Pediatric Chronic Abdominal Pain: A Practical Approach

• Dr. M.A. Kambal — Consultant in Pediatrics, Pediatric Gastroenterology, Endoscopy and Nutrition at Specialized Medical Center Hospital, Riyadh, and an Adjunct Assistant Professor at Alfaisal University

Paediatrics

Chronic abdominal pain in children requires a structured approach to distinguish functional disorders from gastrointestinal, urinary, inflammatory, or other organic causes. Assessment begins with a detailed history covering pain characteristics, bowel habits, diet, growth, psychosocial factors, medication use, and associated symptoms, supported by a focused physical examination. Red flags such as weight loss, gastrointestinal bleeding, persistent vomiting, fever, growth faltering, nocturnal symptoms, or localized pain warrant further evaluation. Investigations should be guided by clinical findings rather than performed routinely. Management focuses on addressing the underlying cause, optimizing nutrition and bowel habits, providing reassurance, and supporting normal daily activities. Children with functional abdominal pain benefit from a biopsychosocial approach, with appropriate follow-up to monitor symptoms, growth, and treatment response.