Abdominal pain is very common in children, and it can be acute pain, meaning it happened all of a sudden, or it can be chronic or long term. You should not force a child with abdominal pain to eat, but you may encourage him to drink plenty of clear fluids. You should call your physician if pain lasts longer than three hours and is not improving or if you suspect that he may have appendicitis, an intestinal obstruction, strangulated hernia, or urinary tract infection.
Among the associated factors that can help determine the cause of abdominal pain include the presence of diarrhea, constipation, fever, and weight loss. The exact location of the pain can also be helpful, as well as how long the pain lasts, what makes it better (especially if you have been using over the counter medications) and what makes it worse.
Although often not necessary for most children with abdominal pain, testing may include plain xray (KUB), abdominal (and/or pelvic) ultrasound or CT scan, stool cultures (for parasites and bacteria), stool test for blood.
- gastroenteritis: pain usually also accompanied by diarrhea and or vomiting.
- appendicitis: continuous abdominal pain that moves to the lower right side and is followed by vomiting.
- constipation: cramping lower abdominal pain, usually in a child with a history of having infrequent bowel movements
- intestinal obstruction: a blockage of the intestines can cause severe pain and vomiting. Your child's vomiting may be bilious (dark green or yellow) and he will probably not be having bowel movements or passing gas. This is a medical emergency.
- nonspecific or functional abdominal pain: chronic or recurrent abdominal pain in children without diarrhea, vomiting, constipation or weight loss. Pain is usually mild and centered around the belly button. It is usually not know what causes this type of pain, but it may be secondary to stress.
- reflux: children with reflux may have a sour taste in their mouth and a burning substernal chest pain. The pain may be worse at night and after meals.
- irritable bowel syndrome: Children with IBS have crampy abdominal pain and bowel movements that alternate between normal, constipation and diarrhea.
- inguinal hernia: severe pain accompanied by a bulging in your child's groin or scrotum.
- urinary tract infection: lower abdominal pain with fever and pain with urination.
- food allergy (lactose intolerance): usually chronic pain that follows eating or drinking certain foods and is accompanied by bloating, gas and diarrhea.
- ulcers: burning epigastric pain, usually worse before meals, at night and in the early morning. Children with ulcers usually also have vomiting and a family history of ulcers. They may also have blood in their stool. The pain may be relieved by antacids and by eating.
- hepatitis: usually caused by viruses that cause inflammation in the liver. There are many viruses that can cause hepatitis, but the most common are Hepatitis A, B, and C. Symptoms include fatigue, pain in the right upper side of the abdomen, vomiting and jaundice.
- celiac disease: with gas, chronic diarrhea, bloating, poor weight gain and recurrent abdominal pain
- inflammatory bowel disease: Children with ulcerative colitis and Crohn disease diarrhea, usually with bleeding, cramping abdominal pain, obstruction (a blockage of the intestine), malabsorption (failure of the intestines to absorb minerals and nutrients), and weight loss or poor weight gain.
- Other causes of abdominal pain can include a lower lobe pneumonia,
- Gynecological causes of abdominal or pelvic pain can includ ovarian cysts, torision, ectopic pregnancy, and pelvic inflammatory disease. Also Mittelschmerz is a dull or cramping lower abdominal pain that occurs with ovulation (midcycle) and may last a few minutes to 6-8 hours