Sudden tummy aches in children

While many children use stomach aches to get out of school, most parents will quickly be able to tell whether the child is shamming or if he/she is in fact suffering from abdominal pain.

Acute pain usually develops or worsens suddenly and might need urgent treatment.

Acute gastroenteritis

One of the most common causes of abdominal cramping in children is an infection caused by a virus or bacteria. Intermittent and non-specific abdominal pain in the upper or lower abdomen, sometimes accompanied by vomiting, diarrhoea or fever are symptoms of acute gastroenteritis.

To determine if the infection is viral or bacterial, a stool test and stool culture are done. If it's a virus, the doctor will treat the symptoms and ensure the child is not dehydrated by observing urine output. If no urine is passed in 6-8 hours, it indicates that the child is dehydrated.

Your child's body will eliminate the virus by itself within a week. In case of bacteria, antibiotics are required. In case of diarrhoea, sweets or fatty food should be avoided and the child should drink oral dehydration solution.

All food needs to be cooked, handled, fed and eaten hygienically. Hand washing including nails and clean spoons and cutlery are important. In the case of babies, clean toys are also a good preventive measure.

Gastritisis, which is seen in many children, has symptoms very similar to gastroenteritis, including upper abdominal pain and vomiting but not diarrhoea. Gastritis is caused by a virus infection and the body eliminates the virus eventually.

Appendicitis

Appendicitis is characterised by umbilical pain, which then moves to the right lower quadrant. Usually, children complain of pain first, followed by fever in some cases. Children are often unable to specify the exact location and kind of pain, making diagnosis difficult. It can be distinguished from gastroenteritis by the continuous pain. Any change in position increases pain, and vomiting and diarrhoea may sometimes be present. It is diagnosed by ultrasound or CT scan of the abdomen. Surgery is the only treatment.

Constipation

Constipation can cause acute and chronic abdominal pain but parents find it difficult to identify. History of difficulty in passing stools, hard stool and withholding stool are all clues. Constipation can be relieved by passing stools, and is very common in children and babies. Acute abdominal pain, intermittent abdominal pain, abdominal distension, and faecal impaction are all symptoms of constipation. The most common cause is insufficient intake of water and fibre, though behavioural problems like withholding stools could also be responsible. Ensure the child eats plenty of fibre and water, and use an enema if required. Motivational tools like a star chart, behavioural therapy and toilet training are other preventive measures.

Intussusception

This disorder occurs when part of the intestine slides into an adjacent part of the intestine. Pain can be intermittent or persistent and it is cause for concern only when the pain is persistent. Usually, such pain is accompanied by bloody stools. Children tend to cry continuously and prefer a foetal position. An ultrasound is the most common diagnostic tool. The problem can be treated by administering barium enema to reduce the blockage. If untreated, it could lead to gangrene in the bowel. Dark red stools indicate an emergency. In some cases, surgical intervention may be necessary.

Gut obstruction

When malrotation, narrowing or blockage of the small or large bowel of the gastrointestinal tract occurs, the child will suffer intermittent abdominal pain with vomiting or abdominal distension. This can be congenital or may follow surgery. Always inform the doctor if your child has had surgery of the abdominal region.

Other causes of abdominal pain could include gastrointestinal problems such as pancreatitis. The symptoms, abdominal pain and vomiting, are very similar to other ailments of the stomach and can often be confused. Liver and biliary disease can be identified when the abdominal pain is accompanied by jaundice, nausea, fever, and in some cases, liver enlargement. History of abdominal trauma or injury could be a marker of internal organ haemorrhage.

Abdominal pain can also be due to non-gastrointestinal problems. In boys, testicular torsion (where blood supply to the testicle is obstructed) and hernia could also cause abdominal pain. A physical exam of the genital area might be necessary to diagnose this. It is usually caused by ligament weakness. Pubescent girls could also experience stomach pain due to pelvic inflammatory disease, ovarian torsion and other gynaecological problems. Urinary tract infection in both boys and girls involves lower abdominal pain, and pain during urination. It can be diagnosed with a urine examination.

When your child complains of tummy ache, often, as parents, you don't know how serious it is. Take your cue from the child. If the child cries continuously for 20 minutes, it is time to head to the hospital. If your child is prone to tantrums, then you may wait a little longer, but definitely, no more than an hour.