One of the most common concerns and consultation of any parent is going to be the situation arising from a child complaining of abdominal pain. Given the wide range of diagnostic possibilities possible, we will highlight these lines only the most frequent and common, to be precisely where they will first think.
The child’s age will give guidance on the possible cause of that pain.
Newborn and infant
In the newborn and infant, the first thing I have to think, to the inconsolable crying, is whether we are using the proper feeding technique: in breastfeeding, should be reviewed smooth start to the chest and vigorous sucking nipple and areola breast, without inadequate intake of air and verify that the amount of milk produced by the mother is sufficient to satisfy the appetite of the baby. Hunger and flatulence (intestinal gas), will be discarded as a cause of abdominal pain and tears.
In artificial feeding will not be checking the suitability of the hole in the nipple, which can prevent the feeding of the child comfortable, requiring an annoying and unnecessary effort. Nipple should always be full of milk, preventing the ingestion of gas by vacuum suction.
Another cause of serious difficulty in feeding, both natural and artificial, in the first months of life, it also causes pain and tears, is inadequate patency of the nostrils, very narrow and often occupied by secretions washing and vacuuming Nasal mucus is one of the first skills to be developed by young parents.
During the first three months of life we will consider the possibility, with a repeated episodes of inconsolable crying and lasting throughout the day, meet with colic, table annoying, but benign and self-limiting, which will disappear spontaneously to the fourth month of life. Attributed to bloating, mild protein intolerance of cow’s milk-contained even in breast milk, “but that does not normally require a change milk formula with hydrolyzed protein vaccines (predigested), and even a certain element of reflux Gastro. That the time of the seizure is made in a quiet, mother and son alone, without anxiety and following a routine or scheduled food, are key to a happy food.
Other categories of abdominal pain, less frequent, but to consider are: episodes of acute gastroenteritis, to start attending day care, and the rotavirus as main culprit. And even more unusually, the dreaded intussusception, with emission of blood per rectum, and that requires prompt pediatric consultation, and even a possible intestinal obstruction, absence of feces and immediate issuance of surgical solution. Will never forget the urinary tract infection as a possible cause of abdominal pain.
Very important to note that the abdominal pain that does not affect the general condition of the infant and relieved with small abdominal massage, adjustment of the food or the ingestion of carmine or antiflatulents, is irrelevant.
Pre-school and school
In the pre-school and school violations will be food, gastric indigestion, constipation due to poor organization of the routine daily bowel movements, and the possible involvement urgent surgical appendicitis leading cadres.
Very funny the possible existence of abdominal pain in children by an extra-abdominal involvement, such as from a lower lobe pneumonia and a lung with abdominal pain reflex, and the faringoamigalitis so frequent at this age and present with abdominal pain as an accompanying symptom in many cases. Do not forget in this section urinary tract infection or abdominal trauma cycling or playing any sport.
Teen
In the adolescent with abdominal pain are going to find a better diagnostic collaboration, if it is not a sham pain to get attention or avoid any school activity. Infectious gastroenteritis, constipation, dysmenorrhea in girls, and acute appendicitis, including the possibility of urinary tract infections are the most pathological stress.
Children with chronic abdominal pain
Up to 17% of school age reaching puberty, especially girls and adolescents, chronic abdominal pain (DAC), generally functional, with an important component of anxiety and behavior disorders in children and their parents, This contributes to the difficulty in diagnosis and to differentiate between organic and functional causes.
* Professional Pain: Lactose intolerance, gluten allergy gastrointestinal, retention of feces and gases, musculoskeletal pain, chronic gastritis (Helicobacter pylori), intestinal parasites (Ascaris, Giardia, tapeworms), inflammatory bowel disease (Crohn’s enf., ulcerative colitis), and hernias, mechanical defects or obstacles, including the possibility of abdominal tumors and ovarian cystic teratoma as a cause of chronic abdominal pain.
* Pain functional and often more frequent somatization of psychological disorder, such as irritable bowel syndrome.
Tips for the physical examination of a child with abdominal pain
* The farther away the pain from the periumbilical area, the more likely it is due to organic disease.
* An abdominal pain that disrupts sleep at night will also link with organic disease rather than simple functional pain.
