a while. Also, stress has a big impact on this. Imagine, if there was a big change in the home environment (moving to a new house, changing schools, family problems, parents separating, etc.), this stomachache may be related to such stressful events . There are some children, they are a little sensitive, they get anxious easily. Such children are also more likely to have this condition.

How does a doctor accurately diagnose this as Functional Abdominal Pain?

When you tell your child about a stomach ache like this, the first thing a doctor will do is make sure there are no other serious medical conditions. This can include:

• Ask your child and yourself about the symptoms: Ask your child and yourself about the nature of the pain, how long it has been present, and what other problems are associated with the pain. In particular, look for weight loss, failure to thrive, fever, body aches, persistent vomiting, blood in the stool , and "red flag" signs such as arthritis.
• Physical examination: The child is examined thoroughly. The abdomen is palpated and other abnormalities are checked.
• Basic tests: Usually, several blood tests and a stool test for occult blood are done. These can give some idea of ​​whether there is inflammation in the intestines.
• Asking about stress:We also ask about recent changes in the child's life, problems at school, and stressors in the home environment. Because, as we said before, stress can affect this.

The important thing is that if the child does not have any of the "warning signs" mentioned earlier, if the physical examination is normal, and if blood and stool tests are normal without any major problems, then in most cases there is no need to do other major, complex tests (e.g., `(Endoscopy)`, `(Ultrasound Scan)`). A doctor will conclude that `(Functional Abdominal Pain)` is present only after other serious causes have been ruled out.

What are the treatments for this? How do I get better?

When it comes to treating Functional Abdominal Pain, there is no one-size-fits-all approach. Treatment may vary from child to child, depending on the nature of the symptoms. Doctors may treat it using one or a combination of these methods:

• Changes in diet:
• Some foods, such as cabbage, broccoli and cauliflower, and beans, may be advised to be reduced in their intake .
• It is good to limit things like oily, fried foods, and fast food .
• Carbonated drinks like soda, sweetened beverages, and spicy foods may also be a problem for some children.
• Some children may also be tested for conditions such as ``Lactose intolerance'' and asked to limit milk and dairy foods if necessary.
• Medicines (drugs):
• There are medications that can be given to reduce stomach pain and cramping.
• If you feel that the acid in the stomach is a little too high, medications that reduce it (e.g., antacids, proton pump inhibitors ) can be given for a short period of time.
• Sometimes, a doctor may also prescribe low-dose medications that affect the nervous system (such as Amitriptyline) to help reduce sensitivity to pain. However, these are given with caution.
• When the pain is at its worst, you may be advised to use a simple painkiller (e.g. paracetamol) for a short period of time.
• Counseling or Relaxation Techniques:
• This is a very important aspect. Counseling or psychotherapy can be very helpful in reducing the child's stress and anxiety and in learning how to deal with such feelings.
• Practicing breathing exercises, mindfulness meditation, and relaxation techniques like yoga can be a great way to help manage pain.

When do you need to see a doctor again?

If your child has been diagnosed with ``Functional Abdominal Pain'' by a doctor, it's usually nothing to worry about. However, if any of these new "warning signs" appear, you should definitely see a doctor again soon:

• If there is blood in the stool (black or red).
• If diarrhea persists for more than two days , especially if it is watery.
• If vomiting continues for more than two days , or if vomiting is severe.
• If there is blood in the vomit (either like coffee grounds or red).
• If the stomach pain persists for more than an hour , or if the pain is getting worse.
• If you have a high fever (especially for no other reason).
• If the child has lost appetite and has reduced their food intake significantly or is unable to eat at all.
• If you have pain or burning when urinating .
• If you have constipation and haven't gone to the toilet in days, and it's uncomfortable for the child.
• If the joints are swollen and painful.
• If it causes harm to the skin.
• If the child is losing weight or has a problem with height.

If you see a sign like this, it is wise to seek medical advice immediately, as it could be something other than ``Functional Abdominal Pain''.

How can we as parents help our child?

Children with Functional Abdominal Pain may sometimes feel sad or anxious as they live with the pain. It's normal for them to feel sad when they miss schoolwork and play. So, as a parent, you can support your child in these ways:

• Keep your child engaged in daily activities: As much as possible, encourage your child to do things as normal, such as sending them to school, playing sports and hobbies they enjoy, and spending time with friends and family. Putting everything on hold and keeping them at home because of the pain will only make the child think about it more.
• Reassure the child: "There is no serious physical cause for this pain. This is something that happens to many children. It will get better soon." Reassure the child and build their confidence.
• Don't talk about your child's pain all the time: Yes, listen to your child when they talk about their pain, and comfort them. But don't constantly ask questions like, "Does your stomach hurt? How are you feeling now?" all day long. Instead, focus on what they say, their talents, and their activities. Children can feel even more distressed and hurt when they see their parents worrying too much about them.
• Think about your mental health too: If you are feeling stressed or anxious about your child's situation, talk to a counselor to get some help. It's nothing to be ashamed of. You can only help your child if you are well.
• Consider counseling for your child: Consider providing your child with the support of a child counselor to help them manage their emotions, learn how to deal with pain, and practice ways to relax.

So, what is the most important thing we should take home from this story? (Take-Home Message)

Okay, so now you have a better understanding of what we've been talking about (Functional Abdominal Pain). Finally, keep these points in mind:

• Simply put, ``Functional Abdominal Pain'' is a stomach ache that occurs in children and that cannot be found through tests to have a clear physical cause, but is actually felt by the child.
• This is usually not a sign of a serious, dangerous illness. If your child is growing well, is not losing weight, and has been examined by a doctor and has confirmed that there is no other serious problem, do not be unnecessarily worried.
• Psychological factors like stress, anxiety, and problems at school can directly affect this pain. Therefore, it is very important to always take care of your child's mental health and talk to them.
• Making small changes to your diet, using medication prescribed by a doctor if necessary, and especially relaxation techniques and counseling are good treatments for this condition.
• Only if your child develops new, serious symptoms (the "warning signs" we talked about earlier) that they didn't have before, should you see a doctor without delay.
• As parents, the best thing you can do is to be patient, understanding, and lovingly support your child on this journey. Your support will be a great strength to your child!