March 18, 2018
ARTICLE:

Tummy Pain in children

By Dr Megan Yap - Paediatrician

Nothing worse for a parent than knowing your child is in pain or ill and not knowing what to do about it or whether to worry.  Tummy pain is a very common symptom in childhood.   Almost any medical problem in a child can present as a “tummy ache” and the challenge is to sort out the serious from the not-so serious.  Most parents know their children and if they can be easily distracted from their pain and they LOOK well, chances are they ARE well.  If they cannot be distracted and are pale and lethargic, things could be more serious.

GPs and doctors (and nurses) who see sick children are used to differentiating between causes of abdominal pain.   They would much rather see your child and reassure you that they are well, than have you stay up all night worrying about your child having a serious illness.

Bottom line is, trust your gut (pardon the pun) – if something is making you worried, seek medical advice.

 

Common causes of abdominal pain – this is a general guide only and not an exhaustive list

• Reflux – after food, burning, epigastric (up behind your breast-bone and lower part of your neck), relieved with milk

• Gastroenteritis – vomiting and diarrhoea

• Constipation – hard and/or infrequent bowel motions

• Mesenteric adenitis – recent viral infection, can mimic appendicitis

• Urinary tract infection – dysuria, frequency, bedwetting, vomiting, back pain, fever (needs medical attention)

 

More serious (but still reasonably common; needing immediate medical attention) causes of tummy pain:

• Intussusception – usually 3-24 mths old, sudden onset screaming and pale, “redcurrant jelly” stool

  • Intestinal obstruction – bile-stained (ie dark green) vomiting, abdominal distension

• Acute appendicitis – not wanting to eat, central to right lower tummy pain, vomiting, fever, feeling very unwell

• Inflammatory bowel disease – blood/mucus in stool, a family history of the same, diarrhoea, weight loss/poor growth

  • First presentation of diabetes

 

Information for parents – how to know when it is serious and when to seek medical review?

– If there is rapid onset and/or severe pain

– If child is unable to hop, jump or walk normally

– If there is associated blood, bile in the vomit

– If there is blood in the stool

– If the pain is associated with fever

– If your child is unable to keep anything down and there is lethargy and dehydration

– If the pain is associated with significant weight loss, vomiting and/or diarrhoea

 

 

Always seek the opinion of a doctor if you are worried or unsure.

Your GP is highly qualified and usually your first port of call.  You can also utilise the 13HEALTH (13 43 25 84) phone service if you live in Queensland, Australia provided by Queensland Health – free of charge.

There are also “home-call” doctors that can visit you at home, many of these will bulk bill.

If you child is very unwell or if it is after normal business hours, present to your hospital emergency department for evaluation. There are doctors and nurses there to look after children, 24 hours a day.

xxDr Megs

For more articles from Dr Megan Yap visit her blog – “Dr Megs – Paeds & Feeds” at http://www.kids-health.guru/

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