Functional Abdominal Pain in Children: When to Call the Doctor

Tummy ache
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If your child experiences frequent stomachaches, such as is the case with the health condition functional abdominal pain (FAP), it can be difficult to know when their symptoms are severe enough to warrant a call to your doctor.

FAP is diagnosed when a child experiences frequent and severe bouts of abdominal pain, for which there is no known cause. FAP is differentiated from irritable bowel syndrome (IBS) when there are no changes in bowel movement frequency and appearance (e.g. diarrhea or constipation).

It is not clear what causes FAP, but it is often triggered by anxiety or the stress that accompanies major changes in a child's life. In some cases, FAP may be related to a child's need for attention.

This concern that your child is just "doing it for attention" may complicate your ability to make a decision about when to call the child's doctor. To give you some guidelines, I turned to an article on chronic abdominal pain in children and adolescents published by UpToDate, a trusted electronic reference used by many physicians and patients looking for in-depth medical information. This is what I found out:

"Parents of children with chronic or recurrent abdominal pain who also have the following signs or symptoms should call their healthcare provider immediately:

  • Bloody stools, severe diarrhea, or recurrent vomiting
  • Abdominal pain that is severe and lasts more than one hour, or severe pain that comes and goes and lasts more than 24 hours
  • Refusing to eat or drink anything for a prolonged period
  • Fever greater than 102ºF (39ºC), or fever greater than 101ºF (38.4ºC) for more than three days.
  • Pain when urinating, needing to urinate frequently or urgently
  • Behavior changes, including lethargy or decreased responsiveness"

The symptoms described above could be considered "red-flag" symptoms, in that they indicate that your child may be experiencing a more serious health condition than only stomach pain. If your child is experiencing any of these symptoms, it is essential that they be seen promptly by qualified medical personnel.

If your child is in pain but is not experiencing any of the above symptoms, your best strategy is to strive for a balance in which you work to soothe your child's anxiety about their pain, while encouraging them to engage in activities that will distract them from their discomfort. Long-term strategies for dealing with chronic abdominal pain include:

Want to learn more? See UpToDate's topic, "Patient information: Chronic abdominal pain in children and adolescents" for additional in-depth, current and unbiased medical information on abdominal pain in children, including expert physician recommendations.


Chacko, Mariam R. "Patient information: Chronic abdominal pain in children and adolescents" UpToDate. Accessed: October 2009.

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