{"id":4060,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/irritablebowelsyndromeibsfunctionalabdominalpainfap\/"},"modified":"2026-09-15T13:14:35","modified_gmt":"2026-09-15T12:14:35","slug":"irritablebowelsyndromeibsfunctionalabdominalpainfap","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/paediatrics\/paediatricgastrointestinal\/irritablebowelsyndromeibsfunctionalabdominalpainfap\/","title":{"rendered":"Irritable Bowel Syndrome (IBS) and Functional Abdominal Pain (FAP)"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><strong>Information <\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">IBS\/FAP is common.&nbsp; 10-15% of school aged children will experience abdominal pain but 90% of these children will have no organic pathology identified.&nbsp; FAP is usually multifactorial; anxiety and parental attention to symptoms usually make things worse whereas acceptance and support usually promote improvement.&nbsp; The teams at SJH &amp; RHSC\/RHCYP have come together to create this helpful guide to be used by anyone supporting families with possible&nbsp;FAP &#8211; including health visitors, school nurses, primary care teams (nursing and medical) as well as other people engaged in the care of younger people, more detailed information can be found here: <a rel=\"noreferrer noopener\" href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/PAEDIATRIC-IRRITABLE-BOWEL-SYNDROME-AND-FUNCTIONAL-ABDOMINAL-PAIN-v-7-1.pdf\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/PAEDIATRIC-IRRITABLE-BOWEL-SYNDROME-AND-FUNCTIONAL-ABDOMINAL-PAIN-v-7-1.pdf\" target=\"_blank\">Paediatric IBS and Abdominal Pain<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Typically, children and young people with functional bowel conditions will show many of the features:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>&gt;3 episodes per month for at least 2m<\/li>\n\n\n\n<li>in IBS, pain is often related to opening bowels and also often a change is bowel habit<\/li>\n\n\n\n<li>&gt;3 yr old<\/li>\n\n\n\n<li>daily activities are affected<\/li>\n\n\n\n<li>usually primary care tests are all negative<\/li>\n\n\n\n<li>may be associated with other symptoms &#8211; headache, sleep disturbance<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Assessment:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>ask about location of pain, bowel habit, exacerbating and relieving factors and check if the child is well between episodes<\/li>\n\n\n\n<li>dietary triggers: irregular eating patterns, overeating, diets high in fat, sugar, caffeine, carbonated drinks<\/li>\n\n\n\n<li>physical triggers: recent viral illness, food intolerances, chronic illness, low activity levels<\/li>\n\n\n\n<li>psychosocial triggers: problems at school, problems at home, significant life events, use of social media, school avoidance<\/li>\n\n\n\n<li>FHx&nbsp;triggers: parents\/carers or siblings with IBS, GORD, constipation, mental health problems<\/li>\n\n\n\n<li>remember to unlock parental ICE: ideas, <em><strong>concerns<\/strong><\/em> and expectations<br><\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>for health visitors\/school nurses, refer to GP\/primary care team<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>for GP\/primary care team, refer any patient that has red flags (involuntary weight loss, dysphagia, persistent vomiting, faltering growth, etc.)<\/li>\n\n\n\n<li>refer any patient where there is a strong suggestion of organic disease, repeated attendances at practice or ED, breakdown in relationship with 1y care (loss of confidence), significant history of atopy<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong><em>&nbsp;<\/em><\/strong>where no red flags exist and there is a good relationship between family and healthcare provider, primary care assessment and investigation may well suffice<\/li>\n\n\n\n<li>after careful history taking and examination, consider blood tests (Coeliac screen, FBC, UE, CRP, LFT, ESR), urinalysis, FCP if &gt;5yr, Stool for helicobacter, pregnancy test and PUSS where appropriate<\/li>\n\n\n\n<li>where all tests are normal, consider using (Link to PILs)<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Where to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>for Edinburgh patients, refer General Medicine RHCYP<\/li>\n\n\n\n<li>for West Lothian patients, refer Paediatrics SJH<\/li>\n\n\n\n<li>for patients in Fife and Borders, please refer to local services&nbsp;<em>first<\/em>&nbsp;and they can refer on to RHCYP where needed.