Chronic Abdominal Pain


Abdominal pain is essentially defined as a sensation of discomfort, distress or agony in the abdominal region, generally associated with functional disorders, tissue injuries and diseases.

The abdomen is an anatomical area, bounded by the lower margin of the ribs above, the pelvic bone (pubic ramus) below and the flanks on each side.

The term ‘abdominal pain’ is also generally used to refer to the pain that originates from organs within the abdominal cavity (from beneath skin and muscles), including the stomach, small intestine, colon, liver gallbladder and pancreas.

A pain in abdomen is termed as ‘chronic abdominal pain’ if it lasts for more than 6 months.

Subcategories of Pain

Pain in the abdomen can be further classified in to various subcategories, including:

Stomach cramps

Stomach ache


Liver pain

Acute abdominal pain

Chronic Abdominal Pain in children

Chronic abdominal pain in children is defined as a pain of more than two weeks duration. The pain might be persistent or recurrent and the intensity varies with age, gender, genetic predisposition, nutritional exposure and many environmental factors.

This type of pain is a common pediatric problem encountered by primary care physicians, medical subspecialists and surgical specialists. According to the International Foundation for Functional Gastrointestinal Disorders, this syndrome causes a vast number of children to miss more schooldays, suffer social withdrawal and feel anxious and depressed about their condition.

Especially in children, there are a series of warning signs to look for. Immediate medical intervention should be sought if any of the below seem to exist:

Severe abdominal pain that wakes up the child at night

Persistent vomiting


Weight loss

Having bloody stools or vomiting blood

Key Symptoms

A series of symptoms indicate that the abdominal pain is chronic in nature. Here we list the few main symptoms of chronic abdominal pain:

Pain that becomes worse with eating

Pressure in the abdomen when you lie down at night

Pain relief after having antacids

Sharp pangs of pain brought on by greasy or fatty foods

Repetitive and alternate episodes of loose and hard bowel movements

Diarrhea-like bowel movements mixed with mucus and blood

Recurrent bouts of pain with fever

Loss of appetite

Causative Factors

Chronic abdominal pain is most commonly caused by a series of gastrointestinal causes. Here we list a few main ones amongst these causes:

Loss of appetite

Peptic ulcers

Chronic pancreatitis

Gastroesophageal reflux disease


Gallbladder disease

Irritable bowel syndrome

Inflammatory bowel disease

However, chronic abdominal pain also might be the result of certain uncommon and rare causes, often difficult to diagnose. These include:

Abdominal wall pain

Fibromyalgia (Myofacial Pain Syndrome)

Painful rib syndrome

Tietze’s syndrome

Posttraumatic pain


Thoracic disk herniation

Spinal-muscle or vertebral-body disorder

Metabolic disease

Psychological disorder

Treatment Strategies

The aim of a treatment plan for chronic abdominal pain is to help gain control over the symptoms and improve daily life efficiency. Various forms of treatment adopted include:

Medications (painkillers and antidepressants)

Surgical procedures

Psychological counseling