Functional Abdominal Pain
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Functional abdominal pain (FAP) also known as intractable abdominal pain, is persistent stomach pain that does not resolve with usual therapeutic treatment. The pain may be constant or may come and go. FAP was originally defined as a pain syndrome composed of at least three episodes of abdominal pain over a period of more than 3 months, which can be severe enough to affect daily activity.
Causes and risk factorsBack to top
FAP has no known or specific cause. A variety of conditions could cause FAP, such as a food allergy, infection, or a disease such as Crohn’s disease (which would require long term care and management). Sometimes, FAP can be caused by anxiety or depression in children, or even a trauma could make a child susceptible to FAP.
Signs and SymptomsBack to top
Children with FAP can experience diarrhea, constipation, or both. The child usually feels pain around the belly button, and it can also be painful in other areas of the stomach. The pain may come on suddenly or it may get more severe over time.
Other symptoms of FAP can include:
• abdominal pain with bowel movements
• feeling full after eating a small amount of food
DiagnosisBack to top
FAP can be tricky to diagnose, as the pain, and not any other underlying condition, is the condition. Diagnosis is therefore a process of ruling out any possible underlying cause and trying to determine the cause of the pain. Some tests may be done to confirm there are no underlying concerns, these could include:
• blood, urine, and stool tests
• abdominal x-ray
• abdominal ultrasound
• CT scan
Impact on quality of lifeBack to top
Children suffering from FAP may result in frequent doctor visits and a distinct interruption in school attendance. Parents with children suffering from FAP reported the following:
– Their child’s disability brought the parents together to help their child.
– The siblings received less attention and complained about too much fuss during pain.
– They would have liked a definitive diagnosis that could be treated efficiently.
– Parents felt anxious that an undetected condition triggered pain.
– Some parents knew that social factors could inflict pain and were concerned that their child was unable to distinguish sensations like anxiety and ‘butterfly’ tensions from physical pain.
TreatmentBack to top
If doctors diagnose an underlying cause, treatment will involve managing the specific condition, however, in most cases there is no specific cause for FAP. Doctors will therefore focus on support and education to help the child to have the best possible quality of life.
Treatment for FAP may address pain triggers and how to control them. If the child is suffering from multiple overlapping problems, like heightened sensitivity to light, insomnia, and anxiety, clinicians may take an interdisciplinary approach to alleviating the symptoms.
Prevention and lifestyle changesBack to top
The treatment plan may include one or several of the following:
– pain control
– physical therapy
– nutrition advice and dietary changes
– identification and treatment of specific pain triggers
– cognitive behavioral treatments
– treatment of associated symptoms and problems
– reintegration into school and other activities
– introduction of a daily probiotic
Studies have shown that probiotics can reduce pain, lower pain intensity and improve quality of life of children with FAP, and that children suffering from FAP have more pain free days when they are taking Reuterina Junior. In addition, L. reuteri DSM 17938 – the probiotic strain found in Reuterina Junior is: – The only probiotic strain with proven effect in FAP- not otherwise specified
– Recommended by the World Gastroenterology Organisation (WGO) to alleviate symptoms and improve the quality of life in patients with FAP- not otherwise specified
Reuterina Junior maintains gut health throughout childhood.
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