Abdominal pain is one of the most common presentations to paediatric clinics. Chronic or recurrent abdominal pain (RAP) is one of the most commonly encountered events in childhood interfering in the normal lifestyle of up to 10-15 % of all children at some point.
Acute onset of severe abdominal pain especially localised to the right lower part of the abdomen should arouse suspicion of serious surgical conditions such as appendicitis. Any pain of sudden onset associated with vomiting also needs urgent attention particularly if the vomit is green.
In most cases chronic pain does not necessarily mean a serious gut disorder. However it is important that a careful assessment is performed to look for any worrying symptoms such as nocturnal pain waking the patient from sleep and other features such as diarrhoea, blood in stool or weight loss.
In most instances, routine blood tests are performed to screen for Coeliac disease, thyroid abnormalities and inflammatory bowel disease. If all tests come back negative and no unusual features identified a possibility of functional abdominal pain is considered which may be related to psychosocial factors.