How common is abdominal pain in children?
Chronic (lasting more than 3 months) or recurrent abdominal pain is one of the most common reasons that parents seek medical attention. The important point here is that the pain recurs or persists for a prolonged period of time as opposed to an acute or sudden, one-time episode of the stomach flu, for example.
What are the causes of recurrent abdominal pain?
Although there can be a lot of possible causes, in most cases, a medical cause of abdominal pain is not found. Surprisingly, when a cause is found, the most common cause is constipation. Other possible causes include
- Lactose intolerance
- Gastro-esophageal reflux and rarely ulcers
- Urinary tract or bladder infection
- Any abdominal organ problem(such as tumor or inflammation
When does one worry about abdominal pain?
Usually children with recurrent abdominal pain have no other associated symptoms and continue to grow and develop normally. Possible alarm or warning signs that there is a serious underlying problem include:
- Weight loss
- Blood in the stools
- Black or white colored stools
- Urinary symptoms
- Decreased appetite
- Any other associated symptoms such as pallor and fatigue
Fortunately in most cases there is no underlying serious medical problem.
What tests are needed when evaluating children with recurrent abdominal pain?
When a physician evaluates a child for abdominal pain there are a variety of tests including x-rays, and blood tests that may be done. Which specific tests and how many are performed, if any, depends on the overall individual situation. Generally if a child is well otherwise with normal growth and there are no alarm symptoms or signs present, there may be no or minimal testing.
What about appendicitis?
As opposed to recurrent or functional abdominal pain of childhood, appendicitis usually doesn’t linger on for months. Acute appendicitis, usually begins suddenly with pain in the center of the abdomen (belly button area) which then slowly, works its way down to the right side. There are also some specific signs that a doctor can find during a physical examination. If you suspect your child has appendicitis, seek immediate medical attention. For more information on appendicitis in children click here
What can be done for constipation?
Parents are often shocked to find out that the most common identifiable cause of recurrent abdominal pain in children is constipation. In many cases, parents do not even realize that their child is constipated. Abdominal pain due to constipation results from “overloaded intestines” that do not empty out completely. The retained stool puts pressure on the intestines resulting in abdominal pain. This is why in some instances the pain is relieved if the child goes to the bathroom. Once the diagnosis of constipation has been confirmed, the treatment is usually simple. For more information on constipation click here.
Can milk allergy or lactose intolerance cause abdominal pain?
Abdominal pain is not the most common symptom of milk allergy although it can rarely be. On the other hand, lactose intolerance can cause recurrent abdominal pain. In most cases there is also associated diarrhea or bloating. However, lactose intolerance can present just with symptoms of abdominal pain. Lactose intolerance means that a child or an adult cannot digest the milk sugar: lactose. For more on milk protein allergy click here.
What if a cause of the abdominal pain is not found?
When no obvious medical cause is found it is referred to as idiopathic or functional abdominal pain of childhood. Once a medical/physical cause has been ruled out, social stressors such as school or family problems (ie: recent family problems such as divorce separation etc) need to be identified as these may be causing the pain. The pattern of pain may be helpful: For example, if a child’s pain is worse during weekdays and absent during weekends and the summer, this is suggestive of school related stress as the cause. If after a complete assessment, social stressors are identified as the cause of a child’s recurrent abdominal pain the treatment approach focuses on helping and supporting the child deal with the stress. Depending on the circumstances, this may require the help of other professionals such as psychologists, guidance counsellors, teachers and/or social workers.
Pediatrician DR.PAUL Roumeliotis is certified by the American Board of Pediatrics and Royal College of Physicians and Surgeons of Canada. The information provided above is designed to be an educational aid only. It is not intended to replace the advice and care of your child’s physician, nor is it intended to be used for medical diagnosis or treatment. If you suspect that your child has a medical condition always consult a physician.