What is the cause of abdominal pain in children?
Abdominal pain is a symptom of a variety of medical conditions. In majority of cases, it is due to comparatively harmless causes, which can be treated without admission to hospital. In less than 5% of the cases, the situation is an emergency and immediate hospitalization is required.
Some of the common causes of stomach ache are:
- Indigestion – commonly known as ‘tummy upset’, it is caused by bad food habits like overeating, drinking too many fizzy drinks or eating junk food. Drinking warm water, keeping hot water bottle over the stomach or taking antacids may help to relieve the pain.
- Constipation – This may cause stomach ache, nausea and vomiting. The stools are hard and dry. A high fibre diet, and gentle laxatives helps to relieve the condition.
- Gastroenteritis – It may be caused due to a viral or bacterial infection. The most evident symptom may be diarrhoea, which is associated with severe abdominal cramps, vomiting and fever. A stool examination can identify the cause.
- Worm infestation – caused mostly by roundworms, it can cause recurrent stomach ache in children, particularly those living in conditions with poor sanitation and contaminated water supply. A course of anti-worm medications usually cures the infection.
- Chronic recurrent abdominal pain – this type of pain is seen in late childhood (8-15 years) and more often in girls than in boys. Typically, there is a history of three or more episodes of severe abdominal pain over a period of 3-4 months.This is associated with vomiting and headache. This pain is usually psychological in origin, caused by worry, anxiety or as an attention seeking behaviour. Any physical cause is excluded after thorough examination and investigations.
- Food allergies – abdominal pain is due to allergy to certain food constituents such as lactose in milk. Certain food preservatives used in cold drinks to give colour or in pickles can also cause of stomach ache in children.
- Drugs – certain drugs like those given for epilepsy or malaria and some antibiotics may cause pain in children.
When is abdominal pain serious?
With harmless causes, the pain is usually better or gone in 2 hours. With gastroenteritis, the cramps may precede each bout of vomiting or diarrhoea. If the pain lasts for more than three hours, the doctor should be consulted.
In any case, if the pain is continuous and keeps getting worse, or if it is associated with vomiting and fever, it needs urgent medical attention.
How to deal with it at home?
- Rest: Let the child lie down and rest. Keep a covered warm water bottle or heating pad on the stomach for 20 minutes till the pain is better.
- Diet: Give only sips of clear fluids, but no solids. Keep a vomiting pan handy as younger children are especially likely to refer to nausea as " stomachache."
- Sitting on the toilet: Encourage sitting on the toilet and trying to pass a stool. This may relieve the pain.
What medicines can be taken?
No medications for stomach cramps should be given without consulting the doctor. All laxatives, enemas, and painkillers should be avoided. Laxatives and enemas may make the pain worse by stimulating the bowel and painkillers may mask a more serious illness like appendicitis.
When should the doctor be called immediately?
Medical opinion should be sought when:-
- The pain is severe, constant or lasts for more than 2 hours.
- The pain comes and goes (cramps) and lasts for more than 24 hours.
- The pain is in the scrotum or testicle.
- The pain is followed by repeated vomiting and fever.
- The child looks very sick.
What should be done for stomach aches due to stress?
- The child should have a complete medical checkup before it is concluded that the recurrent stomach aches are due to worrying too much.
- Help the child to worry less. Children with recurrent stomachaches are more sensitive, serious, conscientious, even model children. This makes them more vulnerable to the normal stresses of life. Help the youngster to talk about events that trigger the pains and how to cope with them.
- These children have a tendency to want to stay home when the going gets rough. Make sure that the child does not miss any school because of stomach aches.
- Teach the child to use relaxation exercises for mild pains. Make them lie down in a quiet place; take deep, slow breaths; and think about something pleasant. Listening to music or a favourite television programme might help.