| Functional abdominal pain syndrome | |
|---|---|
| Other names | Centrally mediated abdominal pain syndrome (CMAP), chronic functional abdominal pain (CFAP) |
| Specialty | Gastroenterology |
Functional abdominal pain syndrome (FAPS), chronic functional abdominal pain (CFAP), or centrally mediated abdominal pain syndrome (CMAP) is a pain syndrome of the abdomen, that has been present for at least six months, is not well connected to gastrointestinal function, and is accompanied by some loss of everyday activities. The discomfort is persistent, near-constant, or regularly reoccurring. The absence of symptom association with food intake or defecation distinguishes functional abdominal pain syndrome from other functional gastrointestinal illnesses, such as irritable bowel syndrome (IBS) and functional dyspepsia.[1]
Functional abdominal pain syndrome is a functional gastrointestinal disorder meaning that it is not associated with any organic or structural pathology. Theories on the mechanisms behind functional abdominal pain syndrome include changes in descending modulation, central sensitization of the spinal dorsal horn, peripheral enhancement of the visceral pain afferent signal, and, central amplification.
The diagnosis of functional abdominal pain syndrome is made based on clinical features and diagnostic criteria. A thorough clinical history must be taken to accurately diagnose functional abdominal pain syndrome. Diagnostic testing to rule out organic disorders should only be done when alarm features are present. Differential diagnosis of functional abdominal pain syndrome includes a variety of other functional gastrointestinal disorders.
There is no well-established treatment for functional abdominal pain syndrome. General measures such as a positive physician-patient relationship are beneficial. Antidepressants are often used to treat other functional gastrointestinal disorders and may be helpful in treating functional abdominal pain syndrome. Psychological interventions including various forms of therapy can also be helpful. While the exact presence of functional abdominal pain syndrome is unknown studies show that it affects between 0.5% and 2% of North Americans. Functional abdominal pain syndrome is more common in women than men and usually occurs in the fourth decade of life.