<\/li>\n\n\n\n<li>refer using SCI-GW &#8211; remember to use &#8216;Advice only&#8217; if this is more appropriate.<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\">\u200b<\/p>\n\n\n\n<figure class=\"wp-block-image\"><div class=\"wpcp-wp-lightbox-host wpcp-advanced-image-lightbox-icon-hover\"><a class=\"wpcp-wp-lightbox-image-link\" href=\"\/files\/sites\/2\/G.I-Abdominal-Pain-flowchart-paeds.png\" data-wpcp-wp-lb-image=\"1\"><img decoding=\"async\" src=\"\/files\/sites\/2\/G.I-Abdominal-Pain-flowchart-paeds.png\" alt=\"G.I. Abdominal Pain flowchart paeds\" \/><\/a><a href=\"\/files\/sites\/2\/G.I-Abdominal-Pain-flowchart-paeds.png\" data-fancybox=\"wpcp-wp-wpcp-wp-1\" class=\"wpcp-lightbox-trigger wpcp-advanced-image-lightbox-icon wpcp-position-top-right wpcp-advanced-image-lightbox-icon-hover wpcp-global-lightbox-icon wpcp-lightbox-icon--global wpcp-lb-icon-style-default\" data-wpcp-lb-icon-source=\"global\" aria-label=\"Open image in lightbox\" data-thumb-src=\"\/files\/sites\/2\/G.I-Abdominal-Pain-flowchart-paeds.png\" data-wpcp-lb-single=\"1\"><span class=\"wpcp-icon-container\"><svg viewBox=\"0 0 20 20\"><path d=\"M17.6585 16.025L14.2437 12.6198C15.1716 11.3338 15.6121 9.7613 15.4871 8.1819C15.362 6.60251 14.6795 5.11847 13.5607 3.99351C12.936 3.36206 12.1916 2.86066 11.3709 2.51845C10.5502 2.17623 9.66952 2 8.77995 2C7.89039 2 7.00969 2.17623 6.18899 2.51845C5.36829 2.86066 4.62395 3.36206 3.99919 3.99351C3.36594 4.61649 2.86312 5.35871 2.51992 6.17708C2.17673 6.99545 2 7.87365 2 8.76068C2 9.64772 2.17673 10.5259 2.51992 11.3443C2.86312 12.1627 3.36594 12.9049 3.99919 13.5279C5.11957 14.6901 6.62279 15.4103 8.23285 15.5562C9.84291 15.7022 11.4517 15.2641 12.7639 14.3224L16.1788 17.7275C16.3849 17.9034 16.6473 18 16.9186 18C17.1899 18 17.4523 17.9034 17.6585 17.7275C18.1138 17.16 18.1138 16.5925 17.6585 16.025ZM5.59278 12.0523C5.16258 11.6298 4.82094 11.1263 4.58774 10.5709C4.35455 10.0156 4.23446 9.41951 4.23446 8.81744C4.23446 8.21536 4.35455 7.6193 4.58774 7.06394C4.82094 6.50859 5.16258 6.00503 5.59278 5.58257C6.01644 5.15359 6.52144 4.81292 7.07838 4.58039C7.63532 4.34786 8.23308 4.22811 8.83687 4.22811C9.44066 4.22811 10.0384 4.34786 10.5954 4.58039C11.1523 4.81292 11.6573 5.15359 12.081 5.58257C12.5112 6.00503 12.8528 6.50859 13.086 7.06394C13.3192 7.6193 13.4393 8.21536 13.4393 8.81744C13.4393 9.41951 13.3192 10.0156 13.086 10.5709C12.8528 11.1263 12.5112 11.6298 12.081 12.0523C11.6573 12.4813 11.1523 12.822 10.5954 13.0545C10.0384 13.287 9.44066 13.4068 8.83687 13.4068C8.23308 13.4068 7.63532 13.287 7.07838 13.0545C6.52144 12.822 6.01644 12.4813 5.59278 12.0523Z\" \/><\/svg><\/span><\/a><\/div><\/figure>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\"><a href=\"\/files\/sites\/2\/IBS-FAP-PILs-1.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">IBS-FAP-PILs 1.pdf<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"\/files\/sites\/2\/IBS-FAP-PILs-2.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">IBS-FAP -PILs 2.pdf<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"\/files\/sites\/2\/IBS-FAP-PILs-3.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">IBS-FAP-PILs 3.pdf<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"\/files\/sites\/2\/IBS-FAP-PILs-Sore-Tummies.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">IBS-FAP-PILs Sore Tummies.pdf<\/a>\u200b<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"\/files\/sites\/2\/IBS-FAP-Symptom-Diary.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">IBS-FAP-Symptom Diary.pdf<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>CAMHS link to general online resources:<\/strong>\u00a0<a href=\"https:\/\/services.nhslothian.scot\/camhs\/resources\/\" data-type=\"URL\" data-id=\"https:\/\/services.nhslothian.scot\/camhs\/resources\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/services.nhslothian.scot\/camhs\/Resources\/Online\/Pages\/default.aspx<\/a>\u00a0<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link to Ref Help&nbsp;Faecal&nbsp;calprotectin:<\/strong>&nbsp;<a href=\"\/files\/sites\/2\/calprotectin-in-children-NHSL-Sept-2018.pdf\" data-type=\"URL\" data-id=\"\/files\/sites\/2\/calprotectin-in-children-NHSL-Sept-2018.