Criteria for the Functional Abdominal Pain Syndrome - all of the following:
(1) The abdominal pain has lasted at least 6 months.
(2) The abdominal pain that is continuous or almost continuous.
(3) The pain has no or only occasional correlation with physiologic events (eating, menses, defecation, etc.)
(4) There is some loss of daily functioning (disability).
(5) There is no evidence of malingering (pain does not appear to be feigned).
(6) There is insufficient evidence for the diagnosis of an alternative functional disorder.
(7) There is no evidence of an underlying organic disorder after a careful evaluation.
Features of the abdominal pain:
(1) The pain involves a large abdominal area (may be multi-quadrant).
(2) The complaints are often associated with other painful symptoms.
(3) The pain may be described in bizarre or emotional terms.
(4) The pain is unrelated or only poorly related to gastrointestinal function.
(5) The pain behavior may diminish if the patient is distracted or if the patient is observed unawares.
(6) The autonomic arousal associated with visceral pain is absent, and eye closure may be observed during the abdominal examination.
(7) Pain behavior may diminish when the stethoscope is applied to the abdomen.
Patients may have:
(1) a history or physical evidence of multiple abdominal and/or pelvic surgeries, usually without obvious pathology that can explain the pain
(2) analgesic and/or narcotic misuse
(3) a history of seeing multiple physicians
(4) strongly deny any possible psychosocial causation
