Dr Chai Pei Fan, Consultant Paediatric Gastroenterologist at Pantai Hospital Kuala Lumpur

In medical terms, a stomach ache or bellyache is called abdominal pain. If a child has abdominal pain that comes and goes regularly, they might have recurrent abdominal pain (RAP).

According to Dr Chai Pei Fan, Consultant Paediatric Gastroenterologist at Pantai Hospital Kuala Lumpur, recurrent abdominal pain (RAP) in children, as defined by Apley’s criteria, is having at least three episodes of pain that occur over at least three months and affect the child’s ability to perform their usual activities.

The daily activity in children that are often affected includes attending school, playing with friends, doing routine sports, or any other social activities.

This type of abdominal pain is often vague and is described as pain “all over” the tummy. It usually lasts for minutes or less than one hour and typically occurs in children between the ages of five and ten.

Recurrent abdominal pain (RAP) is a descriptive term and not a diagnosis. It has been defined as at least three bouts of pain occurring over at least three months that are severe enough to affect daily activities.

When to see a doctor?

Studies in children had reported about 10% of school-going children may experience abdominal pain at some stage. Although abdominal pain is quite common, it’s important to look out for severe symptoms that might indicate a more serious underlying problem.

Some of the more serious accompanying symptoms of recurrent abdominal pain (RAP) may include:

• Sharp localised pain on the abdomen
• weight loss
• slowed growth
• significant vomiting
• recurrent fever
• pain that interrupts your child’s sleep at night
• blood in their stool (poo)
• pain when urinating (peeing) or feeling urgency to pee
• changes in stool pattern (example: pooing more frequently or less frequently than the usual)

What Causes Recurrent Abdominal Pain (RAP)?

There are a number of causes for recurrent abdominal pain (RAP). These causes include those affecting the intestines and other organs in the abdomen. The possible causes may include:

• constipation
• irritable bowel syndrome (IBS)
• food sensitivities (for example, lactose intolerance)
• heartburn (gastroesophageal reflux)
• abdominal migraines
• anxiety or depression
• inflammatory bowel disease (IBD), such as Crohn’s disease or ulcerative colitis
• recurrent urinary tract infections, renal stones
• inflammation of gallbladder or pancrease

Most children don’t have a proper diet and they’re not drinking enough water which can be a contributing factor to recurrent abdominal pain (RAP) – Dr Chai Pei Fan, Consultant Paediatric Gastroenterologist at Pantai Hospital Kuala Lumpur

If your child does not have any of the serious symptoms above, but still have RAP, try keeping a pain diary for your child. Record when the pain happened, how long it lasted and if there were any triggers. This will be very helpful when you go to see your child’s doctor.

“The key is to find out what the core underlying cause is so that they can get an early diagnosis and proper treatment,” concludes Dr Chai.