Society for Pediatric Pain Medicine
Better Care for Children in Pain.

A 5-year-old girl presents with persistent recurrent, poorly localized abdominal pain occurring twice a week over the past three months. The pain is episodic and resolves by the end of each day. It is not triggered by specific foods or activities, and she has had normal bowel movements, although the frequency increases on days when she experiences abdominal pain. The pain has led to her missing several days of school. An abdominal MRI and previous upper and lower endoscopy were negative. Physical exam and lab results are normal, and she has been growing appropriately. The parents deny blood in the stool, weight loss, persistent vomiting, or fever. The only recent change reported by the family is her parents' divorce.

What is the best next course of action?