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Belly (Abdominal) pain

All children suffer abdominal pain at one time or another. Most of the time there is not a serious cause; However, a few serious illnesses do exist for which abdominal pain is a prominent feature, including intussusceptionappendicitis, ovarian torsion, incarcerated hernia, testicular torsion, and volvulus.

When to be concerned.

Abdominal pain is an emergency and requires prompt medical evaluation for children with any of the following:

  • any child with greenish colored vomitus
  • any child with blood in the vomitus ( blood may appear brownish)
  • any child in which the abdominal pain is constant
  • any child whose abdominal pain is severe and not relieved by a bowelmovement
  • any child with abdominal pain followed by lethargy or sleepiness
  • any child who will not walk because of the abdominal pain
  • any child with blood in the stool
  • any child in a motor vehicle accident or who has suffered abdominal traumaIn most other cases, it is safe to wait and have the child seen by her physician on a nonemergent basis.

“Gassy” abdominal pain

While the abdominal cavity is inhabited by a multitude of organs (liver, spleen, bladder, ovaries, uterus), any one of which might be the source of the discomfort, it is the intestines that are overwhelmingly the cause. (After puberty, menstrual cramps make a close second-see under menstrual disorders). Gassy abdominal pain may accompany constipation, lactose+intolerance and accompany or follow viral gastroenteritis (“stomach flu”). It is caused by the stretching of the bowel wall, which is tube shaped by an expanding gas pocket (which expands spherically.) If the pain doesn’t qualify as an emergency (see above), is short-lived, associated with gurgling sounds from the abdomen, and relieved by bowel movement, then it is most likely “gas” pain.

In this case it is reasonable to take a wait-and-see approach. Additionally, the following may be helpful:

In all cases:

  • Avoid carbonated beverages.
  • Avoid “gassy foods” beans, eggs, broccoli, cabbage.

If the stool is hard:

  • Trial of a stool softener–prune or apricot juice at any age.
  • If over age 6 years you may choose an over-the-counter stool softener.

If the stool is loose:

Trial off of lactose containing products (milk, cheese, yogurt, ice cream, etc.).

Lactose is the sugar in milk products. A condition called lactose intolerance causes abdominal pain, bloating, and diarrhea due to a lack of the enzyme (lactase) that is responsible for the breakdown of lactose sugars in the intestine.