Case Report: Breaking the cycle: preventing diagnostic escalation in pediatric chronic functional abdominal pain
By
Khayreddine Bouabida
Margarieta Okang
June 18, 2026
Clinical Scorecard: Case Study: Interrupting the Diagnostic Cycle in Pediatric Patients with Chronic Functional Abdominal Pain
At a Glance
Category Detail
Condition Chronic Functional Abdominal Pain (FAP-NOS) Key Mechanisms Disorders of gut-brain interaction (DGBI) affecting visceral sensitivity, gastrointestinal motility, central sensitization, autonomic regulation, and psychosocial modulation. Target Population Pediatric patients with chronic abdominal pain without identifiable structural disease. Care Setting Tertiary care centers and pediatric gastroenterology.
Key Highlights
Chronic abdominal pain in children often stems from DGBI. Diagnostic uncertainty can lead to unnecessary invasive interventions. Families may misinterpret normal test results as evidence of missed diagnoses. Symptoms may persist despite normal evaluations and invasive procedures. Effective communication about gut-brain mechanisms is crucial. Guideline-Based Recommendations
Diagnosis
Utilize Rome IV criteria for diagnosing functional abdominal pain. Management
Engage in gut-brain-directed therapies to address functional recovery. Monitoring & Follow-up
Regular follow-up to assess symptom progression and functional status. Risks
Iatrogenic harm from unnecessary diagnostic escalation and invasive procedures. Patient & Prescribing Data
Children with chronic functional abdominal pain.
Focus on validating symptoms and addressing caregiver concerns to prevent diagnostic escalation.
Clinical Best Practices
Provide clear explanations of gut-brain mechanisms to families. Avoid unnecessary invasive interventions when evaluations are normal. Support functional recovery through appropriate therapeutic approaches. Related Resources & Content
