Abdominal pain in children is the most common complaint. Approximately 33% of the children visit doctors with abdominal pain by the time they complete 15 years of age. Fortunately, most cases of abdominal pain are not serious and can be managed easily.
Acute abdominal pain is a pain that exists for a short duration. Acute abdominal pain generally requires immediate medical intervention and diagnosis of the cause. Recurrent abdominal pain is defined as the abdominal pain that has three episodes in the last one months and that significantly affects the normal functioning of the patient. The abdominal pain that continuously exists for 2 to 3 months is considered chronic abdominal pain.
Abdominal pain is itself a symptom of underlying medical conditions. Usually, abdominal pain is accompanied by various other symptoms depending upon the type of cause. Some of the symptoms accompanied with abdominal pain are:
Sleeplessness and restlessness
Pain in the groin area
The sick and pale appearance of the child
Following are some of the causes of abdominal pain in children:
Gastrointestinal disorders: Gastrointestinal problems are the primary cause of abdominal pain in children. Diseases causing abdominal pain include appendicitis, gastroenteritis, ulcer, bowel obstruction, and abdominal trauma. Additionally, if the child is constipated or irregular with bowel habits, they may experience repeated pains.
Metabolic disorders: Metabolic disorders interfere with the normal metabolic processes in the body. Metabolic diseases that cause abdominal pain in children are lactose intolerance, porphyria, diabetic ketoacidosis, hypoglycemia, and acute adrenal insufficiency.
Liver and spleen diseases: Problems associated with the liver and biliary systems such as hepatitis and cholangitis may lead to abdominal pain. In addition, diseases causing abdominal pain are pancreatitis, spleen rupture, and cholecystitis.
Urinary conditions: Children with urinary problems such as Urinary tract infection and urinary calculi may also complain about abdominal pain. This is because these conditions cause discomfort in the abdominal area.
Pulmonary diseases: As the lungs are situated in the proximity of the abdominal area, any problem in the lungs, especially in the lower part, may lead to abdominal pain. Conditions such as pneumonia, pleuritis or cystic fibrosis may cause abdominal pain in children.
Ingestion of toxic substances: When the child accidentally ingests toxic substances, it may cause abdominal pain. Abdominal pain may also be due to lead poisoning or iron overdose.
Menstrual Pain: In girls, abdominal pain may occur before the start of the menstruation cycle. The pain is significant in the case of dysmenorrhea.
Muscular pain: Abdominal pain may also be caused when the abdominal muscles are under stress or when the person lifts a heavy object.
Neurological conditions: Abdominal epilepsy is the condition in which gastrointestinal disturbances are caused due to epilepsy. Another condition, known as abdominal migraine, also causes abdominal pain.
Miscellaneous conditions: Other causes of abdominal pain are infantile colic, floating rib syndrome, functional pain, Meckel’s diverticulum etc.
Assessing abdominal pain in children is quite a challenging task and should be done by experienced pediatric gastroenterologists. The challenge further increases when the child is under 5 years of age or with a developmental disability. Following are some of the diagnostic techniques used for determining the cause of pain:
|TYPE OF DIAGNOSTIC METHOD||DETAILED TESTS|
|Physical Examination||Percussion, Palpation, Inspection, Auscultation|
|Blood tests||Complete Blood profile, Liver function tests, Pancreatic enzymes|
|Urine test||Urinalysis for blood and pus cells in urine|
|Stool test||Analysing blood in stools.|
|Imaging techniques||X-rays, Ultrasonography, Endoscopic procedure, Rectal Examination, CT Scan, and MRI|
|Neurological tests||Tests for epilepsy and abdominal migraine|
Treatment of abdominal pain is done according to its cause. Following are some of the treatment measures followed:
When there is a clear requirement of surgical intervention, the parents are asked to take advice from urologists, gynaecologists, nephrologists, or a general surgeon according to the cause of abdominal pain. In the meantime, the condition of the child should be stabilized through fluid and analgesic medications.
When there is no requirement for surgical intervention and urgent care is not needed, the child can be managed on an outpatient basis. However, in cases where the vital parameters are not stable, the child should remain admitted to the hospital.
Until the laboratory reports are yet to receive, the doctor may prescribe drugs to reduce the pain. Pain killer along with acid suppressor are generally prescribed.
You should consult with an experienced pediatric gastroenterologist when your child:
Has severe and recurrent abdominal pain
Is pale and sick
Have nausea and vomiting
Have difficulty in urination or pain or burning during urination
Passes blood in stools
Suddenly refuses taking food or fluid
Have fatigue and restlessness
Has skin rashes
Any other condition which may be a cause of concern
Consultant - Paediatric Gastroenterology and Hepatology
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