Children with recurring stomach pain often hurt elsewhere too, study finds

A study of 522 Hungarian adolescents found that most children with functional abdominal pain also reported pain elsewhere, with school pressure, bullying and poor quality of life among associated warning signs.

Many parents take comfort when repeated stomach pain in a child leads to tests that find no clear disease. But new research from Semmelweis University suggests that a negative result should not always be treated as the end of the story. In adolescents with functional abdominal pain disorders, the pain often appears alongside symptoms elsewhere in the body, and in many cases it has been going on for at least a year.

The study, published in the International Journal of Pediatrics, examined 522 Hungarian schoolchildren aged 11 to 18. It found that 80.6% of those with functional abdominal pain disorders reported pain in more than one part of the body, while 54.8% said their main pain was outside the abdomen. Headaches were the most common extra symptom, but joint and back pain were also frequent.

The researchers said the pattern may begin with an initial trigger such as infection or inflammation. If pain continues and is accompanied by stress, anxiety or other psychological strain, the body’s pain-processing system can become more sensitive over time. That can leave children reacting painfully to sensations that would normally be harmless, including ordinary digestion after a meal.

János Major, the study’s first author and an assistant professor at Semmelweis University, said doctors and parents should look beyond the stomach when a school-age child has recurring abdominal pain. He said the symptoms may point to a broader pain disorder rather than an isolated physical problem, even in children who have already been diagnosed with conditions such as coeliac disease or Crohn’s disease if those illnesses are no longer driving the symptoms.

The study also linked these pain disorders to school life. Adolescents with functional abdominal pain disorders were more likely to report too much academic pressure, too little calm in the classroom and unfair treatment by teachers. Peer exclusion and harassment were also more common. According to the researchers, 14.5% of the affected teenagers had health-related quality of life scores in the extremely low range, with verbal bullying and multisite pain standing out as important warning signs.

Szilvia Ádám, the study’s senior author, warned against assuming children will simply outgrow the problem. She said the factors that set off or sustain the pain may not disappear without help. The researchers argued that timely support matters because persistent pain can affect school attendance, daily functioning and, in some cases, continue into adulthood. They said treatment may include psychological support, changes in the school environment and pain management started early in childhood.