Abdominal/Stomach Pain in Children

About

Abdominal pain in children is a common concern for parents, and it can be challenging to diagnose. From mysterious tummy twinges to recurrent pain episodes, understanding the nuances of abdominal distress in children can be like deciphering a complex puzzle. Many children experience stomach pain, and in most cases, it resolves without special treatment. However, persistent or severe pain may require medical attention(1^✔ ✔Trusted Source
Recurrent Abdominal Pain in Children (RAP)

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Causes of Abdominal Pain in Children

Bowel Problems: Constipation, colic, or irritable bowel issues.
Infections: Gastroenteritis, kidney or bladder infections, and infections in other body parts.
Food-related Problems: Overeating, food poisoning, or food allergies.
Problems Outside the Abdomen: Muscle strain or migraine.
Surgical Problems: Appendicitis, bowel obstruction, or intussusception (telescoping of part of the gut).
Period Pain: Some girls may experience pain before the start of their periods.
Poisoning: Spider bites, ingestion of harmful substances, or smoking.

Did You Know?

Abdominal pain is a common woe among children, with studies indicating that up to 10-20% of youngsters experience recurrent abdominal pain (RAP) during their formative years.

Repeat Attacks of Stomach Pain in Children

Recurrent Abdominal Pain (RAP) often emerges in early childhood, affecting children between the ages of 4 and 6. While it can persist into adolescence, many children outgrow these pains as they enter their teenage years.

RAP among children is characterized by a minimum of three pain episodes spanning three months, impacting the child's routine activities. While RAP is typically attributed to functional (nonorganic) causes, 5% to 10% of cases reveal an identifiable organic origin(2^✔ ✔Trusted Source
Recurrent Abdominal Pain in Children

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Possible reasons for Recurrent Abdominal Pain (RAP) in children are:

Functional bowel disorder: Predominant in RAP, lacking apparent physical causes, often termed functional bowel syndrome if other body parts are involved
Irritable Bowel Syndrome (IBS): Common in adults, IBS can affect children
Functional dyspepsia: Indigestion lacking abnormalities in the upper gut
Abdominal migraine: A cause in 1-2 out of 10 children with RAP
Constipation
Mesenteric adenitis: Inflammation of lymph glands in the abdomen, common in young children, triggered by viral infections
Bladder (urinary tract) infections
Coeliac disease: Immune reaction to gluten, affecting 1 in 100 people in Northern Europe and the USA
Lactose intolerance: Inability to digest lactose, more common in older children and adults, varying among ethnicities
Giardia infection: Digestive infection, once thought overseas, is now identified in the UK, presenting symptoms similar to lactose intolerance

Some children may have recurring episodes of stomach pain without an identified health problem. Emotional factors, such as stress or upsetting situations, can contribute to stomach pain in children(3^✔ ✔Trusted Source
Recurrent Abdominal Pain in Children

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Appendicitis in Children

Appendicitis is a common reason for surgery in children. It occurs when the appendix, a small tube connected to the bowel, becomes blocked and infected.

The initial symptoms of appendicitis often include a mild fever and pain centered around the belly button, initially resembling a common stomachache. However, with appendicitis, the pain intensifies and shifts to the lower right side of the abdomen. If your child experiences belly pain, be vigilant for these appendicitis indicators:

1. Pain Characteristics

Strong pain, initially around the belly button or in the lower right abdomen
Pain may start intermittently, later becoming steady and intense

2. Additional Signs

Low-grade fever
Loss of appetite
Nausea and vomiting
Diarrhea, often in small amounts with mucus
Swollen belly

If the pain extends across the belly, it could indicate a burst appendix, known as ruptured appendicitis, marked by a high fever of 104°F (40°C).

Promptly contact your doctor if you suspect appendicitis, as early detection facilitates easier treatment and surgery may be required to remove the appendix.(4^✔ ✔Trusted Source
Appendicitis In Kids and Teens

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Diagnosis of Abdominal Pain in Children

During an assessment of a child's abdominal pain, a clinician will gather a comprehensive history, including details on the onset, location, type, and progression of the pain. Parents must communicate any known allergies or history of food intolerances to the clinical team.

The child's pediatrician may conduct tests on blood, urine, and stool to eliminate specific conditions linked to abdominal pain. If the initial evaluations raise additional concerns, more extensive tests like X-rays or endoscopy may be recommended for a more thorough investigation. The goal is to gather sufficient information to pinpoint the underlying cause of the abdominal pain and guide appropriate treatment.

Treatment of Stomach Pain in Children

1. Rest for Your Child

Discourage activity, especially post-meals

2. Symptom Management

Offer clear fluids like water, diluted fruit juice, or broth
Introduce bland foods: saltine crackers, plain bread, dry toast, rice, gelatin, or applesauce
Avoid spicy, greasy, caffeinated, or carbonated foods/drinks until 48 hours after symptoms cease
Promote a bowel movement

Consult the child's doctor before administering any abdominal pain medicine to prevent masking or exacerbating pain.

Treatment for Recurrent Abdominal Pain (RAP)

Treatment for recurrent abdominal pain (RAP) in children depends on the underlying cause. If it's due to a physical issue like constipation or coeliac disease, treatments target that cause. However, for RAP without a physical cause:

1. Reassurance and Explanation:

Reassure the child that there's no physical ailment
Explain the source of the pain

2. Talking Therapies:

Cognitive Behavioral Therapy (CBT) for stress-related RAP
Family therapy if family members experience anxiety
Hypnotherapy influences how the brain processes pain

3. Medication:

Generally, not recommended unless severe symptoms persist
Limited effectiveness for brain-originating pain

4. Dietary Changes:

Fruit-rich diets may reduce RAP risk
No clear evidence for modifying diet post-RAP
Limited support for fiber supplements or lactose-free diets
A balanced, healthy diet is beneficial for overall health

5. Alternative Approaches:

True food intolerance is diagnosed by controlled elimination
Caution with alternative allergy tests; consult health professionals

6. Hot Water Bottle:

Provides warmth, easing pain sensations

7. Exercise and Distraction:

Boosts natural painkillers (adrenaline, cortisol, endorphins)
Engage in fun activities to alleviate pain
Distraction methods (reading, movies, music) during pain episodes
Supporting schoolwork may reduce worry and enhance well-being

Taking Care of a Child with Abdominal Pain

Ensure the child gets plenty of rest
Encourage the intake of clear fluids
Offer bland foods if the child is hungry
Apply a hot water bottle or run a warm bath for comfort
Administer paracetamol if the child is in pain or miserable, following appropriate dosage guidelines