Abdominal pain is a frequent clinical complaint, ranging from mild to severe causes. When organic disease is excluded, persistent pain lasting over 3 months is classified as functional abdominal pain. Under Rome III, such pain without bowel habit changes was termed functional abdominal pain syndrome, later renamed centrally mediated abdominal pain syndrome (CAPS) in Rome IV, emphasizing central hypersensitivity and psychosocial factors. A 24-year-old male student developed abdominal pain, appetite loss, and weight loss during exam stress in 2020. Extensive gastrointestinal and neurological investigations revealed no organic disease. Despite nutritional recovery, abdominal pain persisted, and dizziness later developed. At our hospital, workup again excluded organic causes. Stress, study difficulties, and anxiety were significant, with psychological testing showing moderate depression. Prior gastrointestinal therapies were ineffective, so treatment with antidepressants, lifestyle guidance, dietary counseling, and pain coping strategies was initiated. Within 2 weeks, abdominal symptoms, appetite mood, and weight improved. Discussion highlights the overlap of CAPS with conditions such as abdominal epilepsy, abdominal migraine, and somatic symptom disorder, reflecting central nervous system involvement. Genetic susceptibility, stress, and environmental triggers contribute. Effective management requires addressing the brain–gut axis, central hypersensitivity, psychiatric symptoms, and psychosocial context.