Abdominal Pain in Children

Question 1

What are medical causes of Abdominal Pain?

Answer 1

• Constipation
• UTI
• Coeliac Disease
• IBD
• IBS
• Abdominal Migraine
• Pyelonephritis
• Tonsilitis
• DKA

Question 2

What are the Surgical Causes of Abdominal Pain?

Answer 2

• Appendicitis (central abdominal pain spreading to the right iliac fossa)
• Intussusception (colicky non-specific abdo pain with redcurrant jelly stools)
• Bowel Obstruction (pain, distention, constipation and vomiting)
• Testicular Torsion (sudden onset, unilateral testicular pain, Nausea and vomiting)

Question 3

What are the Red Flags for Serious Abdominal Pain?

Answer 3

• Bilious Vomiting
• Fever
• Rectal Bleeding
• Weight loss
• Dysphagia
• Abdominal Tenderness

Question 4

What conditions does Anaemia indicate ?

Answer 4

• IBD and Coeliac disease

Question 5

What condition does Raised Inflammatory markers suggest?

Answer 5

• IBD

Question 6

What condition does a raised anti-TTG and anti-EMA antibodies indicate?

Answer 6

• coeliac disease

Question 7

What condition does a raised faecal calprotectin indicate ?

Answer 7

-IBD

Question 8

What does a positive urine dipstick indicate?

Answer 8

• UTI

Question 9

What is Recurrent Abdominal Pain?

Answer 9

• When a Child presents with repeated episodes of abdominal pain without an identifiable cause. The pain is described as non-organic/ functional
• Often corresponds to stressful life events such as loss of a relative or bullying
• leading theory is increased sensitivity to the visceral nerves in response to normal stimuli

Question 10

What is the Management for Recurrent Abdominal Pain?

Answer 10

• Careful explanation and Reassurance
• Distracting the child from the pain
• Encourage parents not to ask or focus on the pain
• Advice about sleep, regular meals, healthy balanced diet, staying hydrated, exercise
• Support from child psychologist

Question 11

What is an Abdominal Migraine?

Answer 11

• Episodes of central abdominal pain lasting more than 1 hour
• Associated: N+V, Pallor, Headache, Photophobia, Aura

Question 12

What is the management for an abdominal migraine?

Answer 12

• Careful explanation and education
  -involves treating acute attacks: low stimulus environment, paracetamol, ibuprofen, and sumatripta
• Preventative medications: Pizotifen (serotonin agonist), Propranolol ( beta blocker)
• Pizotifen needs to be stopped slowly due to withdrawal symptoms such as depression, anxiety poor sleep and tremor