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. Stomach aches are one of the most common ailments amongst babies, children and adults. And although they can vary in nature from mild to extremely painful, the vast majority of tummy aches pass quickly and is not a symptom of anything more sinister than gas or indigestion.

But a child complaining of non-specific stomach pain is not something that is easily ignored. A child in pain can become easily upset so it helps if you understand the type of stomach ache your child is suffering from, what has caused the stomach ache, some simple remedies as well as when you should be concerned.

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 diarrhea, 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.

Urinary tract infection- Stomach aches associated with urinary tract infection tend to produce tenderness when the pelvic area is touched, as well as frequent and painful urination. Urinary tract infections can also cause nausea, vomiting and fever. If you suspect your child has a urinary tract infection, you should see your doctor for treatment.

Anxiety- Stomach pain associated with anxiety is most common in kids aged 5 - 10 years old. These stomach aches often present as ‘butterflies' in the tummy or diarrhea-like symptoms. If suffering from this type of tummy ache, your child may want to sit on the toilet to find relief. Anxiety-induced stomach aches tend to disappear once the source of the stress is alleviated, so the best thing you can do to help your child is to uncover the problem and then work with your child on strategies to cope with the source of their anxiety.  

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 behavior. 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 color 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.

Appendicitis -When it comes to stomach aches, appendicitis is definitely not the first diagnosis you should jump to! While appendicitis is reasonably uncommon, it does occur and if you suspect your child is suffering from the condition, you should see your doctor immediately. Stomach aches caused by appendicitis get worse over a few hours. The pain is centered over the lower right hand section or middle of the abdomen and is tender to touch. Appendicitis may cause nausea and vomiting as well as a fever.

Stomach ache remedies you can try at home

Rest: Encourage your child to lie down quietly for 20 minutes. Lying flat on his back with his knees bent is the best position to ease a tummy ache.

Heat: Place a covered hot water bottle or heated wheat bag on the tender area to help ease the pain.

Drink water: Small regular sips of water can help ease a tummy ache - be careful though not to let your child drink too much too fast as this can make the pain worse and can result in vomiting.

Massage: Gently massaging your child's stomach in a slow clockwise direction - which follows the direction of the digestive system - can help soothe a stomach ache.

Soothing tea: Make a lemon tea sweetened with a little honey. This warm drink will help relax spamming stomach muscles. A weak ginger tea is also very effective at easing stomach ache but most children will struggle to drink it.

Sit on the toilet: Encourage your child to sit on the toilet - for longer than a minute! Aside from the obvious benefits, the position he maintains while sitting on the toilet is an effective way of dispelling painful gas.