Understanding abdominal pain in children

Every parent will have heard complaints about a ‘tummy ache’ every now and then, but not every case can be regarded the same – indeed, abdominal pain in children can range from being caused by eating too many sweets, to being indicative of a serious condition. In this article, consultant paediatric gastroenterologist Dr Krishna Soondrum explores the different reasons for abdominal pain in children, and what approaches can be taken to address them.

 

 

 

Signs of abdominal pain in children

It can be worrying and stressful when your child approaches you and tells you they don’t feel well. How to know whether they need urgent care, or if a cup of herbal tea will settle their stomach? Abdominal pain can have many possible origins, which is why it can be helpful to ask your child to describe the sensation in their abdomen to narrow down the cause, such as:

• Where exactly is the pain? Is it in the centre of their abdomen, or specifically on just one side? Is it a large, general area of pain, or is it a more concentrated point? Is there a visible marker like a lump or redness in the area?
• What does the pain feel like? Is it like burning, or an ache, or as though they have been hit or bit by something?
• How long have they been feeling the pain? Does it come in waves, is it suddenly occurring, or is there a specific trigger like an activity or a certain food?

Very young children may not be able to communicate verbally or lack the vocabulary to describe their discomfort. Parents can look out for signs of abdominal pain in these children by keeping note if their child is:

• Fussier than usual, not wanting to be bathed or dressed, and avoiding hugs or other points of contact to the abdomen.
• Covering or shielding their abdomen, for example, bringing their legs up to their stomach.
• Changing their habits, such as eating less and going to the bathroom more frequently.

 

Causes of abdominal pain in children

Causes of abdominal pain tend to not be life-threatening, such as air swallowing, colic, constipation and gas, food intolerance (such as to gluten or lactose), food poisoning, overeating or eating too much sweets and snacks, acid reflux, a stomach bug (gastroenteritis), or even anxiety and stress.

However, if your child’s condition does not improve within 24 hours, the pain worsens or becomes more persistent, they exhibit signs of fever, are vomiting, develop a rash, or have uncontrollable bowel movements or cannot pass at all, then it is recommended to get them seen by a doctor as soon as possible.

Your child could be suffering from:

• Appendicitis, where the appendix has become infected and inflamed due to blockage.
• A stomach ulcer, where a lesion forms on the tissue lining of the stomach.
• Gallstones, which are hard deposits that can form in the appendix.
• Toxins, poisons, or harmful objects which were accidentally ingested.
• Hernia, where a part of the muscle wall has a weakness through which part of an organ has poked.
• Inflammatory bowel diseases like Crohn’s disease or ulcerative colitis.
• Bowel obstruction due to tumours, adhesions, or intussusception, for example.

 

Treating abdominal pain in children

To treat mild, nonurgent abdominal pain at home, it is recommended to let the child rest for a period to manage their distress and to see if that alleviates the pain slightly. Encourage them to try and use the bathroom to pass stool, and keep them hydrated with a lot of water. When feeding them, avoid foods that are abrasive, such as caffeine and carbonated drinks, citrus and tomatoes, and dishes heavy in oil.

More in-depth treatment will depend on the origins of the issue. To diagnose abdominal pain, doctors typically will conduct a physical exam and then conduct further testing such as ultrasonic scans or X-rays to visualise the abdomen and chest and find any abnormal structures within the area, and blood, urine, and stool tests to analyse the chemical composition and the bacterial presence within your child.