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Chronic, recurrent abdominal pain can be caused by organic disorders, such as constipation, ulcers, lactose intolerance, Crohn’s disease, irritable bowel syndrome, ulcerative colitis, or gastroesophageal reflux disease.

However, some abdominal pain is related to functional disorders, which have no identifiable cause. FAP is often brought on by stress or anxiety. In addition, experts believe that functional abdominal pain is a disorder of the nervous system, where nerve impulses are hyperactive and cause pain.

Depending on the cause, many associated symptoms occur along with chronic abdominal pain. These symptoms include dyspepsia, nausea, vomiting, constipation, diarrhea, headache, fatigue, and dizziness.

Relaxation techniques - Because stress can worsen pain, many patients benefit from relaxation therapies. This involves deep breathing exercises, which are performed for 10 minutes 2-3 times each day.

Medications - Antidepressants stimulate the brain to increase signals that block pain sensation transmission from the abdomen to the brain. Other medications used for chronic abdominal pain include stool softeners, nonsteroidal anti-inflammatory drugs (NSAIDs), and analgesics.

Dietary changes - Certain dietary changes can help with chronic abdominal pain. This includes avoiding lactose products that cause bloating, cramping, and gas; eating a high-fiber diet; and avoiding triggers, such as caffeine, high-fat foods, and gas-producing foods (beans, cabbage, and onions).

Celiac plexus block and neurolysis - With the block, the doctor numbs the skin with an anesthetic agent, and then places small needles into the back near the celiac plexus nerves. To assure correct placement, x-ray guidance is used. The doctor injects a numbing agent (block) or uses a neurolytic substance to destroy a portion of the nerves (neurolysis). In a recent meta-analysis, the block had a success rate of 90% and for patients who had neurolysis, and 90% reported pain relief that lasted for 3 months or longer.

Patient controlled analgesia (PCA) - For patients with long-standing CAP, FAP, or RAP, the doctor may recommend a PCA pump. This involves delivery of pain mediation through the vein (IV), and the patient can control the dosing of the drug.

Superior hypogastric plexus block - The hypogastric plexus is a nerve bundle that supplies the abdomen. With this block, the doctor numbs the skin with an anesthetic substance, and uses x-ray guidance to insert small needles into the back. Once in position, a long-acting anesthetic is injected onto the nerves. According to research studies, this block has a 72% efficacy rate, with pain relief lasting for up to 6 months.