What Is Functional Abdominal Pain Like
The tummy pain is typically around the belly button. Your doctor finds no signs or symptoms that point to a physical condition causing your child’s pain. They are well between episodes and are not losing weight. They may be quite anxious about the pain and about the effect that it is having. Most children experiencing RAP will have functional abdominal pain.
When Should My Child See A Doctor
Many children recover from abdominal pain quickly and dont need to see a doctor.
Take your child to a doctor immediately or go to your nearest hospital emergency department if they:
- are in pain that goes on for longer than 24 hours or if youre worried about them
- have pain that is severe or debilitating even though they have taken pain medicine
- are hard to wake and are unwell
- vomit for more than 24 hours, or they are unable to keep any fluids down, refusing to drink any fluids and their vomit is green
- have blood in their poo or vomit
- are having trouble doing a wee
- have pain and lumps in the groin
- were recently injured for example, falling onto the handlebars of a bike
If your child is still a baby and they have fewer than 4 wet nappies per day, as well as their abdominal pain, you should take them to a doctor immediately or go to your nearest hospital emergency department.
The Microbiome And Abdominal Migraines
The microbiome, the good and bad bacteria in our intestines, tells the brain when the body is healthy or not healthy. “Changes in the microbiome play a key role in gut health and can lead to abdominal migraines and other conditions such as irritable bowel syndrome,” says Dr. Sanghavi.
Probiotics, the living “good” bacteria found in foods such as yogurt and cheese help maintain good bacteria in the intestines. The American diet is low in these nutrients, explains Dr. Sanghavi, preventing good bacteria from growing. Taking a lot of antibiotics can also disrupt the healthy balance in the gut and encourage the harmful bacteria to thrive.
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What Are The Symptoms Of Abdominal Migraine
The most common symptom is stomach pain around the belly button. Other symptoms include:
- Pale skin
Some children may also experience migraine headaches that are not associated with their stomach pain.
If your child vomits, it is important to distinguish between abdominal migraine and cyclical vomiting syndrome, a condition that causes frequent vomiting that suddenly goes away.
Children who get abdominal migraines are symptom-free between episodes. The condition can be tricky to diagnose because symptoms are similar to other common causes of stomach aches.
“A 2-year-old may not be able to verbalize what is going on, so we keep abdominal migraines in the back of our minds as a possible condition to test for,” says Dr. Sanghavi.
When Should I Take My Child To The Doctor For Stomach Pain
Stomach pain in children is usually nothing to worry about. But, if your child experiences any of the following symptoms, schedule an appointment with your child’s pediatrician to determine the cause of your child’s pain:
- Constipation that is becoming frequent
- Recurrent stomach pain with no clear cause
- Blood in stool
- Unexplained weight loss
- Looks or acts sick
- Pain that is waking your child up from sleep or is starting to affect their daily lives
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Avoiding Smoking And Drinking Alcohol
Smoking can irritate the throat, increasing the likelihood of an upset stomach. If the person has vomited, smoking can further irritate the tender tissue already sore from stomach acids.
As a toxin, alcohol is difficult to digest and can cause damage to the liver and stomach lining.
People with an upset stomach should avoid smoking and drinking alcohol until they are feeling better.
Time For A New Name: Primary Pain Disorder
Many different chronic and recurrent pain syndromes in both adult and pediatric populations are now considered to be manifestations of an underlying vulnerability or pain spectrum condition, rather than being viewed as separate disorders . Considerable evidence, especially from twin studies, points to a role of shared biological sensitivity, pain vulnerability,pain sensitivity, or central sensitivity syndrome . Thus, conditions such as primary headaches , centrally mediated abdominal pain syndromes, localized or widespread musculoskeletal pain are no longer regarded as separate entities with differing underlying pathophysiologies in need of different treatments. Instead, these conditions are now generally regarded as pain manifestations of the same underlying condition that present at varied locations.
Toward advancing an improved understanding of primary pain disorder and its relation to chronic pain in children and adolescents, the following section presents a review of the three most prevalent symptoms, manifestations, and locations of a primary pain disorder .
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Home Remedies For Stomach Pain
Warm towelling: Weighing down your babyâs tummy with a heavy warm towel can help relive the gas and improve digestion. You can use mild heat compresses for older children and during period cramps.
Bicycling: Bicycling your babyâs legs gently for 5 minute stretches helps pass gas. For older kids, make them lie on a smooth flat floor and bring their knees to their chest. Clasp their hands around the knees and let them hug their knees as tight as they can, pressing their stomach flat. This helps expel gas. You can also ask them to gently roll from side to side for five times while holding their knees to better relive gas. This wind relieving technique is also called Pawanmuktasana in yoga.
Homemade Gripe Water: Industrially manufactured gripe water is made from glycerine, citric acid, sodium bi carbonate, fennel and ginger, along with other additives, binders and fillers. You can make your own natural gripe water in minutes from scratch. Boil a teaspoon of fennel seeds and cumin seeds with a tiny piece of ginger for two minutes. Strain the water and give it lukewarm. You can add a drop of honey for taste and its medicinal property. For babies smaller than 4 months, skip the ginger.
