What is it about ?
A large number of children complain of stomach aches without actually suffering from a serious illness. Stomach pain is usually due to an infection in the intestines, but other conditions such as pneumonia or kidney disease can also cause an upset stomach. It is sometimes very difficult to know exactly what symptoms the child is suffering from. The diagnosis is therefore not always easy to make.
The most common causes of stomach aches in children are, by age category:
- 0-2 years: narrowing of the outlet of the stomach, gastroenteritis, hernia in the groin (inguinal hernia) or navel (umbilical hernia) strangled, folding of part of the intestine to the inside itself (intussusception), testicular torsion, otitis media, urinary tract infections.
- 3-11 years: appendicitis, inflammation of the abdominal glands, gastroenteritis, constipation, infection of the lungs, sinuses, tonsils or urinary tract. In some cases, it is impossible to find any cause.
- over 11 years: appendicitis, gastroenteritis, inflammation and cysts of the ovaries, urinary tract infections.
How to recognize them?
Infections of the stomach (gastritis) and / or intestine (enteritis) are usually accompanied by diarrhea, vomiting, fever and loss of appetite. Sometimes there are signs of dehydration, such as a dry tongue, sunken eyes, and loss of skin elasticity. The child may look woozy.
A narrowing of the outlet from the stomach (pyloric stenosis) gradually develops from the second week of life. This narrowing completely or partially prevents food from passing from the stomach to the intestine. The major symptom is “jet vomiting” after being fed, the ingested food being rejected in a powerful projection.
In the case of intussusception, the child has attacks of painful cramps. Between attacks, the child has no complaints. The stools are watery (diarrhea) and contain blood; they look like gravy. An elongated, sausage-shaped mass is sometimes felt in the stomach.
Strangulated inguinal or umbilical hernias most often occur before the age of 6 months. The child is in pain, is vomiting and is constipated. You may see a hard, tender lump in the fold of the groin that cannot be squeezed.
In conditions affecting the testicle, the child usually develops swelling and pain on the affected side. In the event of testicular torsion, blood no longer reaches the testicle. The testicle can retract and move up into the inguinal canal. Only one testicle is then palpated.
In acute appendicitis, the first symptom is usually pain in the navel area. Then the pain moves to the right of the lower abdomen and gradually increases. Pain can be triggered by moving and jumping. After a while, the child also begins to vomit. Diarrhea is not as common and most often its intensity is limited. Pressure on the stomach, followed by sudden relaxation, causes pain. The stomach can also be hard when you feel it.
With acute constipation, severe pain may occur, usually in the middle of the stomach. Sometimes the child does not produce any more stools.
In a child suffering from stomach aches and signs of infection (cough, earache, pain when urinating, etc.), the infection is usually also the cause of the stomach ache.
In girls who are already sexually active, the sudden onset stomach pain may be a sign of inflammation of the ovary, a sexually transmitted infection (STI), or an ectopic pregnancy.
How is the diagnosis made?
The doctor will ask you about the onset of stomach aches and their evolution. He will examine the child: the belly, lungs, nose, throat and ears, and look for swollen lymph nodes. He will possibly do an internal examination, by digital rectal examination. If the diagnosis is not yet clear, a stool culture, urinalysis and blood test may be necessary. If he suspects a serious illness, the doctor will always refer you to an emergency department for further examinations and treatment.
What can you do ?
In most cases, waiting is the best attitude, especially if the child does not have a fever. Avoid giving her laxatives or strong painkillers, as these can make it harder to find the diagnosis. If your child has diarrhea, give him enough to drink, preferably water mixed with ORS (oral rehydration solution) powder (one sachet in half a liter of water). ORS contains salts and sugar and improves water retention. If the pain increases and other symptoms appear, such as vomiting and fever, see the doctor.
What can your doctor do?
Doctors will start by distinguishing between conditions they can treat on their own and conditions that require urgent surgery. Since viral infections heal on their own, the only medications he prescribes will be aimed at relieving symptoms. Antibiotics are sometimes needed to treat a bacterial infection. If the prescribed treatment is not enough, the doctor will always send you to the hospital.
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