Recurrent Abdominal Pain Syndrome in Children

Recurrent Abdominal Pain Syndrome in Children (RAP) is a common cause of repeated episodes of belly pain in otherwise healthy children. It is a common cause for missing school and other activities.

CAUSES

The pain of RAP is real but there is no known cause. Although it can cause stress for the child and family, it is not a serious disease. Stress in the child's life may make the pain worse.

SYMPTOMS

Common symptoms of RAP include:

  • Repeated episodes of belly pain – usually around the belly button.

  • Pain that lasts 1 to 3 hours.

  • The child often lies down with the belly pain.

  • After the pain, the child acts normally.

DIAGNOSIS

Diagnosis of RAP is based mostly on the story and a normal physical exam. Your caregiver may have ordered one or more tests to search for other causes of belly pain. If testing has been ordered and all tests are normal, there is a greater chance that the problem is RAP Syndrome.

TREATMENT

Most children with RAP get better with time. Your child's caregiver may suggest:

  • The child keep a diary of when the pain comes, how long it lasts, what helps, where the pain is located, etc.

  • Your child should go to or stay in school even if the pain is present.

  • Parents and the school should approach the child with RAP in a consistent manner.

  • Over the counter pain medicines (other than aspirin which should not be given to young children).

  • Referral for counseling or relaxation therapy.

HOME CARE INSTRUCTIONS

  • Distract your child with toys, books, games, etc.

  • Try gentle rubbing of the belly.

  • Check with your child or the school for stresses such as teasing, bullying, etc.

Finding out the results of your tests

If tests have been ordered, not all test results may be available during your visit. If your test results are not back during the visit, make an appointment with your caregiver to find out the results. Do not assume everything is normal if you have not heard from your caregiver or the medical facility. It is important for you to follow up on all of your test results.

SEEK MEDICAL CARE IF:

  • The pain is worse or more frequent.

  • The pain is located in one place (other than the belly button).

  • Pain wakes your child up at night.

  • Pain comes with eating.

  • Heartburn.

  • Unexplained fever.

  • Weight loss.

  • Diarrhea or constipation.

  • Feeling sick to one's stomach (nausea) or repeated vomiting.

  • Excessive belching.

  • Your child looks pale, tired or disoriented during or after the pain.

  • Urinary pain or frequent urination.

  • Blood in stools (red, dark red, or black stools).

SEEK IMMEDIATE MEDICAL CARE IF:

  • Vomiting red blood or material that looks like coffee grounds.

  • Belly is swollen or bloated.

  • Pain and tenderness in one part of the belly (appendicitis commonly causes right lower belly pain and tenderness).