Functional Abdominal Pain

Abstract

Functional abdominal pain (FAP) is a frequent complaint seen in the pediatric primary care setting. Current diagnostic criteria for functional gastrointestinal disorders (FGIDs) are defi ned in the Rome III criteria, which outline a positive symptom profi le for diagnosis. In addition, clinicians should be aware of specifi c “red fl ag ” rule-out symptoms that may suggest organic disease rather than FAP. Although an organic etiology for functional abdominal pain is unclear, substantive research supports the role of “visceral hyperalgesia ” and biopsychosocial determinants in the maintenance of FAP. Prognostic factors for this condition suggest that individuals reluctant to adopt a biopsychosocial model of pain are more likely to experience continued symptoms and impairment into adulthood. Assessment of FAP generally involves a thorough history and minimal laboratory tests. For treatment, several promising biobehavioral strategies have received empirical support for successfully addressing FAP symptoms. This chapter will review our current understanding of FAP, how to adequately assess for this condition, and promising treatment strategies for children with living with painful FGIDs.