Chronic and recurrent abdominal pain: Case

This boy shows the classic features of a functional abdominal pain disorder: recurrent central pain over months, tightly linked to school mornings and relieved at weekends, in a well child with steady growth and a normal examination. The absence of alarm features and preserved growth allow a positive diagnosis, while his anxiety, the school avoidance, and the recent family bereavement are the psychosocial drivers that management must address. ^[1]

Clinical findings

The pattern is strongly functional. Periumbilical pain that clusters with school stress and eases on holidays reflects the brain-gut mechanism, and the normal growth and examination make significant organic disease unlikely. The grandfather's bowel cancer is a source of family fear rather than a genuine red flag, because adult sporadic colorectal cancer does not confer meaningful childhood risk, though it must be acknowledged and addressed sensitively. The differential still includes coeliac disease and, if the pattern were to change, inflammatory bowel disease. ^[2]