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Chronic Functional Abdominal Pain

What is chronic functional abdominal pain (CFAP)?

CFAP is chronic or frequent pain for which there is no known cause. No infection or disease can be found.

What causes CFAP?

We believe that CFAP is a disorder of the nervous system. Nerve impulses are increased “like a stereo system turned up too loud” and result in pain. 

Certain parts of the brain sense abdominal pain. One part is focused on the amount of pain and where it is located. The other part is focused on memories and feelings. Our nerves and the way we sense pain can be affected by feelings and stress.

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While symptoms of CFAP can come on without a cause, they can also happen after a stressful event. During times of added stress, symptoms can get worse. Injury, such as surgery, can also cause nerves in the abdomen to become very sensitive. Even normal abdominal activity may be painful. This is sometimes called hypersensitivity of the abdominal organs.

What is the treatment?

The goal for treating CFAP is to help you gain control over and improve your symptoms to allow the most pain relief. Sometimes medicine is prescribed to help with pain. The most important treatment is the use of non-medicine techniques to relax and distract yourself from the pain.  

How does the treatment work?

The brain not only affects how you feel pain, it is also able to block pain. When nerve impulses travel up from the abdomen they go through a “gate” that is controlled by nerve impulses coming down from the brain. These impulses can block pain signals by closing the gate. You can use techniques to close the gate to pain signals.

How can I retrain my brain to decrease my feelings of pain?

There is no proven way to do this, but there are some things you may want to try. The first step is to understand how and when your symptoms start. Use a journal to keep track of your bowel movements, pain symptoms, and feelings during the day. This can help you find patterns and triggers. Be sure to bring your journal to clinic when you see your doctor.  

What can I do to relax?  

It helps to have a few different ways to relax. Some ideas you can try:

  • Exercise

  • Read 

  • Watch TV 

  • Practice mind body techniques like yoga, meditation and tai chi.   

  • Talk to other people about your feelings. If this sounds like you, ask family and friends to listen to you. Join a support group to talk about your feelings related to CFAP.

  • Write your feelings down in a journal. If this sounds like you, set aside time each day to write. 

What medicines are used to treat abdominal pain?

Medicines may be used to treat the pain or other problems like constipation, diarrhea, or anxiety. For constant or severe pain, your doctor may order medicines that block nerve messages of pain. This may include an anti-depression medicine, muscle relaxants, or anti-seizure medicine. It may take a few weeks before you see a change. Opioid medicines (narcotics) rarely help with CFAP and can be harmful. Over time, opioids can worsen symptoms of CFAP.

Each medicine is different and can cause side effects. Take time to understand what the side effects are and when to report them to your doctor. Often, the side effects will go away after a few days. Try to keep taking the medicine(s) until you feel it is working. 

Do I need follow-up care?

It helps to see a doctor who has an interest and is an expert in CFAP. Treatment works best when you and your doctor act as a team. Your doctor will teach you about CFAP and what your treatment options are. You know yourself and your symptoms best, and how they respond to the treatments. The result is a plan that allows you to have the most pain relief.

If you are a patient receiving care at UnityPoint – Meriter, Swedish American or a health system outside of UW Health, please use the phone numbers provided in your discharge instructions for any questions or concerns.