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How to manage abdominal pain in children

Written by Dr Rotimi Adesanya
Web: www.doctoradesanya.
~Punch Nigeria. Friday, November 11, 2016. 

Dr Rotimi Adesanya
Most children complain of abdominal pain (or stomach ache) at one time or another. While there may be no cause for alarm in most cases, parents should take such children to the hospital if the pain is severe and persistent or if such children seem generally unwell.

Causes of stomach ache
The term 'stomach ache' is casually used for all types of pain experienced in the abdominal area, but anyone who has suffered it knows that one stomach ache can be different from another. Not only can a stomach ache occur high up under the ribs or down low in the guts; its intensity varies.

Stomach pain in children is often caused by excessive gas and indigestion, which might not be a serious issue. A 'sore tummy' may also be a sign of infections like food poisoning, gastroenteritis, pneumonia or urinary tract infections.

Severe stomach pain might be caused by more serious or surgical illnesses like appendicitis or intussusceptions, which is when part of the gut slides into or over itself. Pain in the stomach that keeps coming back might be associated with constipation, food intolerance or inflammation in the gut.

The symptoms that come with stomach pain may include nausea, vomiting, diarrhoea, fever, constipation, bloating and loss of appetite. These symptoms vary, depending on the underlying cause of the pain.

A 'sore tummy' is more likely to be a sign of something serious if it wakes up your child or if the pain is in a specific area of the abdomen, away from the child's belly button.
Appendicitis patients often describe a sharp pain, which starts in the middle then moves to the lower right section of the abdomen. The child may also throw up, come down with a fever or suffer loss of appetite.

If the stomach pain comes with loss of appetite, nausea, vomiting and diarrhoea, the problem could be gastroenteritis or food poisoning. Cramps and general pain might be associated with excess gas.

Pain in the stomach that doesn't subside could be constipation or a urinary tract infection. If the child has a urinary tract infection, he or she may also feel pain when urinating, urinate more than normal, vomit, become irritable and feel feverish.
The pain can also be associated with pneumonia or a viral infection. In this case, your child will probably feel feverish, cough and possibly have a sore throat.
In all types of stomach pain, there's a risk that the child will become dehydrated. He or she should be watched for signs of dehydration, such as sunken eyes, less urination, lethargy and weight loss.

Encourage your child to lie down quietly for 20 minutes. Lying flat on his back with his knees bent is the best position to ease the ache. Regular sips of water can help ease a tummy ache - be careful not to let your child drink too much water and too fast, as this can make the pain worse and result in vomiting.
Gently massaging your child's stomach in a slow, clockwise direction can help to soothe a stomach ache. Encourage him to sit on the toilet for longer than a minute! Apart from the obvious benefits, the position that he maintains, while sitting on the toilet, is an effective way of dispelling painful gas.

Don't give your child any medication for stomach ache without consulting your doctor first. Laxatives can make the ache worse by upsetting the bowels and painkillers can mask more serious symptoms.

Most stomach aches will resolve themselves naturally. They are not symptoms of anything more serious than a little gas, but there are times when an ache should not be ignored.
In conclusion, parents are to immediately take their children to the hospital if they complain of severe ache in the abdomen or if the ache becomes worse with movement. If the ache is regular, occurs frequently and lasts longer than a couple of hours, the child should be taken to the hospital. That should also be the case if the ache is accompanied by a fever, rash, or if the child is very pale.

A child should be taken to the hospital quickly if the pain results in vomiting that contains blood or looks greenish. If your child becomes drowsy and floppy or his stool is black, he should see the doctor as soon as possible.

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