慢性腹痛是指腹部持续性不适或持续六个月及以上的间断性不适。 疼痛可能来自任何系统，包括泌尿生殖系统、胃肠道或妇产科疾病。 慢性腹痛的病因非常之多，这里只是总结了一些最常见的。 并非所有腹痛都总是能找到其解剖上或是可理解的其他原因。
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分类
慢性腹痛从病因学上可以分为器质性和功能性两种。 前者有明确的解剖、生理或代谢上的病因， 尽管进行了仔细诊断评估、但仍不明原因的慢性腹痛，通常称为功能失调。
相较于急性腹痛而言，慢性腹痛更难找到明确的病变器官。 急性腹痛一般都有突然出现的生理学的改变，例如空腔脏器的梗阻或穿孔、感染、膨胀或缺血等。
流行病学
慢性腹痛多见于基层医疗机构。 其流行病学尚未完全弄清，但流行病学调查数据显示每年慢性腹痛的发病率约为千分之22.9。 横断面调查显示25%的成年人发生过慢性腹痛。[1]Wallander MA, Johansson S, Ruigomez A, et al. Unspecified abdominal pain in primary care: the role of gastrointestinal morbidity. Int J Clin Pract. 2007;61:1663-1670.http://www.ncbi.nlm.nih.gov/pubmed/17681003?tool=bestpractice.com[2]Penston JG, Pounder RE. A survey of dyspepsia in Great Britain. Aliment Pharmacol Ther. 1996;10:83-89.http://www.ncbi.nlm.nih.gov/pubmed/8871447?tool=bestpractice.com[3]Sandler RS, Stewart WF, Liberman JN, et al. Abdominal pain, bloating, and diarrhea in the United States: prevalence and impact. Dig Dis Sci. 2000;45:1166-1171.http://www.ncbi.nlm.nih.gov/pubmed/10877233?tool=bestpractice.com 不同年龄和地区、民族的人群其发病率并无太大区别。[4]Heading RC. Prevalence of upper gastrointestinal symptoms in the general population: a systematic review. Scand J Gastroenterol Suppl. 1999;231:3-8.http://www.ncbi.nlm.nih.gov/pubmed/10565617?tool=bestpractice.com[5]Jones R, Lydeard S. Irritable bowel syndrome in the general population. BMJ. 1992;304:87-90.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1880997/pdf/bmj00055-0029.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/1737146?tool=bestpractice.com[6]Drossman DA, Li Z, Andruzzi E, et al. U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. Dig Dis Sci. 1993;38:1569-1580.http://www.ncbi.nlm.nih.gov/pubmed/8359066?tool=bestpractice.com[7]Talley NJ. Irritable bowel syndrome: definition, diagnosis and epidemiology. Baillieres Best Pract Res Clin Gastroenterol. 1999;13:371-384.http://www.ncbi.nlm.nih.gov/pubmed/10580915?tool=bestpractice.com[8]Halder SL, McBeth J, Silman AJ, et al. Psychosocial risk factors for the onset of abdominal pain. Results from a large prospective population-based study. Int J Epidemiol. 2002;31:1219-1225.http://ije.oxfordjournals.org/cgi/content/full/31/6/1219http://www.ncbi.nlm.nih.gov/pubmed/12540725?tool=bestpractice.com[9]Hotopf M, Carr S, Mayou R, et al. Why do children have chronic abdominal pain, and what happens to them when they grow up? Population based cohort study. BMJ. 1998;316:1196-1200.http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=9552994http://www.ncbi.nlm.nih.gov/pubmed/9552994?tool=bestpractice.com
由于慢性腹痛的诊治极为困难，医患双方时常无法得到满意的结果。 导致这一切的原因很多，有时是因为病史不清，有时是查体不够仔细，即使辗转很多专家，经历了很多检查，患者最终也经常是只能得到一个阴性的结果。
流行病学研究发现非常多的慢性腹痛患者有功能性的胃肠道功能失调，类似于肠激惹综合征或功能性的消化不良。[1]Wallander MA, Johansson S, Ruigomez A, et al. Unspecified abdominal pain in primary care: the role of gastrointestinal morbidity. Int J Clin Pract. 2007;61:1663-1670.http://www.ncbi.nlm.nih.gov/pubmed/17681003?tool=bestpractice.com[2]Penston JG, Pounder RE. A survey of dyspepsia in Great Britain. Aliment Pharmacol Ther. 1996;10:83-89.http://www.ncbi.nlm.nih.gov/pubmed/8871447?tool=bestpractice.com[3]Sandler RS, Stewart WF, Liberman JN, et al. Abdominal pain, bloating, and diarrhea in the United States: prevalence and impact. Dig Dis Sci. 2000;45:1166-1171.http://www.ncbi.nlm.nih.gov/pubmed/10877233?tool=bestpractice.com[4]Heading RC. Prevalence of upper gastrointestinal symptoms in the general population: a systematic review. Scand J Gastroenterol Suppl. 1999;231:3-8.http://www.ncbi.nlm.nih.gov/pubmed/10565617?tool=bestpractice.com[5]Jones R, Lydeard S. Irritable bowel syndrome in the general population. BMJ. 1992;304:87-90.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1880997/pdf/bmj00055-0029.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/1737146?tool=bestpractice.com[6]Drossman DA, Li Z, Andruzzi E, et al. U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. Dig Dis Sci. 1993;38:1569-1580.http://www.ncbi.nlm.nih.gov/pubmed/8359066?tool=bestpractice.com[7]Talley NJ. Irritable bowel syndrome: definition, diagnosis and epidemiology. Baillieres Best Pract Res Clin Gastroenterol. 1999;13:371-384.http://www.ncbi.nlm.nih.gov/pubmed/10580915?tool=bestpractice.com[8]Halder SL, McBeth J, Silman AJ, et al. Psychosocial risk factors for the onset of abdominal pain. Results from a large prospective population-based study. Int J Epidemiol. 2002;31:1219-1225.http://ije.oxfordjournals.org/cgi/content/full/31/6/1219http://www.ncbi.nlm.nih.gov/pubmed/12540725?tool=bestpractice.com[9]Hotopf M, Carr S, Mayou R, et al. Why do children have chronic abdominal pain, and what happens to them when they grow up? Population based cohort study. BMJ. 1998;316:1196-1200.http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=9552994http://www.ncbi.nlm.nih.gov/pubmed/9552994?tool=bestpractice.com[10]Keefer L, Drossman DA, Guthrie E, et al. Centrally mediated disorders of gastrointestinal pain. Gastroenterology. 2016 Feb 19 [Epub ahead of print].http://www.ncbi.nlm.nih.gov/pubmed/27144628?tool=bestpractice.com 然而，和这些功能失调相关的疼痛往往都是非特异性的，有些很类似于器质性的病变，有时还会和器质性的病变并存。
