ABDOMINAL PAIN IN KIDS AND TEENS
ABDOMINAL PAIN IN KIDS AND TEENS
Abdominal pain
in children is a common problem When your tot’s tummy is upset. About 1 out
of 3 children is seen by a child doctor for abdominal pain by the time they are
age 15, but only a small number of these children have a serious problem.
Complaints of
abdominal pain are more common in children younger than 11 years and are often
caused by changes in eating and bowel habits. Most cases of abdominal pain are
not serious, and home treatment is often all that is needed to help relieve the
discomfort.
SYMPTOMS
Your little one might be telling you
he’s got tummy pains if he shows one or more of these signs:
- Acts fussy
or grumpy
- Doesn’t
sleep or eat
- Cries more
than usual
- Diarrhea
- Vomiting
- Trouble
being still (squirming or tensing up muscles)
- Makes faces
that show pain (squeezing eyes shut, grimacing)
Stomachaches are common for kids.
Luckily, they’re not usually caused by anything serious. They can be painful,
though, so it’s good to have soothing strategies on hand.
CAUSES
It can happen for many reasons.
Colic usually happens in babies under 3
months old. Doctors aren’t sure why babies get colic, but they think it may
make the intestines tighten painfully. Your baby might have colic if he:
- Cries more in the late afternoon or evening
- Cries for at least 3 hours for 3 days a week or more
for at least 3 weeks
- Pulls his legs to his chest when he cries
- Passes lots of gas
Soothing strategy: Every baby is different, but
there are options you can try:
- Swaddle your baby in a blanket.
- Hold your baby and walk around or rock him.
- Use white noise as a distraction.
- Offer a pacifier.
But not all crying is colic. See a
doctor if your baby is crying a lot and doesn’t seem to be better or has other
symptoms such as diarrhea, fever, or not eating well. Also, take care of
yourself. The constant noise and stress of a crying baby can wear down even the
most patient parent. Call on a partner or caregiver to step in when you need a
break.
Gas. In babies, colic and gas often go
hand and hand. Their new digestive systems are still working out the kinks as
they grow. Gas can come from:
- Swallowing air
- Trouble digesting formula or certain foods
- Trouble with breast milk when mom eats certain foods
If you’re
breastfeeding your baby, talk to his doctor about the foods you eat. You may be
able to solve the problem by avoiding foods that seem to bother your baby. If
he takes formula, ask your doctor if switching to a different kind might help.
Constipation. It can hurt when little systems back
up. If all your child can get out is hard, dry bowel movements, or none at all,
he’s constipated.
Some of the reasons constipation
happens include:
- Holding in
bowel movements
- Not eating
enough fiber-rich foods like fruits and vegetables
- Not drinking
enough water
- Changes in
diet or routine
- Taking
certain medications
- Milk
allergies
Although it can happen in babies,
it’s more common once a child starts to eat solid foods. Keep in mind that it’s
normal for babies to strain and grunt while they try to poop. It’s even OK for
them to go a few days between bowel movements if they’re otherwise OK.
Soothing strategies: The best way to calm a
constipated tummy is to get bowel movements moving again. There are a few ways
you can help get things going:
- Give your child, depending on her age, 1 or 2
teaspoons of prune juice.
- Don't feed you baby foods that can constipate, like
milk and cheese.
- Make sure your child is moving around.
- Take a break from toilet training.
Don’t give your child a laxative
until you check with his doctor.
Reflux. Babies with reflux (heartburn)
have a burning sensation from stomach acid coming back up their esophagus.
Sometimes, infants with reflux have a digestive disorder called GERD
(gastroesophageal reflux disease). Signs include:
- Refusing to
eat
- Hiccups
- Gagging or
choking
- Coughing a
lot, especially at night
- Wheezing
- Frequent ear
infections
- Rattling in
the chest
- Vomiting or
spitting up a lot
- Poor weight
gain
Soothing strategies: If you are worried about
reflux, see your baby's doctor. The doctor can recommend different feeding
positions that keep your baby upright and help acid stay out of his esophagus.
There are also medications your doctor can prescribe that take away stomach
acid and make the stomach empty faster. Many infants outgrow reflux problems by
age 1.
TYPES
OF TUMMY TROUBLES
Here are some of the things that cause tummy troubles:
- Constipation is a top reason kids get belly pain. If you haven't had a bowel movement (poop) for a while or if it hurts to go to the bathroom or your bowel movements are hard, you are probably constipated.
- Diarrhea is often caused by an infection that
some people call "the stomach flu." When you have diarrhea
— runny, watery bowel movements — you may also feel sick to your stomach.
The pain is one way your body tells you to stay near a bathroom!
- Other belly troubles. Belly pain also can happen with a urinary
tract infection or a blocked intestine. Infection by bacteria or a
parasite, heartburn, irritable bowel disease,
or inflammatory
bowel disease also can cause it.