Asafoetida: Just like its odour, the flatulence relieving strength of asafoetida is powerful too. To relieve stomach pain, add a pinch of asafoetida to a cup of water or herbal tea and drink it. For smaller babies, you can make a paste of asafoetida in water and apply it around the belly button.
How Will The Doctor Make The Diagnosis
In most cases of RAP the diagnosis is made by your GP after taking a clear history and examination and checking carefully for ‘alarm’ signs and for anything that suggests a physical cause, such as constipation or lactose intolerance. Your GP may do some tests to exclude coeliac disease. If lactose intolerance is suspected they may also suggest a food diary and some trials to see if excluding milk is helpful.
Your doctor is likely to want to review your child, after an interval has passed, to see whether things are settling down and to make sure that things aren’t changing and that your child – even if they still have some symptoms of RAP – is feeling better.
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Common Causes Of Stomach Ache
Before we list the common causes of stomach ache in children, the following are points to consider:
- The common causes of abdominal pain in children are age related. Children under 5 are not likely to suffer with ovarian cyst for example, just as a 10 year old is not likely to suffer with abdominal colic and reflux like that seen in a 3 month old baby.
- Psychological or emotional disturbances play a huge role in many complaint of abdominal pain everyone though, especially doctors must be careful not to ascribe any pain as psychological, until other common causes of pain has been excluded by means of a careful examination and tests as deemed necessary.
- Abdominal pain in a child can be classified as acute, if it has been going on for less than 7 days, and chronic if it has been going on for more than 7 days
- It is more likely that a cause of abdominal pain would be found in an acute abdominal pain than in chronic pain
The following are the most common causes of abdominal pain in the respective age groups shown below.
Stomach Pain Around The Belly Button
Stomach pain around or near a child’s belly button is usually nothing to worry about. It’s one of the most common stomach pain complaints among kids.
“Children often rub their bellies when they hurt and complain about general pain around the belly button,” says Dr. Mehta. “This type of stomach pain is typically caused by stress or eating something that didn’t quite agree with them.”
If your child is complaining about stomach pain near the belly button, you can:
- Encourage them to lay down and rest
- Check to see if they need to poop
- Offer a glass of water
- Try distracting them by reading a book together or playing a quiet game
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How Is The Cause Of Abdominal Pain Diagnosed
If you are experiencing abdominal pain, you will need a physical examination and possibly some tests to help your doctor diagnose the cause of the pain. The examination or tests you have will depend on what sort of pain you are experiencing, how long you have had it, and your gender. If you are female, the physical examination may include a pelvic exam and pregnancy test. If you are a male, the examination may include checking your penis and scrotum.
The most common tests include:
- x-rays or CT scans
- ultrasound, in which a probe-like microphone is moved over your abdomen
- endoscopy or colonoscopy, in which a long tube is put either down your mouth or into your back passage , while you are under anaesthetic, so a doctor can see what your stomach and bowel look like
Causes Of Functional Abdominal Pain
Functional abdominal pain is thought to be caused by the input from overly sensitive nerves of the GI tract muscles and nerves that are processing these signals in the brain. We call this our brain-gut axis. In functional abdominal pain and other functional gastrointestinal disorders, there is a heightened sensitivity to the normal function of the gastrointestinal tract.
Daily functions of the GI tract, like stretching and pushing food down after we eat, may feel more painful due to these sensitive nerves. Any periods of stress, anxiety and depression can worsen these symptoms because of the close interaction between the brain and the GI tract.
Functional abdominal pain is not caused by an anatomic, biochemical, inflammatory or infectious abnormalities.
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What Are The Signs And Symptoms Of Chronic Abdominal Pain
Signs and symptoms of chronic abdominal pain will come and go. Your child may have them for a day or more, and they may go away but return. Your child may feel pain in all areas of his or her abdomen, and he or she may not want to eat. He or she may not want to do his or her daily activities, such as school or sports. He or she may also have any of the following:
- Slow growth or growth failure
- Nausea or vomiting
- Weight loss without trying
Testing And Diagnosis Of Functional Abdominal Pain
Your healthcare provider will obtain a detailed history of the pain and perform a physical exam. In functional abdominal pain, physical exam is normal and the child is growing well. Screening tests may be performed to screen for other conditions causing pain. Extensive testing, including endoscopy is usually performed only if basic screening lab results do not fit the diagnosis of functional abdominal pain. If physical exam and screening tests are unremarkable, then a diagnosis of functional abdominal pain may be made.
Testing may include:
- Blood tests. These tests are done to evaluate whether your child is anemic, has an infection, or has an illness caused by inflammation, irritation or autoimmune factors.
- Urine analysis and culture. These are done to help assess for urinary tract infections.
- Stool sample. This sample is taken to check for bacteria and parasites that may cause diarrhea.
