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Functional abdominal pain — RACGP Fellowship MCQ

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HardPaediatrics and adolescentFunctional abdominal painRACGP Fellowship

A 10-year-old girl has recurrent abdominal pain, headaches on Monday mornings and school refusal. Her symptoms consistently improve during school holidays. Examination, growth and urinalysis are normal. Bullying at school is identified. What is the most appropriate management?

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Correct answer: A — Explore psychosocial stressors, validate symptoms and coordinate support with school and family

This scenario is classic functional abdominal pain in a child, triggered by school-related stress (bullying), with normal examination and investigations, and symptom resolution during holidays. Australian RACGP guidance emphasises reassurance, a biopsychosocial approach, and coordinated psychosocial support as first‑line management. Over‑investigation (CT), opioid prescribing, antibiotics, or dismissing symptoms are inappropriate and potentially harmful.

Reference: Functional abdominal pain disorders in children (AJGP, RACGP 2025), https://www.racgp.org.au/getattachment/8cfd70bf-8ae3-4781-99c6-2967bf5fcc93/attachment.aspx