Gems Medical Specialists is proud to share that Dr. Cheng Hiang Lee, our Paediatric Gastroenterologist, was invited to present a lecture on Functional Abdominal Pain (FAP) in Children and Adolescents at the 2025 Practical Paediatrics for the General Practitioner Weekend, hosted by the Sydney Children’s Hospitals Network (SCHN) Education Hub.
Understanding Functional Abdominal Pain in Children (FAP)
Recurrent abdominal pain is one of the most common complaints in childhood, affecting approximately 25% of children globally. Unlike pain caused by diseases like Crohn’s disease or coeliac disease, FAP originates from dysfunction in the gut-brain axis—the complex communication network between the digestive system and central nervous system.
The development of FAP can be best understood through the biopsychosocial model, which recognizes multiple interacting factors:
- Biological factors: Including genetic predisposition and alterations in gut microbiota (dysbiosis)
- Psychological factors: Such as stress, anxiety, and heightened pain sensitivity
- Social factors: Including family dynamics and environmental stressors
These factors collectively lead to visceral hypersensitivity, where the nervous system becomes overly sensitive to normal gut sensations, causing real pain despite the absence of structural damage or inflammation.
Diagnosing Functional Abdominal Pain
A comprehensive medical assessment, including history, examination, and screening investigations, should be completed before diagnosing FAP. The Rome IV criteria are the gold standard for diagnosing functional gastrointestinal disorders in children. These evidence-based guidelines help clinicians differentiate between specific FAP subtypes, including:
- Irritable Bowel Syndrome (IBS)
- Functional Dyspepsia
- Abdominal Migraine
- Functional Abdominal Pain – Not Otherwise Specified (NOS)
Red Flags: When Should Parents Worry?
While most recurrent tummy pain is harmless, warning signs that need urgent evaluation include:
⚠️ Weight loss
⚠️ Persistent vomiting/diarrhoea
⚠️ Blood in stool or vomit
⚠️ Difficulty swallowing
⚠️ Fever or joint pain
If your child has no red flags but has ongoing pain, a consultation with your GP or a paediatric gastroenterologist can help rule out serious causes.
Helping Your Child Manage Functional Abdominal Pain
After checking for serious causes, we focus on:
✓ Believing your child’s pain is real, even if scans look normal
✓ Avoiding unnecessary tests that may increase anxiety
✓ Teaching lifelong skills to manage discomfort
Treatment for functional abdominal pain is tailored to your child’s needs.
- Dietary Adjustments (guided by a paediatric dietitian)
Start with basics: Focus on good hydration and appropriate amounts of fruits and vegetables. Avoid highly processed foods.
Keep a food diary: Helps spot patterns and identify foods that trigger abdominal symptoms. - Relaxation Techniques (guided by a gut specialist psychologist)
Gut-directed hypnotherapy teaches kids to soothe their digestive system. - Focus on Normalised Daily Function
Aim to reintegrate children with functional abdominal pain back into school and extracurricular activities. - Medications (only if needed)
Concerned About Your Child’s Abdominal Pain?
If your child suffers from chronic abdominal pain, Dr. Cheng Hiang Lee and the Gems Medical Specialists team are here to help your family. Please contact us at
📞 Call: (02) 7228 4428
📧 Email: reception@gemsmedic.com
Gems Medical Specialists 