Abdominal Pain or Stomach Ache is the most common complaint in children and one of the most common reasons for parents to take their children to pediatricians. There are many causes for abdominal pain in children. Some of them are quite minor, whereas some can be quite serious in nature. However, with correct diagnosis and right treatment, the pain can improve quite quickly. The tricky part for parents is to decide whether their children's complaint warrants immediate medical attention or not. Treatment depends on the cause of the pain and can range from rest and liquid diet to hospitalization and even surgery.
Causes of Abdominal Pain or Stomach Ache in Children
Given below are some of the common causes for abdominal pain in children
- Infections: such as bacterial or viral can cause abdominal pain, e.g. stomach flu (gastroenteritis). Viral infections have a tendency to abate quickly, whereas bacterial infections need antibiotics for treatment.
- Food intake: Eating contaminated food causes food poisoning, which has symptoms similar to that of gut/stomach flu. Other food related causes for stomach/abdomen pain include: Overeating, food allergies, gases resulting in bloating and discomfort. If the pain in the abdomen is due to something in the food, then it often occurs immediately after eating.
- Medications: Over dosage of medications like acetaminophen (acetaminophen poisoning) also causes stomach pain in children.
- Accidental Swallowing: Kids, especially infants, tend to put everything in their mouth, such as medicine tablets, eating soap, swallowing coins etc… all these things result in abdominal pain in children.
- Surgery Related: Causes or problems related to surgery such as obstruction of the bowels or appendicitis also causes stomach pain.
- Other Medical Issues: Children can have abdominal pain, as a result of complications from diabetes. Other causes such as getting bitten by a black widow spider also causes pain in the abdomen.
Signs and Symptoms of Abdominal Pain or Stomach Ache in Children
When children, especially infants, have abdominal pain, they will cry a lot or curl up; this is the first indication that something is not right. Older children can easily tell their parents how they feel, where it hurts, etc. It's very important for a parent to elicit correct information from their children so that their doctor can arrive at the correct diagnosis and treatment.
Parents should look into the following things:
- Duration: Length of the time for which the child has had stomach pain is important. Pain subsides in a short time if the cause is minor. Other causes, such as stomach flu, can cause persistent abdominal pain for more than a day and needs medical attention.
- Site of the pain: Usually pain from simple reasons is situated in the abdomen's center. In such cases, children tend to rub around their belly button. If the pain is felt in other regions, then it is a cause for concern, especially if it is in the lower abdomen or in the right abdominal region, as it could be due to appendicitis.
- General Appearance: If the child appears very sick, i.e. if he/she has pallor, is sweating, is not able to eat or hold down any food, then immediate medical attention should be sought.
- Vomiting: Abdominal pain is often accompanied by vomiting and it does not necessarily mean a serious problem. However, if the vomiting persists for a long time, i.e. for more than a day; and if the vomit is of yellow or green color; or if it contains blood, then it is a cause for concern and parents should take their child immediately to the ER.
- Diarrhea: Like vomiting, diarrhea also often accompanies abdominal pain and indicates viral cause. In most cases diarrhea doesn't last for more than 3 days, but if it persists beyond that and contains blood, then parents should seek immediate medical care.
- Fever: If the cause of abdominal pain is infection, then fever is present and it may not necessarily be a serious problem; likewise, for some serious causes of abdominal pain, the child may have a normal temperature.
- Pain in the groin: Abdominal pain can be radiated from other sources, such as in testicular torsion, boys complain of abdominal pain. So, if your child indicates any groin pain, immediate medical attention should be sought and if ignored, then it can result in a serious situation.
- Problems with the Urinary System: If abdominal pain is accompanied with difficulty in urinating, pain with urination, frequent urination, then it may indicate an infection and needs medical attention.
- Appearance of Rash: Abdominal pain accompanied with a rash is a serious concern and requires immediate medical attention.
Investigations for Abdominal Pain or Stomach Ache in Children
- Blood tests including CBC, LFTs, blood cultures, lead level and/or amylase/lipase levels.
- Stool test to check for parasites, bacteria or blood.
- X-ray of the abdomen.
- Ultrasound of the abdomen (and testicles if needed).
- CT scan of the abdomen.
- Barium enema/swallow.
- Pelvic exam.
- Anal manometry.
Treatment for Abdominal Pain or Stomach Ache in Children
Treatment depends on the cause of the pain. Minor causes only require rest, lots of fluids and a bland diet. If the abdominal pain is from something serious, then hospital stay and surgery may be needed.
Given below are some simple measures which can help in relief from abdominal pain in children:
- Rest: Rest is important for any illness. For abdominal pain, lying face down helps in alleviating pain from gases.
- Diet: Liquid diet is very important; however, you should never force your child, especially if he/she is vomiting, as they won't be able to hold too much liquid. The best way is to give your child small sips of fluids (around 1-2 ounces), periodically (every 10-15 minutes), till the child is able to keep down more. Drinks which are sugary, tinted, caffeinated, carbonated, salty or fatty should be strictly avoided.
- Fluids to give: Milk, tea, coffee, dark colas, fruit juices and sports drinks should not be given. Water and boiled milk should be avoided in infants, as they can cause disturbances with the salt content in their bodies, plus milk is difficult to digest for a sick stomach. Over-the-counter oral electrolytes are easily available and are recommended by the doctors as best to be given in such cases. However, parents should try to get back their child on normal feedings as soon as he/she child feels better.
- Start Solid foods slowly such as with toast and crackers then you can move on to regular foods depending on the tolerance level of your child.
- Fruits, such as apple sauce and banana, and other foods like cooked rice are also recommended after a liquid diet.