Causes of abdominal pain in childhood

Although abdominal pain is a major concern for parents, its severity is very variable. Depending on its time of evolution, it can be classified as acute abdominal pain (if it lasts a few days) or chronic (if it lasts at least a month). The causes that can motivate one and the other are innumerable.

Although abdominal pain is a major concern for parents, its severity is very variable. Depending on its time of evolution, it can be classified as acute abdominal pain (if it lasts a few days) or chronic (if it lasts at least a month). The causes that can motivate one and the other are innumerable.

Depending on the symptoms that accompany the abdominal pain, and the durability of the pain, four possible causes can develop.

Causes of abdominal pain in children

Acute appendicitis: Clinically presents with fever (temperature between 37 and 37.5º), vomiting and intense abdominal pain, constant, progressive in intensity, which in principle is diffuse and then focus on the lower right part of the abdomen. For diagnosis, the main thing is to make a good clinical history and a detailed physical examination. As a complement, we can request an abdominal ultrasound and / or a blood test. Its treatment is surgical.

Abdominal pain by ganglia: As we have ganglia in the neck, there are also nodes near the intestine. When these increase in size, the pain may resemble that of acute appendicitis (it also hurts the lower right), but it is usually not as intense. The child, in addition, usually has catarrhal symptoms. The treatment consists in administering painkillers on demand.

Abdominal pain due to gastroenteritis: it presents with diffuse abdominal pain and colic ('it appears, it becomes more intense and then it goes away'). It is accompanied by vomiting and soft stools. Sometimes there is fever or fever. This pain is sometimes relieved with conventional painkillers (paracetamol, ibuprofen, metamizole), but it does not respond as well as in other pains, such as headache or pains of osteo-muscular origin.

Long-term or chronic abdominal pain: represents 3% of pediatric visits. Its prevalence increases with age, and it has a recurrent nature (it comes and goes in time). The exact cause is unknown, although most of these children have a problem of high sensitivity to pain, as well as a psychological factor (stress, high level of demand in the studies, etc.). In this table it is not usually necessary to make complementary explorations, unless there are signs of alarm. Among these: pain away from the navel, night awakenings, presence of blood in the stool, vomiting, fever, joint inflammation, weight loss and family history of inflammatory bowel disease.

Finally, it should be remembered that abdominal pain is not always due to a problem in the digestive tract. Entities such as pneumonias of the lung base, lower-sided infarcts, diabetes, or rare metabolic diseases such as porphyria can also cause it.