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Abdominal pain is a common complaint of childrenAlthough most children with acute abdominal pain have self-limiting conditions, the pain may herald a serious medical or surgical emergency. The diverse etiologies include acute surgical diseases (e.g., appendicitis, intussusception, strangulated hernia, trauma to solid or hollow organ), intraabdominal medical ailments [e.g., gastroenteritis, urinary tract infection (UTI), gastric ulcer disease, gastroesophageal reflux disease], extraabdominal conditions (e.g., pneumonia, pharyngitis, contusions of the abdominal musculature or soft tissue), systemic illnesses (e.g., “viral syndrome,” leukemia, diabetic ketoacidosis, vasoocclusive crisis from sickle cell anemia), and, commonly, functional abdominal pain.♣Abdominal Pain-FUNCTIONAL PAIN
There is considerable variation among children in their perception and tolerance for abdominal pain. This is one reason the evaluation of chronic abdominal pain is difficult. A child with functional abdominal pain (no identifiable organic cause) may be as uncomfortable as one with an organic cause. It is very important to distinguish between organic and nonorganic (functional) abdominal pain because the approach for the management is based on this. Normal growth and physical examination (including a rectal examination) are reassuring in a child who is suspected of having functional pain
♣Abdominal Pain- SERIOUS CAUSE
Pain that suggests a potentially serious organic etiology is associated with age <5 yr; fever; weight loss; bile or blood-stained emesis; jaundice; hepatosplenomegaly; back or flank pain or pain in a location other than the umbilicus; awakening from sleep in pain; referred pain to shoulder, groin or back; elevated ESR, WBC, or CRP; anemia; edema; or a strong family history of inflammatory bowel disease (IBD) or celiac disease.
Dr. Jayaprakash
Superintendent, ICH.
Institute of Child Health.
Gov. Medical College Kottayam.
Kerala, India.