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Wednesday, 11 May 2016

Mommy, my tummy hurts!!! Abdominal Pain in Children

By Dr. Alvin Khoh | Consultant Paediatric Gastroenterologist | Gleneagles Kota Kinabalu Hospital

Abdominal pain in children is a common occurrence. Thankfully, in most cases, it is not caused by a serious condition. Irregardless, it does cause a lot of discomfort and distress to both the child and the family. It tends to interfere with the child’s daily activities, including schooling and other play activities.

Abdominal pain can happen suddenly or developed slowly over time. Most often, it is associated with other symptoms e.g.. vomiting, diarrhoea or fever.

The causes of abdominal pain in children are quite diverse. Among the more common cause may be food related (too much food, fizzy drinks or food poisoning), constipation or even viral infection (including gastroenteritis, causing vomiting and diarrhoea).

Other causes includes:
• Gastritis
• Heartburn
• Food allergy
• Appendicitis
• Urine infection
• Period pain in girls

In some children, the cause of abdominal pain may not be easily diagnosed at the onset. Over time, as more symptoms appear, it becomes more obvious. Thus it is very important for the child to be closely followed-up by their regular doctor in these instances.

Diagnosis and Treatment

Depending on the signs and symptoms that your child has, your doctor may order some tests: e.g.. blood, urine, x-ray or ultrasound. However, in most cases, investigations are not needed.

Similarly, treatment depends on the cause of the abdominal pain. Pain relief such as paracetamol are commonly used if needed. Antibiotics and gastric medications are used when necessary. If appendicitis is suspected, then your child may require surgery.

My child has been having abdominal pain for a long time!!

Some children have recurrent abdominal pains for months without any obvious cause. These children are usually healthy looking and growing well. This phenomenon is usually described as functional abdominal pain” and is not caused by any serious disease.

However, the pain tends to interfere with their daily activities, including school. It is usually triggered by stress or significant emotional events in life. These can cause the brain to send “excessive signals” to the nerves in the gut- thus causing the pain.It is important to recognise that the pain is real to the child, and not to brush it away by calling it “attention-seeking” behaviour.

These children should be assessed and managed by a specialist doctor thoroughly to ensure that they are not suffering from any significant disease.

When to seek help from a doctor?

If the pain or problem persists more than 1 day, it is best to seek medical advice. Seek help urgently if your child has the following:

• Has severe pain, frequent pain or the pain has moved
• Does not want to move
• Becomes pale, sweaty, lethargic or has high fever
• Refuses to drink fluids
• Vomiting > 24 hours and unable to keep fluids down
• Blood in the vomit or stools
• Recent injury to the abdomen (eg. falling down from bicycle, sports-related etc)

What can you do if your child develops abdominal pain?

Many children with abdominal pain get better quickly without any specific treatment. It is advisable for them to get lots of rest. The following may also help your child:

• Encourage your child to drink fluids
• If hungry, let your child eat what they want, or offer bland food - eg. biscuit, banana, porridge
• Do not force feed
• Encourage sitting on the toilet - passing motion may help
• Rubbing a child’s tummy gently and distract them (eg story telling)
• Paracetamol may be used (in the correct dosing)


Many children get abdominal pain, and most get better by themselves. Often, no cause can be found and at other times, the cause only becomes more obvious with time. Seeking timely help is important in managing these children, especially if they are unwell.

For more information, please contact Gleneagles Kota Kinabalu Hospital at 088-518 888.
Address: Riverson@Sembulan, Block A-1, Lorong Riverson@Sembulan, 88100 Kota Kinabalu, Sabah. For Emergency, please call 088-518 911