Recurrent Abdominal Pain (RAP)

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 eating.
• Pain that occurs anytime of the day or night.
• 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 excitement.

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.