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Paediatric Abdominal Pain

Summary

Abdominal pain is a common issue in children and often resolves on its own. However, persistent or severe pain can indicate a serious underlying condition that requires medical attention. Some causes of abdominal pain, such as acute appendicitis, can be emergencies and require urgent care.

The cause of abdominal pain can range from benign conditions to more serious ones, making it a challenge to diagnose. In most cases, doctors rely on a detailed history of the child’s symptoms and a physical examination to narrow down potential causes. Further tests may be necessary to confirm the diagnosis.

Diagnosis and When to Seek Help

While most cases of abdominal pain are not serious, parents should seek medical advice if:

  • The pain is persistent or worsening
  • The child has a fever along with abdominal pain
  • There are changes in appetite, vomiting, or diarrhea
  • The child has blood in the stool or vomit
  • The pain is severe or associated with sudden, sharp pain
  • There is unexplained weight loss or lethargy

Because children may find it difficult to fully describe their symptoms, obtaining a complete history can be challenging. This makes the clinical expertise of the healthcare provider especially important in determining the cause.

Management

Treatment depends on the underlying cause of the pain. If the pain is related to a benign condition (e.g., indigestion or constipation), the treatment may include:

  • Dietary changes (increasing fiber, hydration)
  • Pain management with mild over-the-counter medications, such as acetaminophen
  • Regular physical activity to promote digestive health

If the pain is due to a more serious condition, such as appendicitis or an infection, more specific treatments (e.g., surgery, antibiotics) may be required.

Follow-Up and Monitoring

For most cases of abdominal pain, symptoms improve with appropriate care. However, if symptoms persist or worsen, further evaluation is necessary. Regular follow-ups may be required for ongoing or complex issues, particularly if the child has an underlying medical condition that affects digestion.

Prompt action and timely medical advice are important to ensure your child receives the proper care. If you are concerned about your child’s abdominal pain, consult a healthcare provider for an accurate diagnosis and treatment plan.

History and Exam

Key diagnostic factor

  • History of anorectal, neurological, or spinal abnormalities, or gastrointestinal surgery
  • Faecal soiling or diarrhoea
  • Constipation
  • Peri-anal skin irritation

Other diagnostic factors

  • Behaviour problems
  • Painful bowel movements
  • Abdominal pain/cramping
  • Posturing described as tightening of buttocks

Risk factors

  • Chronic constipation
  • Male sex
  • Age: 5 to 6 years
  • Diet lacking in fibre

Diagnostic Investigations

1st investigations to order

  • Abdominal x-ray

Investigations to consider

  • Unprepared barium enema
  • Spinal x-ray
  • MRI spine
  • Radiopaque marker transit x-ray

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      1 Reason for referral *

      2 Parent Surname *

      3 Patient First Name *

      4 Email *

      5 Patient Surname *

      6 Phone *

      7 Child’s date of birth *

      8 ADDRESS