Chronic Abdominal Pain in Children

Chronic abdominal pain in children is a common issue that can lead to distress and confusion for both children and their parents. While many causes can contribute to this discomfort, it is important to understand the underlying reasons and treatment options. If your child experiences continuous or severe abdominal pain, timely diagnosis and medical attention are crucial.

What is Chronic Recurrent Abdominal Pain?

Chronic recurrent abdominal pain refers to ongoing or recurring stomach discomfort that lasts for weeks or months. It is a common issue in children, with many experiencing episodes that interrupt daily activities like school or play. Typically, this pain can vary in intensity, duration, and location. It is important to note that while this pain can be alarming, it is not always linked to a serious underlying medical condition. However, the chronic nature of the pain can lead to anxiety and stress, making it important to understand the issue and approach it with the right care.

Chronic Recurrent Abdominal Pain Causes

There are several potential causes of chronic stomach pain in children. Some of these may be related to dietary habits, emotional stress, or underlying medical conditions. Below are some of the most common causes:

Functional Gastrointestinal Disorders
These are conditions where children experience symptoms like stomach pain, bloating, and changes in their bowel movements, but tests don’t show any clear issues with the digestive system. Essentially, the digestive system is not working properly, even though everything looks normal. One common example of this is Irritable Bowel Syndrome (IBS), where children might have cramping, bloating, or a mix of constipation and diarrhoea.

Constipation

One of the most common causes of abdominal pain in kids is constipation. When children are not able to pass stool regularly, it can cause bloating, discomfort, and pain.

Food Sensitivities or Allergies

Certain foods may trigger abdominal pain in children, especially if they have sensitivities or allergies to dairy, gluten, or other common ingredients.

Gastroesophageal Reflux Disease (GERD)

CERD is a condition where stomach acids flow backwards into the oesophagus, leading to discomfort, pain, and sometimes vomiting. It can be a significant source of chronic abdominal pain in children.

Psychological Factors

Stress, anxiety, or emotional issues can also manifest as physical pain in the abdomen. This is often referred to as “psychosomatic” pain. Children dealing with stress or major life changes, like school pressure or family dynamics, may experience stomach aches as a response to these emotions.

Infections

Bacterial, viral, or parasitic infections can cause temporary stomach pain. These are often accompanied by other symptoms such as fever, diarrhoea, or vomiting.

Appendicitis

While less common, appendicitis can cause sudden and severe abdominal pain, usually starting around the belly button and shifting to the lower right side of the abdomen. This condition requires urgent medical attention.

Chronic Recurrent Abdominal Pain Diagnosis

To diagnose paediatric abdominal pain, a paediatrician will perform an in-depth assessment, including a detailed medical history and physical examination. Some diagnostic steps may include:

Medical History Review

The doctor will ask about the child’s symptoms, including the frequency, intensity, and duration of the pain. They will also inquire about eating habits, bowel movements, and any recent stressors or emotional concerns.

Physical Examination

A thorough physical exam will help the doctor rule out any obvious causes of pain. This may involve checking for tenderness, bloating, or signs of infection.

Blood Tests

Sometimes, doctors may recommend blood tests to look for infections, inflammation, or other conditions like food allergies or anaemia.

Imaging Tests

If the pain is severe or persistent, imaging tests like an ultrasound or X-ray may be recommended to examine the digestive system and identify any structural issues, such as constipation or a problem with the organs.

Endoscopy or Colonoscopy

In rare cases, doctors may recommend more invasive tests, such as an endoscopy or colonoscopy, to examine the inside of the digestive tract. These procedures are typically reserved for severe or long-term cases.

Psychological Assessment

If the doctor suspects emotional factors are contributing to the pain, they may refer the child for psychological evaluation. Stress, anxiety, and depression can manifest as physical pain, including stomach ache in kids.

