Clinical Practice and
Referral Guidelines

Chronic Abdominal Pain

Abdominal pain is a frequent chief complaint for visits to pediatricians and the evaluation can be lengthy, complex and expensive. The objective in developing this guideline was to provide the pediatrician with the tools to efficiently triage these children in order to better define functional abdominal pain (FAP) from organic causes.

This guideline includes recommendations for:

  • If history and evaluation, which includes delineation between acute and chronic pain, identification of alarm signs, occult blood testing, urinalysis and urine culture, and other blood tests as indicated.
  • If history, physical and lab tests are negative, education with the child and the family may include definition of FAP, causes, patterns within occurrence and treatment options.
  • If history, physical or lab tests reveal positives not consistent with FAP, evaluation should continue based on abnormal symptoms or signs.
  • If evaluation if consistent with known organic diagnosis, appropriate referral or treatment should follow.
  • If evaluation is non-diagnostic and the condition is severe enough to significantly affect the quality of life, referral to a pediatric gastroenterologist may be considered.

If you are a physician and would like more information on the Clinical Practice and Referral Guideline for Chronic Abdominal Pain, please email If you are a parent and are concerned about your child’s chronic abdominal pain, please consult with your child’s pediatrician or primary care physician.

This guideline was developed from the American Academy of Pediatric Subcommittee on Chronic Abdominal Pain and NASPGHAN Committee on Abdominal Pain, 2005. The recommendations in the KHF guidelines do not indicate an exclusive course of treatment. The intent is to build a consensus of care in the pediatric market and provide a framework for clinical decision-making. This guideline was last revised in 2/2010. 

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