Functional abdominal pain

Common, Gastro, General paediatrics

Rome III classification (now Rome IV?) of functional GI disorders – has child section.  Colic, rumination, cyclical vomiting, diarrhoea, dyspepsia, abdo migraine, IBS, abdominal pain, constipation.

Functional abdominal pain (FAP) must include all of the following:

  • Episodic or continuous abdominal pain

  • Insufficient criteria for other functional GI disorders

  • No evidence of an inflammatory, anatomic, metabolic, or neoplastic process that explains the subject’s symptoms

Criteria fulfilled at least once per week for at least 2 months before diagnosis

Childhood Functional Abdominal Pain Syndrome

Must include childhood functional abdominal pain, and at least 25% of the time have 1 or more of the following:

  • Some loss of daily functioning

  • Additional somatic symptoms such as headache, limb pain, or difficulty sleeping

Criteria fulfilled at least once per week for at least 2 months before diagnosis

That loss of daily function is an optional criterion is because it would exclude motivated children who continued activity despite the pain and children whose parents insisted that they continue activities. However, it is recognized that there is a subgroup of children in whom loss of daily functioning and/or accompanying somatic symptoms form an important component of their symptom complex. This group is now referred to as having FAPS.