Chronic Recurrent Abdominal Pain Treatment

Treating chronic abdominal pain in children depends on the underlying cause. Here are some general approaches to managing the condition:

Dietary Adjustments

If food sensitivities or allergies are identified, the child may be advised to avoid certain foods. A paediatric nutritionist may help design a suitable diet to minimize discomfort.

Laxatives or Stool Softeners

For constipation-related pain, doctors may recommend the use of laxatives or stool softeners to relieve bowel obstruction and improve regularity.

Stress Management

If psychological factors are involved, stress management techniques such as relaxation exercises, therapy, or mindfulness may help alleviate pain. Cognitive-behavioural therapy (CBT) is often effective in treating pain related to anxiety or depression.

Medications

In some cases, medication may be necessary to manage symptoms. Over-the-counter antacids, probiotics, or medications for IBS may be prescribed. However, always consult a doctor before giving medicine for stomach pain to a child to ensure it’s safe and effective.

Hydration and Fiber

Increasing water intake and consuming a diet high in fibre can promote healthy digestion and help prevent constipation, which is a common cause of abdominal pain.

Probiotics

Probiotics may help improve the balance of gut bacteria and reduce bloating or discomfort, especially in children diagnosed with IBS or digestive issues.

Surgical Intervention

If the child is diagnosed with a more serious condition like appendicitis or a gastrointestinal obstruction, surgical intervention may be required.

When to Seek Urgent Medical Help for Abdominal Pain in Children

While most cases of abdominal pain in children are manageable and not serious, certain warning signs require immediate medical attention. Here’s when you should seek urgent help:

• Severe, sudden pain: Severe and sudden abdominal pain, especially in the lower right side, maybe a sign of appendicitis or some other serious condition that requires immediate attention.
• Pain with vomiting or fever: If the pain is accompanied by vomiting or fever, especially if it lasts for more than 24 hours, it could indicate an infection.
• Blood in stool or vomit: Any blood in a child’s stool or vomit should be taken seriously and warrants immediate medical attention.
• Pain with difficulty breathing: If the child experiences abdominal pain along with difficulty breathing, it could signal a serious condition, and urgent medical help is necessary.
• Pain after injury: If the pain starts after a fall or injury, it may suggest internal damage that needs immediate assessment.

If you’re ever uncertain about your child’s condition, it’s always better to consult a doctor. A paediatric hospital in Bangalore can provide expert care in diagnosing and treating any underlying conditions causing abdominal pain.

Conclusion

Chronic abdominal pain in children can be distressing, but understanding the causes, diagnosis, and treatment options can help parents better manage the situation. Whether the pain is functional or caused by an underlying health issue, seeking timely medical advice is essential for both the child’s comfort and long-term health. Always ensure your child is seen by a healthcare professional when symptoms persist or worsen. With proper care and attention, most children can recover and go on to live pain-free lives.

Frequently Ask Questions

When should I worry about abdominal pain in a child?

While abdominal pain is common in children, you should be concerned if it is intense, lasts more than 24 hours, or is accompanied by symptoms like fever, vomiting, diarrhoea, weight loss, or blood in the stool. Immediate medical attention is necessary if the pain is so severe that the child cannot move or if it is focused in specific areas like the lower right abdomen, which might indicate appendicitis.

What are the red flags for paediatric abdominal pain?

Some warning signs to watch for include:

• Ongoing or intense pain.
• Pain disrupting sleep.
• Vomiting blood or bile.
• Blood in stools.
• Fever along with abdominal pain.
• Signs of dehydration, such as a dry mouth or infrequent urination.
• A bloated or tender stomach.

How can I relieve abdominal pain in a child?

For mild abdominal discomfort:

• Let the child rest and avoid heavy meals.
• Offer small amounts of water or clear fluids to keep them hydrated.
• Use a warm compress on their tummy for relief.
• Provide easy-to-digest foods like rice or bananas if they feel hungry.

If the pain doesn’t improve or worsens, consult a healthcare provider.