Abdominal Pain

What Is Abdominal Pain?

• Discomfort in the stomach and stomach area;
• Pain that is localized from the lower ribs to the groin;
• An older child may complain of abdominal pain;
• A younger child is crying, pointing at the abdomen or moving the legs.

Causes of Acute Abdominal Pain

• Overeating food - causes mild abdominal pain;
• Hunger pains - causes abdominal pain while fasting;
• Viral illness of the gastrointestinal tract (e.g. rotavirus) - spastic pain that may be accompanied by vomiting and/or diarrhea;
• Food poisoning - sudden onset of pain, vomiting and/or diarrhea that develops a few hours after eating suspicious food, due to toxins in the food. In most cases, the symptoms go away within 24 hours. This can be managed at home;
• Constipation - spastic pain in the lower abdomen;
• Strep throat infection (sore throat) - in 10 per cent of cases, causes abdominal pain together with fever;
• Urinary tract infection - in some cases, the only symptom is pain in the lower abdomen, but most often, there is painful urination and foul-smelling urine;
• Appendicitis - appendicitis can be suspected if the pain is localized in the right lower abdomen and radiates to the leg. The child refuses to run or jump and lies still;
• Intussusception - an attack of severe pain that is followed by rest periods and then repeated. It is a condition in which part of the intestine slides into an adjacent portion of the intestine. Most often occurs between the ages of 6 months to 2 years.

Causes of Recurrent Pain

• Stress and nervousness - occurs in 10% of patients. These children are very sensitive and serious. Pain is mainly localized to the navel area.
• Abdominal migraine - attacks of abdominal pain and vomiting have a sudden onset and end. It often develops in children with migraine headaches and is strictly genetic.
• Functional abdominal pain - occurs in children with a sensitive gastrointestinal tract. Organic pathology is not expressed.
• Shirking - occurs predominantly on school mornings, causing the child to miss school.

Severity of Pain

• Mild: the child feels and complains of pain, but the pain does not interfere with everyday activities. The rhythm of school, play and sleep does not change.
• Moderate: pain makes it difficult for the child to do some activities. The pain may wake the child up.
• Severe: strong, unbearable pain. It interferes with any regular activity.

Seek Medical Attention Immediately in The Following Situations:

• The child cannot move or stand because of weakness;
• You think the child has a life-threatening or urgent condition;
• You think the child has appendicitis;
• Severe and constant pain (child cannot move or do anything);
• Cannot walk or holds hands on the stomach when walking;
• There is blood in the stool or vomit;
• Vomit contains bile (green color). The exception is gastric juice, which is yellow;
• You suspect that the child has swallowed a foreign body (e.g. a coin);
• The pain is localized in the lower right side;
• Persistent pain or crying for 2 hours or more;
• Trauma to the abdominal area;
• Child at high risk (e.g., diabetes, sickle cell anemia, recent surgery);
• A baby less than two years old;
• A child has a fever of 40°;
• A child does not look well.

Seek Medical Attention Within 24 Hours in The Following Situations:

• Mild pain that prevents some activities;
• Mild spastic pain that starts and goes away but lasts more than 24 hours;
• Significant fever;
• Suspected urinary tract infection;
• Abdominal pain is a frequent problem.

What Can Be Done at Home?

Let the child lie down until it feels better.

Clean Liquids

• Give water or clean liquids of any kind;
• If pain is mild, give regular food.

Be Prepared to Vomiting 

• Have a basin ready at hand;
• Small children may have abdominal pain if nauseated and before vomiting.

• Take the child to the toilet for a bowel action;
• Bowel action may help if the abdominal pain is the result of constipation or diarrhea.

Do Not Give Medicines

• Some medicines (e.g. ibuprofen) may make the abdominal pain worse;
• Do not give painkillers or laxatives for spasmodic pain;
• If the fever is high (39° or more) give paracetamol.

What to Expect?

• Pain resolves or goes away within 2 hours unless a serious cause is present;
• Spastic abdominal pain with diarrhea gets worse before an episode of vomiting or diarrhea;
• Pain in the stomach from a severe illness (e. g. appendicitis) is worse and more persistent.