What are the Causes of Abdominal Pain?
What are the Causes of Abdominal Pain? Most pediatricians have heard that phone call before. The one that typically starts with, “Hello Doctor, my child has a stomach ache! What’s wrong with him?” From this benign statement, there are lots of possibilities that start to flow through the head of every pediatrician. There are important questions that need to be answered. Some of these include:
- Did the child just eat too much candy?
- Is this possibly an emergency?
- What if this child has appendicitis?
- Does he need to go to the emergency room?
- What if it is a harmful ingestion?
- Could the child be constipated?
The world of abdominal pain can run the spectrum from the life-threatening emergency to the benign stomach ache. It is important for parents and medical providers to understand some of the common causes of abdominal pain in children. Ensuring that children receive the proper treatment depends on making the right diagnosis.
Location is Everything
The first step in sorting through abdominal pain is to figure out where in the abdomen this pain is coming from. Unfortunately, in a child, this can be a challenge. Children often have trouble verbalizing what they are feeling and where it is coming from. Some important possibilities to think about include:
- First, epigastric pain is located at the belly button. This could come from reflux, an ulcer, or even pancreatitis.
- Next, pain in the right upper quadrant could be caused by hepatitis, gallstones, or even a gallbladder infection. Sometimes, this could even be a sign of right lower lobe pneumonia.
- Left upper quadrant pain could also be caused by a pneumonia of the left lung. The spleen also sits in this region and could be damaged.
- Pain in the left lower quadrant is frequently caused by constipation; however, it also could be a sign of testicular torsion or ovarian torsion. In teenage girls, don’t forget about an ectopic pregnancy.
- The right lower quadrant is home to the appendix; however, testicular torsion and ovarian torsion should also be considered
Finally, remember that children often point at the belly button for all abdominal pain. Because of this, it can be hard to tell where the pain is coming from. What are some of the common culprits?
Common Causes of Abdominal Pain in Children
First, when children complain of abdominal pain, they often say that their tummy hurts. Therefore, it is important to think about the common causes. Some of these include:
Constipation: Children can be nervous to use the bathroom in an unfamiliar place. Therefore, they often hold in their stool until they get home. Because of this, their stool can build up and cause constipation. This is a common cause of abdominal pain.
Gastroenteritis: Whenever there is associated vomiting and diarrhea, parents should think about a stomach bug. This is even more likely if there are other children around them with similar symptoms. Keep the child well-hydrated during times of diarrhea and emesis.
Functional: Functional abdominal pain is the catch-all for unexplained pain. This could be a manifestation of anxiety or nervousness. Children often carry their stress in their abdomen.
Some Causes are Surgical Emergencies
On the other hand, some cases of abdominal pain are surgical emergencies. Some of these examples include:
Testicular Torsion: If the testis twists back on itself, this will lead to severe abdominal pain. This twisting cuts off blood flow to the testis and can cause it to die. This child needs to go to the operating room to detorse the testis before this happens.
Appendicitis: Appendicitis starts as pain at the belly button and migrates to the right lower quadrant. Children often don’t want to move and may have a fever. The appendix needs to be removed before it ruptures. If it ruptures, this could be fatal.
Traumatic Spleen Injury: A history of mononucleosis followed by contact sports is concerning for a splenic rupture. The spleen lives in the left upper quadrant. If the spleen ruptures, the child could bleed to death internally. Children infected with EBV should avoid contact sports to minimize this possibility.
Contact a Local Pediatrician
When a child has developed abdominal pain, it is important for parents to think about the possibilities. Sometimes, the child has a mild stomach ache from overeating. Other times, this could be a life-threatening emergency. Some of the important questions to answer include:
- How long has this abdominal pain been there?
- What has the child eaten recently?
- Are there any signs of an infection, such as a fever?
- Is there any associated vomiting or diarrhea?
- What kind of medications has the child taken recently?
Parents should try to collect this information. This will make it easier for the doctor to sort through what is going on. As always, do not hesitate to reach out to a local pediatrician. We are here to answer any questions or concerns. Please remember that we are always there to help families in need.
David Randolph, MD
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