Severe abdominal pain, does this sound like functional pain?

Hi jo34531, have the doctors ruled out a muscle injury and has your daughter seen a Gastroenterologist?  It sounds quite possible that it's a functional disorder of the bowel and I know exactly how severe it can be.  Is your daughter a worrier with an anxious personality.  My first experience of IBS lasted two years, but I was mentally unwell at the time and the more I cried and got upset, the worse the pain got.  You are quite right in saying that distraction is a way of alleviating the severity, if only temporarily.  Other methods worth trying are listening to relaxation and or slow breathing Apps.  Probiotics also help, because she might have too many bad bacteria in her gut.  I have every sympathy with your daughter.  The calmer she can remain, the less pain she should feel.  The connection between the brain and gut is inextricably linked.  Hypnotherapy helps me.  If you are not happy with the Consultants diagnosis, ask the GP to be referred for a second opinion.  I hope things slowly improve for your daughter. 

It may be worthwhile having a CT and colonoscopy. IBS typically causes change of bowel habit along with shifting stomach pain which be constant or come and go.  It is sometimes caused by stress and stress itself makes flare ups worse.  Does eating make the pain worse?  Perhaps try a food diary to see if any food is causing symptoms.  Sometimes you can get atypical IBS which means you have IBS but your symptoms are not typical of IBS.  Does her pain improve temporarily after a bowel movemement?  IBS can be caused by anxiety, surgery, or stomach infections.  How long has she had the pain?  

Hey.. Get mormodica (bitter melon) we use mormidica here in Africa to treat stomach pain... Use it twice a day for one week

.. I bet you she will improve.. Hang on there!

I would think it is from certain food she eats. So I would add probiotics to her diet. Try to stay away from Lactose first.. if that is not the cause, maybe gluten. 

And give her Aloe Vera. That helps very much to calm the GI tract down. 

.. and make sure she drinks a lot of water... no juices, just flat water

I feel very much for your daughter

as her pain is very real and prior to jumping on anything like psychological, functional and the likes, all other components must be excluded.

The problem:

her age.

As you see already she has a personality or due to being so young, taking every examination as "bad" and "what is wrong with me".

It can backlash in severity feeling to be sicker than being actually, if examinations are not experienced as helpful to get closer to a diagnosis or knowing, that exclusions are actually good too.

You might be able to pre explain what was happening and as to why it was important.

There is a lot missing in your girl's list of exclusions and tests, yet as said, it is difficult due to her age.

So it is your gut feeling, that is asked.

(my girl was 13 when starting with severe abdominal pains in right pelvis, unable to go to school and vomiting her heart out and was the other way round: being talked down as IBS or psychological issues after a negative abdominal x-ray for obstruction like a first line diagnosis, was the worst; any examination and if it was 20vials of blood taking or vein access during imaging, was welcomed. For small patients examinations, that could frighten, can be done sedated....)

None invasive:

calprotectin in stool test - has this been done?

It's really simple to take a sample of her poop (by you) and have it sent off to see if leucocytes were too many in guts granting an inflammatory issue in guts. This will not show up in a blood test.

Be aware that a "normal" ultrasound does

a) not look at everything and

b) does not exclude everything

c) can't see a grumbling appendix. BUT good to know, the appendix didn't look blown up and inflamed.

She has not been in an MRI, has she?

There is a condition called :

- mobile caecum as you mentioned activity to hurt more.

It's worth looking into it. 

Did she ever have a plain quick abdo x-ray when her pain was the worst? This would pretty much include or exclude mobile caecum, a twist, that often resolves on its own (luckily), but will come again and again. Hence a plain abdo x-ray in acute abdo pain has a good indication and is peace of mind.

There is also a condition called:

abdominal migraine. Helpful is to trial medication to treat it. If it doesn't help, it most likely was not abdo migraine.

Yet it doesn't sound much like it.

Other thing, yes, muscular structures, that could be upset. No hernia, right?

Is it very localised pain?

Has she been tested with the Carnett's sign test

(very easy, not invasive. Spot is touched, ouch, but patient lifts head and legs = contracts belly muscles, if it hurts more, a nerve in abdo wall is upset. My girl had referred pain into belly muscle and a lidocaine injection into that muscle helped instantly....for 12 hours. A steriod injection additionally should help if it was that nerve only. It did nothing in our case, as it was not an inflammed abdo nerve, just referring pain. As said, my girl doesn't mind examinations and even treatments with needles. So that might be not easy for your girl if she was positive for Carnett's sign. It needs the patient to guide the needle to the area of pain. But then again, maybe your girl is Carnett sign negative and not the case. Just giving examples.)

All the best!

There is nothing out there, that is not possible and a "don"t know, functional" is the last resort diagnosis. You can have a food diary in the meantime to see, if it was connected with food.

Could well be too, but having very localised, not general or spot changing pains, is odd.