Does your child often have stomach aches? Can't seem to find a reason? Let's talk about Functional Abdominal Pain!

Does your little one often say, "Mommy, my stomach hurts"? Sometimes, even after seeing a doctor, they can't find the exact cause, saying, "This is what's wrong." As a parent, it's only natural that you feel a lot of anxiety. Today, we're going to talk about a stomach ache that's difficult to find a clear cause for, but is common in children. We call this functional abdominal pain . Sometimes, doctors also call this condition 'Centrally Mediated Abdominal Pain Syndrome'.

What is Functional Abdominal Pain?

Simply put, functional abdominal pain is pain in a child's stomach. But there are a few things that are special about it:

• A doctor can examine you and find no clear cause: that is, the doctor confirms that there is no specific medical condition, such as a stomach ulcer or infection, causing the pain.
• This pain comes four or more times a month: not once or twice, but more frequently.
• This condition has been present for at least two months: We suspect this only if stomach pain persists for two or more months in a row.
• Most of the time, the pain doesn't last longer than an hour: once it comes, it subsides after a while.
• There is no particular connection between food, activity, or bowel movements: some stomach upsets get worse after eating a heavy meal, or get worse after bowel movements. But it's hard to see such a clear pattern in this case.
• The child is growing well and not losing weight: This is something that surprises many parents. Even though the child has a stomachache, the child is eating well, drinking, playing, growing taller, and getting bigger.
• It can be related to stress or anxiety: For example, when a school exam is approaching, when you have to move to a new class, or when you have some problems at home, your child may feel stressed. This is when stomach pain is likely to appear.

But there is good news! Most children with this type of functional abdominal pain will recover completely within a few weeks or months. Long-term serious problems are rare.

What are the symptoms of Functional Abdominal Pain?

The main symptom is stomach pain . However, children may also experience other symptoms, such as:

• Nausea: This is a feeling of nausea or vomiting.
• Headache : A headache accompanied by stomach pain.
• Dizziness: Some children may feel light-headed or dizzy.
• Fatigue: Feeling tired all the time, feeling lifeless.

These symptoms do not occur in the same way in every child. Some children may only have a stomachache, while others may have several of these symptoms together.

Why does this functional abdominal pain occur?

In fact, doctors still haven't been able to pinpoint the exact cause of this. However, there are different opinions on this.

One major theory is that this may be due to a sensitivity in the brain-gut axis, the signaling system between the brain and the digestive system . Think about it, our brains are constantly sending messages (nerve signals) from our stomachs to our brains, and from our stomachs to our brains. In children with functional abdominal pain, this nervous system may be a little more sensitive. This means that even small changes in the stomach that a normal person would not notice (for example, a slight distension of the stomach, air trapped in the intestines) may be felt as pain by these children. Just like a person who is startled by the slightest sound.

These nerve messages can be stimulated:

• Due to stomach or intestinal distension (when eating, when full of air).
• Due to the expansion of the rectum when you need to defecate.

This condition is most common in children between the ages of 4 and 16. Sometimes, a child can develop stomach pain even after they have recovered from a previous gastrointestinal infection. Also, a stressful event in the family – for example, moving to a new home, a divorce, or a problem at school – can cause or worsen this pain.

How is this functional abdominal pain diagnosed?

When you take your child to a doctor, he or she will follow several steps to diagnose this condition:

1. Ask about symptoms: The doctor will ask you about how your child's stomachaches started, when they started, how long they've been going on, and if there are any other symptoms. They will also look for signs of a more serious illness, such as weight loss, failure to thrive, fever, rash, persistent vomiting, diarrhea, or arthritis . These are called "red flag signs" or "warning signs."

2. Performs a physical examination:The doctor will examine the child carefully. He will palpate the abdomen and check for any other abnormalities.

3. Some basic tests: If necessary, a few blood tests and a stool test for occult blood may be done. These are done to make sure there are no other diseases.

4. Asks about stress: The doctor will also talk about things that may be causing stressors to the child, such as recent changes in the home environment, problems with friends at school, and exams. Because, as we have already said, stress can affect this.

The important thing is that if the child does not have the previously mentioned "red flag signs", and basic blood and stool tests are normal, most of the time there is no need for other major, complex tests (e.g., endoscopy, CT scan).

How is Functional Abdominal Pain treated?