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/ResourcesLinks\/calprotectin in children NHSL Sept 202018.pdf<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link to RefHelp H Pylori:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"\/files\/sites\/2\/Paed-GI-Heliobacter-Pylori-RHCYP-22-Aug-2019.pdf\" data-type=\"URL\" data-id=\"\/files\/sites\/2\/Paed-GI-Heliobacter-Pylori-RHCYP-22-Aug-2019.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/ResourcesLinks\/Paed GI Heliobacter Pylori RHCYP Aug 2019.pdf<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Helpful Apps:<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Mindshift&nbsp;<\/strong>(free CBT) :&nbsp;<a href=\"https:\/\/play.google.com\/store\/apps\/details?id=com.bstro.MindShift&amp;hl=en_GB\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/play.google.com\/store\/apps\/details?id=com.bstro.MindShift&amp;hl=en_GB<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>HospiChill<\/strong>&nbsp;(Preparation for coming to hospital and appointments but also great activities to reduce stress, manage anxiety, pain) &nbsp;<a href=\"http:\/\/hospichill.net\/index.html\" target=\"_blank\" rel=\"noreferrer noopener\">http:\/\/hospichill.net\/index.html<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Relax Lite&nbsp;<\/strong>(relaxation):&nbsp;https:\/\/play.google.com\/store\/apps\/details?id=com.saagara.relaxlite.app&amp;hl=en_GB&amp;gl=US<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Smiling Mind<\/strong>&nbsp;(relaxation)&nbsp;<a href=\"https:\/\/play.google.com\/store\/apps\/details?id=com.smilingmind.app&amp;hl=en_GB&amp;gl=US\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/play.google.com\/store\/apps\/details?id=com.smilingmind.app&amp;hl=en_GB&amp;gl=US<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Chill Panda&nbsp;<\/strong>(for children and adults who want to learn how to mange stress and worry and feel better)&nbsp;<a href=\"https:\/\/www.nhs.uk\/apps-library\/chill-panda\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.nhs.uk\/apps-library\/chill-panda<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Stress control classes<\/strong>&nbsp;(free online):&nbsp;&nbsp;<a href=\"https:\/\/services.nhslothian.scot\/stresscontrol\/\" data-type=\"URL\" data-id=\"https:\/\/services.nhslothian.scot\/stresscontrol\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/services.nhslothian.scot\/stresscontrol\/Pages\/default.aspx<\/a>&nbsp;(adult classed but suitable for mid-teens upwards)<\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Information IBS\/FAP is common.&nbsp; 10-15% of school aged children will experience abdominal pain but 90% of these children will have no organic pathology identified.&nbsp; FAP is usually multifactorial; anxiety and parental attention to symptoms usually make things worse whereas acceptance and support usually promote improvement.&nbsp; The teams at SJH &amp; RHSC\/RHCYP have come together to<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3956,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[521],"class_list":["post-4060","page","type-page","status-publish","hentry","category-irritable-bowel-syndrome-ibs-functional-abdominal-pain-fap"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/paediatric\/paediatric-gastrointestinal\/irritable-bowel-syndrome-ibs-functional-abdominal-pain-fap\/\" rel=\"tag\">Irritable Bowel Syndrome (IBS)Functional Abdominal Pain (FAP)<\/a>","rttpg_excerpt":"Information IBS\/FAP is common.&nbsp; 10-15% of school aged children will experience abdominal pain but 90% of these children will have no organic pathology identified.&nbsp; FAP is usually multifactorial; anxiety and parental attention to symptoms usually make things worse whereas acceptance and support usually promote improvement.&nbsp; The teams at SJH &amp; RHSC\/RHCYP have come together to","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4060","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4060"}],"version-history":[{"count":1,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4060\/revisions"}],"predecessor-version":[{"id":29945,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4060\/revisions\/29945"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3956"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4060"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4060"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}