ABDOMINAL PAIN IN CHILDREN

GENERAL INFORMATION:

What is it? Abdominal (ab-dom-ih-null) or "belly" pain is pain between the bottom of your child's rib cage and his groin. The groin is the area where your child's leg and abdomen meet. Your child can have pain inside or outside his abdomen. The pain may get better and go away. Or, the pain may get worse and not go away. Pain is your child's body's way of responding to injury or illness. Everybody reacts to pain in different ways. What your child think is painful may not be painful to someone else. But, pain is whatever your child says it is!

Causes:

Many things can cause pain in your child's abdomen. Pain may be caused by an infection or an injury. The pain may be due to a serious problem or by something as simple as gas. It can be caused by nerves being stretched, or by appendicitis. Diarrhea or constipation may also cause your child to have pain in your belly.

An injury or a stomach or bowel infection may cause belly pain. Things your child eats or drinks may cause your stomach to be upset and cause belly pain. Or, it may not be known what is causing your child's abdominal pain.

What are the different types of pain? Pain may be acute or chronic.

Acute pain is short-lived and usually lasts less than 3 months. Caregivers help first work to remove the cause of the pain, such as fixing a broken arm. Acute pain can usually be controlled or stopped with pain medicine.

Chronic pain lasts longer than 3 to 6 months. This kind of pain is often more complex. Caregivers may use medicines along with other treatments, like relaxation therapies to help your child's pain.

Signs and Symptoms: Your child's abdominal pain may be as "sharp as a knife." or dull pain. The pain may stay in the same place or move around. Your child may have the pain all the time or it may come and go. Your child may have nausea (upset stomach), vomiting (throwing up), fever, diarrhea, or fainting. Your child may cry or scream with the abdominal pain.

What is your child's abdominal pain like? Because children act so differently from ages 0 to 18 years old, knowing when they have pain may be difficult for you and caregivers. Also children, like adults may adapt or get used to the pain over time. This means they may act normal or opposite of how you think they should act even though they are in very bad pain.

Babies and very young children have trouble talking and saying what they feel. Knowing they are in pain in pain may be very hard. Physical signs are often the only way you and caregivers may understand babies and young children are in pain. The following are some signs you can watch for that may mean your child or baby has pain.

Bites or squeezes his lips very tightly.

Cries with a higher pitch that sounds upset and harsh.

Does not move out of a position very often (because it hurts to move). Or he moves around a lot trying to lie in a way that will not hurt.

Frown or squeezes eyes shut very tightly.

Is not easily comforted.

Moves arms around a lot.

Pulls his knees up to his chest.

Pulls the part of his body part that is hurting away from your touch. Or, gets upset at being touched.

Shudders (mild shake).

Sleeps more or less than usual.

Touches, rubs, or massages parts of body.

Whimpers or groans quietly.

The following are signs you can watch for with your toddler/preschooler/young child that may mean he has pain.

Arms, legs or body are moved or held stiffly.

Crying.

Generally restless (moves around a lot and cannot get comfortable).

Guards or protects painful area(s) from touching anything.

Kicks when someone comes near.

Loses control of bowel and bladder (if your child was "potty trained" before the pain event).

May deny pain because they are "being brave" or are "afraid of the cure".

Seems withdrawn and does not do normal activities like play.

Touches, tugs, rubs, or massages parts of body that hurt.

Whimpers or groans quietly.

Caregivers want you or your child to talk to them about his pain if he is older. This helps them learn what may be causing the pain and how best to treat it. Caregivers will want you or your child to answer the following questions if he can.

Where does it hurt? Where does it not hurt? Does the pain move from one area to another?

How would you rate the pain on a scale? On 0 to 10 scale, 0 is no pain, and 10 is the baddest pain your child ever had. Or, try a smiley face scale. A smiling face is no pain, and a sad face with tears is very bad pain. Some caregivers may suggest other ways to help your child tell you how much he hurts, like colors or even poker chips.

How does the pain feel? Try to choose words that tell caregivers what type of pain your child is having.

Is the pain sharp, cramping, twisting, squeezing, or crushing? Or, is the pain stabbing, burning, dull, numb, or "pins-and-needles" feeling? Younger children may not talk about their "pain" the same way as an adult would. They may use words like "hurt", "boo-boo", or "owie" to mean pain. They may not understand the word "pain" at all.

They may also say they feel like they are "in an oven" or "like a crocodile is biting me". Or they may say that is feels like "being stood on by a huge monster". These are all ways they may use to tell you they are in pain.

When did the pain start? Did it begin quickly or slowly? Is the pain steady or does it come and go?

How often does the pain bother you and how long does it last?

Does the pain effect the things you do or your daily life? Can you still play or go to school?

Does the pain wake you from sleep?

Do certain things or activities cause the pain to start or get worse like coughing or touching the area?

Does the pain come before, during, or after meals?

Does anything lessen the pain like changing positions, resting, medicines, or changing what you eat?

Care: Your caregiver will ask you questions about your child and check his abdomen. Blood, urine, or BM tests may be done. Your child may have x-rays of his abdomen. Your child may need to go into the hospital for more tests and treatment. Pain medicine may be needed to help the pain in your child's belly. Sometimes surgery is needed to treat abdominal pain.

CARE AGREEMENT:

You have the right to help plan your child's care. To help with this plan, you must learn about abdominal pain and how it can be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care will be used to treat your child.

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