Stomach-aches for child
Like fevers, stomach-ache is common in childhood and parents are faced with deciding whether it warrants seeing a doctor or if it will pass without treatment. Stomach pain can be a symptom of certain serious conditions in the abdomen, however, some children say their stomach hurts when the cause is elsewhere, so only a professional can judge the situation. To give you an idea of the likelihood of a serious cause, try to answer these questions. A yes answer will indicate the need for medical advice:
Is she listless, off her food and obviously in discomfort?
Does she have diarrhoea?
Is she vomiting?
Did the pain wake her up?
Is she constipated?
Have her stools been blood-stained or maroon or black? The darker colours indicate old blood while bright red stools would mean fresh bleeding.
Does she have a fever?
Does it hurt when she moves, even if she is distracted?
Does she have a burning sensation when she passes water? Does her urine contain blood?
Is the pain constant or does it come and go? Both can be significant.
Are there any lumps where there shouldnt be?
intussusception is the commonest cause of intestinal obstruction: a portion of the bowel telescopes inside another section blocking the passage of food. The child is likely to pull up her legs and cry with pain intermittently because the pain comes and goes. Important signs that help differentiate it from colic and other childhood stomach pains are the presence of small blood-stained stools and vomiting of green matter, possibly blood-stained. Caught early, the condition can be treated without surgery, but often an operation is required. See your doctor within 24 hours.
Inguinal hernia is another cause of intestinal obstruction. A swelling is seen in the groin (257).
Kidney and urinary tract infections can cause pain in the abdomen or back. The child may have a raised temperature and blood in her urine and a burning sensation when she urinates. She may also feel like passing water frequently even though she produces little when she does, or she may revert to bed wetting. In infancy, diarrhoea, vomiting and failure to gain mass may be a sign of urinary tract infection, but often symptoms are very vague. It is important that medical help is sought as these infections do not clear up by themselves.
Your doctor will want a specimen of urine and this is best taken after washing the vaginal area with soap and water and drying with clean cotton wool. Catch a small amount in a perfectly clean bottle.
Appendicitis is probably the most common abdominal condition that requires surgery in children over the age of five. Although rare before this age, it can occur. Because the consequences of allowing an inflamed appendix to burst are potentially very serious, it is important to be aware of this possibility when a child has a stomach-ache. Unfortunately appendicitis is not easy to diagnose but it is better to remove an appendix unnecessarily than to leave it until it is too late and have to cope with a generalised internal infection because it has burst.
Usually one of the first signs of appendicitis is loss of appetite. Then the child has pain in the middle of the tummy around the navel. Over the next six to 12 hours the pain usually moves down to the lower right side, which is very sore if pressed or when the child moves. A raised temperature, usually not very high, develops and the child may vomit. The child with appendicitis will usually be more comfortable lying with her knees bent and any pressure on the lower right abdomen produces pain. Dont take a chance: call or visit a doctor straight away if you suspect she may have appendicitis.
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