- Stool samples for occult blood. Occult blood cannot be seen and is only detected by a special solution that turns blue when coming into contact with blood. It suggests an inflammatory source in the gastrointestinal tract.
- Abdominal ultrasound. A diagnostic imaging technique which creates images from the rebound of high-frequency sound waves in the internal organs. Used to evaluate for potential disorders of the kidneys, liver, pancreas and gallbladder.
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Diagnosis Of Stomach Pain
The doctor will first ascertain if the pain is due to some infection, food poisoning or allergy. In such cases, tests are not required. But if they suspect some serious ailment, they may suggest
- Blood, urine test, and stool tests
- X-ray of the abdomen
- A CT scan or computed tomography to check the internal organs
- Other specific tests as deemed fit by the doctor
The treatment for the pain depends on the underlying ailment.
Signs Which Suggest A Physical Cause
- Joint pains.
- Symptoms which are worsening over time.
If one or more of these symptoms are present, this does not mean that your child is seriously ill, or that you should be alarmed. They are sometimes called ‘alarm’ symptoms because they set off an alarm in the mind of a doctor, reminding them to consider other physical causes for the pain.
When Should You Be Concerned About Your Childs Stomach Pain
- Kids experience stomach pain for many reasonssome more serious than others.
- Anxiety and stress can cause belly pain. Thats something to keep in mind as families continue to cope with the disruptions caused by COVID-19.
- Learn the most common causes of abdominal pain in kids and how your childs doctor may be able to help.
Mom, my stomach hurts!
Its a common refrain of childhood, one that parents are accustomed to hearing. Most of the time the pain is fleeting. A few hours of rest, perhaps a bowel movement, and all is well. But sometimes tummy trouble can mean real trouble.
When To See A Doctor For Your Childs Stomach Ache
As you try these home treatments for your child, you should also monitor them to see whether they are helping.
Mild stomach aches will usually go away pretty quickly, but be careful not to ignore other serious symptoms that may accompany stomach pain. Contact your childs doctor right away in the cases of:
- Severe stomach pain. If your child keeps crying and cannot be distracted by anything, their pain may be severe.
- Abdominal pain that continues after 24 hours.
- Abdominal tenderness .
- Bloody stools. This can be a sign of a serious infection or an intestinal disease, such as inflammatory bowel disease .
- Diarrhea that lasts for more than 3 hours.
- Vomiting for longer than 24 hours.
- Bloody vomit.
- Green vomit. If your child has an allergy to some food, their vomiting may appear green. This is a sign of anaphylaxis, which is a severe allergic reaction. Dial 911 and get medical help.
- Abdominal pain in the right lower side of the belly. This can be a sign of appendicitis.
- Fever and a bad cough. These symptoms may indicate pneumonia.
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How To Relieve Stomach Cramping In Kids
Children can experience stomach cramping for a variety of reasons. Constipation, diarrhea, infections, stress, overeating, food poisoning, eating foods they are allergic to and, in severe cases, appendicitis can cause stomach pain and cramping in children. Stomach cramping can wake children at night, cause them to miss school or miss out on playing with friends. As a parent, there a number of actions you can take to help ease stomach cramping in children and get your child back to his normal self. However, always consult with your child’s pediatrician in case the pain calls for medical care.
Apply a heating pad or warm water bottle to your child’s stomach. Heating pads are best for older children, while warm water bottles work better for babies. Lie your child on her belly on top of the heat for babies, put the bottle on your knees and gently put the baby’s belly on top. Use a heating pad on a low setting. Apply heat for 15 minutes at a time, a few times per day. A parent should always be present when a child is using a heating pad or warm bottle to prevent burns.
Massage your child’s stomach. Gently massage his stomach in a circular motion for 15 minutes several time per day. A massage can help relieve gas and constipation in children.
Consult your child’s doctor about taking an over-the-counter pain medication to help alleviate pain. Give your child the appropriate amount of medication as indicated on the bottle for his age and weight.
Tips For Anxiety Relief
A number of short-term remedies may help bring immediate relief to your child, and more involved methods can help provide longer-term relief.
Short-term Anxiety Busters
Breathe!Breathing techniques are quick, easy-to-learn and can help your child de-stress on the spot. Diaphragmatic breathing, commonly called belly breathing, involves taking long, full breaths that work the diaphragm and make the belly rise and fall. Check out more tips in our post on Teaching Your Anxious Child to Calm Themselves with Their Breath.
Additional ways to bring near instant relief can be taking a quick break to listen to soothing music or giving your child your complete attention so he or she can cry, cringe, scream or otherwise share how they are feeling and why.
Longer-term Anxiety Helpers
Longer-term solutions include ensuring the basic are being met with success. These include ensuring your child eats a healthy diet,gets adequate sleep, engages in plenty of exerciseand takes time to unwind. Mindfulness and meditation are two more ongoing, anxiety-busting strategies you and your child can incorporate into your daily routines. And if the stomach aches become too overwhelming, dont be afraid to address the underlying issues with the help of a therapist.
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