When treating this condition, doctors don't treat everyone the same way. Treatment methods may vary from child to child, depending on the nature of the symptoms. Typically, things like this are done:

• Changes in diet:
• Some children find relief by limiting foods that cause gas (e.g., cabbage, cauliflower, broccoli, lentils).
• It is also a good idea to reduce your intake of oily, fried foods, spicy foods, and foods and drinks with artificial sweeteners.
• Limiting carbonated drinks (like soda) and fruit juices (especially those high in sorbitol, such as apple and pear) also helps some children.
• Some children may have difficulty digesting milk and dairy products containing lactose. If there is any doubt, you may want to avoid them for a while, as advised by your doctor.

• Medicines:
• There are medications that can be given to reduce stomach cramps.
• Medications that reduce stomach acid can sometimes help.
• Very rarely, the doctor may decide to give a low dose of other medications that help control pain and affect the nervous system. However, it is essential that all of these medications are used only under the doctor's prescription and as directed. Avoid giving your child pain medicine at will.

• Counseling and Relaxation Techniques:
• Because this pain is associated with stress, counseling services that help the child manage their emotions and reduce stress can be very helpful.
• Teaching your child relaxation techniques such as deep breathing exercises, meditation, and yoga can also provide relief.

The important thing is not to dismiss the child as "a mental illness." The child is actually experiencing pain. Even if the cause is not an obvious physical illness, the pain is real.

When should you see a doctor as soon as possible? (Signs to watch out for)

Even a child with functional abdominal pain can sometimes have another serious condition. So, if your child develops any of the following symptoms, don't waste time and see a doctor right away:

• If there is blood in the stool (black or dark red).
• If you have diarrhea for more than two days.
• If you have been vomiting for more than two days.
• If the vomit contains blood (red or looks like coffee grounds).
• If the stomach pain lasts for more than an hour, or if the pain is getting worse.
• If you have a high fever.
• If you continue to have a loss of appetite and are losing weight.
• If there is pain during urination.
• If constipation is severe or has just started and is ongoing.
• Swelling or redness of the joints.
• If you have a skin rash and stomach upset.
• If the child's growth seems to be stunted.

Symptoms like these mean that it may not be functional abdominal pain. It could be another medical condition and needs to be evaluated immediately.

How can you as a parent help your child?

Your support, love, and understanding are invaluable to a child living with this condition. The child may feel sad and anxious because of this pain. It is normal for them to feel frustrated when they miss out on daily activities and play. You can help by:

• Keep your child engaged in normal daily activities: Don't let the pain stop them from doing things like going to school, playing, spending time with friends, or enjoying time with family. When your child is engaged in these activities, they may be less likely to think about the pain.
• Reassure your child: "This is not a serious illness, and you will get better soon." Tell him that the doctor said it's nothing serious.
• Don't focus too much on your child's pain: Yes, it's hard for your child. But when you constantly ask, "Does your stomach hurt?" "How are you doing?", your child's attention can be drawn to the pain. Instead, talk about other good things your child is doing, their talents. Redirect their attention elsewhere.
• Don't show your child your worries: If your child sees you worrying too much about them, they may become even more afraid and anxious. Your calm and positive attitude is a great source of strength for your child.
• If you're worried about this too, talk about it: Sometimes parents can also find it difficult to cope with this situation. If you feel this way, talk about it with someone you trust, or a counselor. Your mental health is also important.
• Consider counseling for your child: It can be very helpful to provide your child with the support of a counselor to help them talk about their feelings, cope with pain, and learn ways to relax.

Remember, never assume that your child is "lying" or "faking it." Functional abdominal pain is real pain. Even if there is no obvious physical cause, your child is still experiencing it.

The most important things to remember (Take-Home Message)

Okay, so now you have a better understanding of what we talked about today, Functional Abdominal Pain. Let's recap the most important things:

1. Functional abdominal pain is a stomach ache that occurs without a clear physical cause, but is actually felt.

2. This is not a dangerous condition in most cases, and it will get better over time.

3. If the baby is growing well and not losing weight, that's a good sign.

4. Stress can affect this. Therefore, be careful about your child's mental well-being.

5. It is important to follow the treatment as prescribed by a doctor and to continue with your daily life as normal.

6. Be aware of "red flag signs." If you see any, see a doctor immediately.

7. Your love, support, and understanding are a great strength for your child to overcome this situation.

If your child has this problem, don't panic, talk to a doctor and get the necessary advice. Every child deserves to live a healthy, happy life!

` Functional Abdominal Pain, Children's Stomach Pain, Centrally Mediated Abdominal Pain Syndrome, Stomach Pain, Pediatric Diseases, Stress and Stomach Pain