October Q&A: Stomach pain is rarely a reason for panic
A child wakes up in the night with stomach pains, but without vomiting or a fever. The alarmed parents rush the child to the emergency room, fearing he or she has appendicitis. After drawing blood, performing a CT scan and/or other expensive tests, the doctor ultimately determines the child is just constipated.
Over the years, I’ve seen this scenario play out countless times in my practice. Stomach pain seems to spark fear and panic in many parents. Hopefully, it will bring peace of mind to know that the source of your child’s stomach pain usually isn’t serious and, in most cases, will resolve quickly.
Q: What are the most common causes of abdominal pain?
Viral infections or gastroenteritis. Pain is usually dispersed throughout the abdomen and can include vomiting and diarrhea. This condition is typically short-lived and often simply has to run its course. However, a child who shows signs of dehydration, develops a fever of 104 degrees that does not improve after two hours after meals, or who has abdominal pain with severe vomiting – especially if it is green – requires prompt medical attention.
Constipation is also a frequent source of stomach discomfort. Parents often think that if their child is having bowel movements every day, he or she is not constipated. This isn’t true. A child can have stools daily without fully emptying the bowel. Over days or weeks, he or she can get backed up and experience abdominal pain. The pain can get worse with eating and is often located on the left side. It is always okay to try an enema or other over-the-counter remedy to see if that helps resolve the problem. If this isn’t effective, call your pediatrician.
Stress. Never underestimate the power of the mind to subconsciously cause abdominal pain. A strong connection exists between the brain and the stomach. Children experiencing pressures and problems at home and/or school often complain of stomach discomfort. Straight-A students are more likely to suffer from this than less high-achieving students.
Q: How do I know if it’s appendicitis?
Appendicitis is often feared by parents. Acute appendicitis pain starts around the belly button and moves to the lower right quadrant. It is usually severe and gets worse. Vomiting and a low-grade fever are also often present. The child will usually have a lack of appetite and find it very uncomfortable to move. I tell parents that if their child can hop or is able to walk, it’s unlikely he or she has appendicitis.
Q: When should I call my pediatrician?
It’s difficult to remain calm when your child is in pain. But unless your child is exhibiting the more serious symptoms described above (high fever, dehydration, signs of appendicitis), don’t panic. He or she will most likely be fine within a few days. If you’re not sure if your child’s symptoms are cause for concern, or if symptoms persist, always call your pediatrician.
Other reasons to call your child’s pediatrician include: a history of abdominal surgery, questionable pregnancy, pain in the testes, bloody stool or vomit, suspected poisoning and if your child looks or acts very sick.