Topic Overview

Recurrent abdominal pain (RAP) with no cause is
defined as at least 3 separate episodes of abdominal pain that occur in a
3-month period. These episodes are often severe, and the child is not able to
do his or her normal activities. It may affect up to 30% of children between
the ages of 4 and 12.

Symptoms of RAP are different for every child and may change with
each episode. Symptoms may include:

  • Sharp or dull pain.
  • Severe pain that causes the child
    to look pale, become sweaty, or cry and bend over in pain.
  • Pain
    that lasts a few minutes or hours.
  • Pain in the belly button area or
    anywhere in the belly.
  • Pain that may or may not be related to
  • Pain that occurs anytime of the day or
  • Abdominal pain that occurs with vomiting, headaches, or pain
    in the arms or legs.
  • Not being hungry like normal or skipping meals
    but usually without losing weight.

A physical cause is found in less than 10% of children diagnosed with
RAP. The physical exam and routine tests often do not show any abnormal
problems. As with chronic conditions, RAP may get worse with stress, anger, or

A child with RAP should eat regular meals, not skip any meals, and
not overeat at any one meal. Different foods, such as spicy foods or dairy
foods, may trigger an episode in some children. Your child should not eat any
foods that cause abdominal pain.

It is important to keep your child doing normal activities as much as
possible so that he or she can cope with the symptoms of RAP. Many children are
able to keep their pain under control if they remember it is “just their usual
bellyache” when the pain starts. Be sure that your child has regular meal and
snack times as well as a regular bedtime so he or she gets enough sleep.

About one-third of children with RAP feel better when they recognize
their symptoms and how to deal with them. Another third of children will feel
better but may have other ongoing problems with their intestines or stomach.
Another third will have ongoing episodes of RAP.

Having RAP does not increase the chance of the child having an ulcer
or other intestinal problem as an adult. But any child complaining of
ongoing abdominal pain should be evaluated by a doctor.


ByHealthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP – Emergency Medicine
Adam Husney, MD – Family Medicine
Kathleen Romito, MD – Family Medicine

Current as ofMarch 20, 2017