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Reviewed by

Dr. Srikanth K P

Consultant - Paediatric Gastroenterology and Hepatology

Manipal Hospitals, Old Airport Road

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Abdominal Pain In Children

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What Is Acute Abdominal Pain, Chronic Abdominal Pain, and Recurrent Abdominal Pain?

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 abdominal pain that has three episodes in the last 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.

What Are the Signs and Symptoms of 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 by abdominal pain are:

Fever
Diarrhea
Vomiting
Flatulence
Gastric bloating
Diarrhea
Irritability
Sleeplessness and restlessness.
Pain in the groin area
Rashes
The sick and pale appearance of the child.
Sweating

What Are the Causes of Abdominal Pain in Children?

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, ulcers, 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 infections 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 a 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.

How is the Diagnosis of Abdominal Pain Done in Children?

Assessing abdominal pain in children is quite a challenging task and should be done by experienced pediatric gastroenterologists in Bangalore. 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	Analyzing blood in stools.
Imaging techniques	X-rays, Ultrasonography, Endoscopic procedure, Rectal Examination, CT Scan, and MRI
Neurological tests	Tests for epilepsy and abdominal migraine

How to Treat Abdominal Pain in Children?

Treatment of abdominal pain is done according to its cause. Following are some of the treatment measures followed:

When there is a clear requirement for 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 be received, the doctor may prescribe drugs to reduce the pain. Painkillers along with acid suppressors are generally prescribed.