Children often suffer from abdominal pain. It can be mild pain or severe enough to require medications, injections or admission in hospital. Pain in the abdomen in children can be significantly distressing for parents and children with multiple hospital visits to often different doctors, loss of school attendance and loss of work days for parents. Pain can be accompanied by symptoms like fever, nausea, vomiting, diarrhoea, loss of appetite, blood in stools etc.
A very wide spectrum of problems can cause pain in the abdomen. This includes gut infections, food poisoning, typhoid fever, constipation, food allergies, celiac disease, pancreatitis, hepatitis, intussusception, bowel obstruction, appendicitis, Meckel’s Diverticulum etc. Sometimes, pain in the abdomen can be functional or psychological. But children need to be thoroughly investigated and all other causes of pain should be ruled out before labelling this as functional or psychological.
Severe pain abdomen requires detailed and sometimes urgent work-up (investigations) for proper management and to prevent life-threatening complications. This includes blood tests, X-ray and Ultrasound of the abdomen. Sometimes, advanced tests like CT scan of the abdomen, Endoscopy and Colonoscopy may also be required for proper diagnosis and management.
Causes like bowel obstruction, intussusception, appendicitis and perforation need to be dealt urgently by a Paediatric Surgeon. It is also important to remember that constipation has become an important cause of pain in the abdomen in children now-a-days due to changing life-style and dietary habits. Your child can be constipated even if he/she is passing stools daily and normally.
Untreated and long-standing pain abdomen can have significant ill-effects on the body and mind of the child with poor attention span, frequent absence from school, poor school performance and behavioural problems. It is very important for parents/caregivers to not ignore pain in the abdomen in children and consult a Paediatric Gastroenterologist for proper management.
What Causes Abdominal Pain in Children?
The reasons for abdominal pain in children are varied and can stem from many different sources. Some causes are mild, while others are serious and require urgent care. Common causes include infections in the gut, food poisoning, typhoid fever, or constipation. Other possibilities include food allergies, celiac disease (a condition where gluten damages the intestines), pancreatitis (inflammation of the pancreas), or hepatitis (liver inflammation). More serious conditions like intussusception (when part of the intestine folds into itself), bowel obstruction, appendicitis, or Meckel’s Diverticulum (a small pouch in the intestine) can also cause pain. In some cases, the pain might be functional or psychological, meaning no physical cause is found. However, doctors must rule out all other causes before considering this diagnosis.
Symptoms That Accompany Abdominal Pain
Abdominal pain rarely comes alone. Children may experience additional symptoms that can help doctors identify the cause. These symptoms include:
- Fever, which might point to an infection.
- Nausea or vomiting, often seen in food poisoning or gut infections.
- Diarrhea, which could indicate a viral or bacterial infection.
- Loss of appetite, common in many conditions.
- Blood in the stools, which may signal a more serious issue like intussusception or inflammatory bowel disease.
Paying attention to these symptoms and sharing them with your doctor can help in making an accurate diagnosis.
When to Worry: Severe Abdominal Pain
Severe abdominal pain is a red flag and often requires urgent investigation. Conditions like appendicitis, bowel obstruction, intussusception, or a perforation (a hole in the intestine) are surgical emergencies. These may need immediate attention from a pediatric surgeon. To diagnose the cause, doctors may order tests like blood work, an X-ray, or an ultrasound of the abdomen. In some cases, advanced tests such as a CT scan, endoscopy (a camera to look inside the stomach), or colonoscopy (a camera to examine the colon) may be necessary. Quick action is essential to prevent life-threatening complications.
When to Call Your Doctor
You should contact your child’s doctor if your child has any of the following:
- Stomach pain that lasts more than a week, even if it comes and goes
- Pain that is getting worse or more frequent
- Nausea or vomiting along with the pain
- Pain that does not get better after 24 hours
- A burning sensation during urination
- Diarrhoea that lasts more than two days
- Vomiting for over 12 hours
- Fever over 100.4°F (38°C)
- Poor appetite for more than two days
- Unexplained weight loss
These symptoms could be signs of an infection, digestive disorder, or another underlying issue that needs attention.
When to Seek Immediate Medical Attention
In some cases, abdominal pain can be a sign of a serious or even life-threatening condition. Take your child to the hospital or emergency room right away if they:
- Are a baby under 3 months old with diarrhoea or vomiting
- Can’t pass stool, especially if they are also vomiting
- Are vomiting blood or have blood in the stool (especially if it looks dark red, maroon, or black and tarry)
- Complain of sudden, sharp abdominal pain
- Have a hard or rigid belly that is painful to touch
- Have had a recent injury to the stomach area
- Are having trouble breathing
- Are currently undergoing treatment for cancer
These signs require urgent evaluation by a doctor and could indicate conditions like appendicitis, bowel obstruction, internal injury, or infections.
The Role of Constipation in Abdominal Pain
Constipation is a surprisingly common cause of abdominal pain in children today. Changes in lifestyle and diet, such as eating more processed foods and less fiber, have made this issue more frequent. Interestingly, a child can be constipated even if they pass stools daily and the stools appear normal. Constipation can cause cramping, bloating, and discomfort. If your child has recurring tummy aches, it’s worth discussing their bowel habits with a doctor. Simple changes, like adding more fruits, vegetables, and water to their diet, can often make a big difference.
Functional or Psychological Pain: What Does It Mean?
Sometimes, abdominal pain has no clear physical cause. This is called functional abdominal pain. It might be related to stress, anxiety, or other psychological factors. However, doctors only diagnose functional pain after ruling out all other possible causes through thorough testing. It’s important not to dismiss your child’s pain as “just stress” without proper investigation. Functional pain is real and can still affect your child’s quality of life. A paediatric gastroenterologist can help manage this type of pain with strategies like stress management, dietary changes, or counselling.
The Impact of Untreated Abdominal Pain
Ignoring or leaving abdominal pain untreated can have serious consequences for your child. Chronic pain can affect their body and mind. It may lead to poor attention span, frequent school absences, lower academic performance, and even behavioural issues. Children may feel frustrated or anxious because of ongoing discomfort. Addressing the pain early with the help of a specialist can prevent these long-term effects and help your child lead a healthier, happier life.
Keeping a Record of Abdominal Pain in Your Child
If your child is experiencing abdominal pain, don’t ignore it. Start by keeping a record of the pain—when it happens, how severe it is, and any other symptoms. This information can be very helpful for the doctor. Consult a paediatric gastroenterologist, who specializes in children’s digestive issues, for a thorough evaluation. They can recommend the right tests and treatments to get to the root of the problem. In the meantime, encourage your child to eat a balanced diet, drink plenty of water, and stay active, as these habits can support overall gut health.
Conclusion: Taking Abdominal Pain Seriously
Abdominal pain in children is not something to brush off. Whether it’s caused by a simple issue like constipation or a serious condition like appendicitis, getting the right diagnosis and treatment is key. It can range from mild discomfort to severe pain that needs immediate medical attention, such as medications, injections, or even hospital admission. This pain can be deeply distressing for both children and their parents. It often leads to multiple doctor visits, missed school days, and parents taking time off work. The pain may come with other symptoms like fever, nausea, vomiting, diarrhoea, loss of appetite, or even blood in the stools. Understanding the cause of the pain is crucial for proper treatment and to help your child feel better.
By working closely with a paediatric gastroenterologist, you can help your child feel better and avoid complications. Pay attention to your child’s symptoms, seek medical advice promptly, and take steps to support their overall health. With the right care, most children can overcome abdominal pain and get back to being their happy, active selves.