Chronic Abdominal Pain in Children
Chronic abdominal pain is a common issue among children. Studies show that approximately 14 percent of children experience it. The most common causes are disorders of gut-brain interaction (DGBI), previously known as functional gastrointestinal disorders. These conditions involve a sensitivity of the nerves in the intestines, often related to stretching pressures within the gastrointestinal tract.
At RWJBarnabas Health, our comprehensive pediatric gastroenterology specialists provide expert care for children with chronic abdominal pain, ensuring they receive the best possible treatment and support.
What Is Chronic Abdominal Pain?
Chronic abdominal pain persists in the abdomen for weeks or even months. It’s not just a one-time occurrence; it can come and go or be constant. This pain can disrupt a child's daily activities, including school, playtime, and social activities. It's important to understand that this pain is real and can significantly impact a child's quality of life.
Types of Chronic Abdominal Pain We Treat
At RWJBarnabas Health, we treat various types of chronic abdominal pain, including:
- Functional abdominal pain
- Functional dyspepsia
- Irritable bowel syndrome (IBS)
- Peptic ulcer disease (PUD)
- Chronic pancreatitis
- Celiac disease
- Lactose intolerance
Chronic Abdominal Pain Causes
A variety of factors can cause chronic abdominal pain in children. Some common causes include:
- Disorders of gut-brain interaction (DGBI). These conditions involve a sensitivity of the nerves in the intestines.
- Celiac disease. An autoimmune condition where the ingestion of gluten leads to inflammation and damage to the small intestine's lining.
- Lactose intolerance. Difficulty digesting lactose in milk; Unabsorbed lactose causes gas, bloating and diarrhea.
- Peptic ulcer disease. Using nonsteroidal anti-inflammatory medications or an infection with H. pylori often causes stomach or small intestine ulcers.
- Chronic pancreatitis. This condition involves severe pain in the upper abdomen and may be due to genetic mutations.
Chronic Abdominal Pain Symptoms
The symptoms of chronic abdominal pain in children can vary, but common signs to look out for include:
- Weight loss or poor weight gain
- Blood in the stool
- Persistent vomiting
- Pain localized to a specific organ, not the belly button
- Difficulty or painful swallowing
A family history of inflammatory bowel disease, celiac disease, or peptic ulcer disease can be a clue. Other symptoms might include nausea, diarrhea, bloating, and changes in bowel habits. If your child is experiencing any of these symptoms, it is important to seek medical advice to determine the underlying cause and appropriate treatment.
Chronic Abdominal Pain Diagnosis
Diagnosis often involves:
- Screening blood tests (for example, anti-tissue transglutaminase IgA for celiac disease)
- Upper endoscopy for biopsy and confirmation
- Trial of lactose or a breath test for lactose intolerance
- Using specific diagnostic criteria called the Rome IV criteria for DGBIs
- Imaging studies if pain is localized to a specific organ
Chronic Abdominal Pain Treatments
RWJBarnabas Health offers comprehensive support services to help manage chronic abdominal pain, including:
- Cognitive behavioral therapy. A psychological treatment method that helps manage symptoms of digestive disorders by changing negative thought patterns.
- Anti-spasmodic medications. Drugs that relieve muscle spasms in the digestive tract, reducing abdominal pain and discomfort.
- Neuromodulators. Medications like low-dose antidepressants that alter nerve activity to reduce pain and improve gut function.
- Low-FODMAP diet. A dietary approach that reduces intake of fermentable carbohydrates to alleviate symptoms of IBS.
- IB-Stim. An FDA-approved medical device that uses electrical stimulation of ear nerves to reduce symptoms of functional gastrointestinal disorders.
- Gluten-free diet. A strict diet that excludes gluten to prevent immune reactions and damage to the small intestine in patients with celiac disease.
- Limiting lactose or using lactase supplements. Adjustments that help manage symptoms of lactose intolerance by reducing or breaking down lactose.
- Acid-blocking medications. Drugs that decrease stomach acid production, promoting healing of ulcers and reducing peptic ulcer disease symptoms.
Regular screening and early detection can help manage and prevent the progression of conditions causing chronic abdominal pain. For example, early screening for celiac disease in at-risk children can lead to timely dietary adjustments.
Help for Chronic Abdominal Pain
If your child is experiencing chronic abdominal pain, contact RWJBarnabas Health to schedule an appointment with our pediatric gastroenterology team. We are here to provide comprehensive care and support to help your child lead a healthy and active life.