- Something you eat. Some kids get belly pain because they
ate too much of something, a food that was too spicy or greasy, or food
that sat around in the fridge for too long and went
bad.
- Food intolerance or food allergy. Some people have foods that are hard for
them to digest. This is called a food intolerance. For example, people with lactose intolerance have
a tough time digesting lactose, a type of sugar found in milk and other
dairy foods. A food allergy is
different, and some can be very serious. Food allergies can cause immune system reactions
that can harm the body. Someone with a food allergy must always avoid that
food.
- Appendicitis. If the pain starts by your belly button
and then moves to the lower right side of your belly, it might be appendicitis. Fever or
vomiting, along with pain that gets worse and worse and a loss of
appetite, also can be signs of appendicitis.
- An infection someplace else in your body may cause belly pain too. A sore throat, pneumonia,
an ear
infection, or a cough can sometimes cause tummy trouble.
- Stress. Many, many kids
(and adults, too) have a "nervous stomach" when they are worried
or stressed.
WHEN TO SEEK URGENT MEDICAL HELP FOR ABDOMINAL PAIN IN CHILDREN
If your child’s stomachache comes on really quickly, or if it won’t go
away, check in with the pediatrician. His doctor will especially want to know
if your child has other symptoms, such as:
v Vomiting
v Fever of 100.4 or higher
v Headache
v Sore throat
v Diarrhea that lasts a few days or
more
These can be signs of infections,
such as:
- Strep throat, which is very uncommon in babies
- Urinary tract infection (most common in girls ages
1-5)
- Gastroenteritis
- Rotavirus
- Salmonella
- E. coli
- Campylobacter
- Shigellosis
WHEN TO CALL A
DOCTOR
Call your child’s doctor immediately if your child has any of the
following:
Ø Persistent
pain on the right side of the abdomen, which could be an appendicitis
Ø Pain
confined to one part of the abdomen
Ø Severe or
rapidly worsening abdominal pain or pain that doesn’t go away within 24 hours
Ø Pain or
tenderness when you press on the belly
Ø A swollen
abdomen or an abdomen that is rigid to the touch
Ø Pain in
the groin, or pain or swelling in a testicle
Ø Unexplained fever
Ø Lots
of vomiting or diarrhea
Ø Bleeding
from the rectum
Ø Blood in the stool or vomit
Ø A recent
abdominal injury
Go
to your local doctor or the emergency department of your nearest hospital
straight away if your child has:
·
severe or
worsening pain or pain that has moved position
- ·
fever or chills
- ·
become pale,
sweaty and unwell
- ·
been vomiting for
more than 24 hours
- ·
refused to eat or
drink
- ·
blood in their
vomit or poo
- ·
problems passing
urine or is producing less than four wet nappies a day
- ·
skin rash with
pain
·
any other problem
that concerns you.
A STOMACH ACHE WORRIES DOCTORS WHEN…
- .
The pain is severe. By severe, I mean that the child cannot
be distracted from it and is crying or otherwise showing that they are
extremely uncomfortable. Any severe pain warrants a trip to the doctor, whether
it’s unrelenting or it comes and goes.
- . There is blood in the stool. Most of the time, we see blood in the
stool with constipation, which
is usually not serious and can be easily treated. But a bad stomach ache with
blood in the stool can be a sign of a serious infection, inflammatory bowel disease,
or another intestinal problem. So, any time your child has a stomach ache and
blood in the stool, give your doctor a call to be on the safe side.
- . The child vomits blood. As with blood in the stool, this isn’t
always a sign of something serious. Children who have been vomiting a lot can
sometimes vomit some blood, and children who have nosebleeds, or bleeding from
a lost tooth or some other problem of the mouth, may vomit that blood back up.
But as with blood in the stool, any stomach pain with vomiting blood requires a
call to the doctor.
- .
There is green vomit. Green vomit can be a sign of a blockage
in the intestine. Sometimes people vomit some yellow-green material when they
have vomited up everything else, but stomach pain and green vomit should never
be ignored.
- . The child has hives, looks pale,
complains of dizziness, or has swelling of the face. Anaphylaxis, the most serious kind of
allergic reaction, can cause stomach pain, often with vomiting. For this one,
you should call 911. If your child has a known allergy and you have epinephrine
at home, give it while you wait for the ambulance to arrive.
- .
The stomach pain is in the right lower
side of the belly. That’s where the appendix is. Early on, the stomach ache
of appendicitis is usually around the belly button, but then it moves to what
we doctors call “the right lower quadrant.” Constipation can cause pain there,
and girls who get periods can have pain there when they ovulate, but we don’t
like to miss appendicitis. So, any pain in that part of the belly should get
checked out.
- The child has a fever and a bad cough. Pneumonia can sometimes cause a
stomach ache. Now, many viruses can cause a stomach ache along with a cough,
but if the cough is particularly bad, or the stomach ache is getting worse, or
the child seems to be breathing quickly or otherwise differently, call the
doctor.
- .
The child says it hurts to
urinate. Sometimes a
stomach ache can be a sign of a urinary tract infection.
- .
The child has a high fever or seems
much sleepier than usual. Stomach aches can be seen in serious infections — and
being very sleepy when you are in pain can be a sign not just of infection but
of low blood pressure or blood loss. High fevers and extra sleepiness should
always be checked out, but especially if there is a stomach ache too.
- . The child is losing weight. It’s not uncommon for a child to lose a
little weight from vomiting or diarrhea. Usually they gain it back once they
feel better. But if a child who gets stomach aches is steadily losing weight —
for example, their clothes no longer fit — they should be thoroughly checked
out by the doctor.
TAKING CARE OF YOUR CHILD WITH ABDOMINAL PAIN
·
Make sure your
child gets plenty of rest.
·
Help your
child drink plenty of clear fluids such as cooled boiled water or juice.
·
Do not push
your child to eat if they feel unwell.
·
If your child
is hungry, offer bland food such as crackers, rice, bananas or toast.
·
Place a hot
water bottle or wheat bag on your child’s tummy or run a warm bath for them.
Take care not to scald yourself or your child.
·
Give paracetamol
if your child is in pain or is miserable. Remember that doses for children are
often different to those for adults, so check the packet carefully for the
right dose. Avoid giving aspirin.
STOMACH PAIN QUESTIONS
The following questions may be
helpful in clarifying details of the abdominal pain and possible triggering
factors, such as specific foods or stressors. They can also be valuable when
discussing your child’s condition and treatment with your doctor.
Ø
Food – what
did you eat today?
Ø
Sleep – did
you sleep well? Did you have any nightmares?
Ø
School/daycare
– how was school/daycare today?
Ø
Leisure time –
what did you do in your leisure time today?
Ø
Sport – have
you done any sport or other physical activity today?
Ø
Did anything
special or remarkable happen today?
Ø
Toilet habits
– normal or unnormal today?
Ø
Stool form –
for example hard lumps, like a sausage, soft, fluffy or watery?
TESTING AND
DIAGNOSIS OF FUNCTIONAL ABDOMINAL PAIN
Your healthcare provider will obtain a detailed history
of the pain and perform a physical exam. In functional abdominal pain, physical
exam is normal and the child is growing well. Screening tests may be performed
to screen for other conditions causing pain. Extensive testing, including
endoscopy is usually performed only if basic screening lab results do not fit
the diagnosis of functional abdominal pain. If physical exam and screening
tests are unremarkable, then a diagnosis of functional abdominal pain may be
made.
Testing may include:
ü
Blood tests. These tests are done to evaluate whether your child is
anemic, has an infection, or has an illness caused by inflammation, irritation
or autoimmune factors.
ü
Urine analysis and culture. These are done to help assess for
urinary tract infections.
ü
Stool sample. This sample is taken to culture to check for bacteria
and parasites that may cause diarrhea.
ü
Stool samples for occult blood. Occult blood cannot be seen and is
only detected by a special solution that turns blue when coming into contact
with blood. It suggests an inflammatory source in the gastrointestinal tract.
ü
Abdominal ultrasound. A diagnostic imaging technique which
creates images from the rebound of high-frequency sound waves in the internal
organs. Used to evaluate for potential disorders of the kidneys, liver, pancreas
and gallbladder.
CONSULT YOUR
CHILD’S DOCTOR EARLY WHEN:
Any of the symptoms in your child, e.g.
stomach pain, vomiting or diarrhoea, becomes worse within 12 – 24 hours
v
Your child’s stomach pain becomes localised
(e.g. in the right lower abdomen, as in the case of acute appendicitis)
v
Your child’s stomach pain is severe, constant
or lasts for more than 1 hour
v
Your child’s abdomen becomes painful to touch
v
Your child’s abdomen becomes distended
v
Your child is unable to pass motion or gas
v
There is fresh blood in your child’s urine,
stools, or vomitus
v
Your child’s vomit is greenish in colour
v
Your child’s stools becomes black, sticky,
and foul smelling
v
Your child is having difficulty passing urine
or has pain on passing urine
v
Your child keeps vomiting and is unable to
retain any oral fluids
v
Your child is lethargic and appears unwell
v
Your child is having fever
v
Your child appears breathless or off-colour
Dr Mohit Ghai (Ghai Mother & Child Clinic)
Address: Shop No 140,Mahagun Mywoods Mart FF, Sector 16C Opp Gaur City 2,Noida Extension, Landmark: Mahagun Mywoods Mart FF, Noida
Email: drmohit@ghaihealthcare.com
for more information kindly visit website
for on line appointment
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