About Us
Let's Talk Health

About Us

Introducing Let's Talk Health, an initiative from Apollo Hospitals, where our endeavor is to share knowledge which you can use to keep yourself and your family fit & healthy.

Let's Talk Health.
Let's Talk Happiness.


#BeatDiabetes#CareForHer#GiftAnOrgan#KnowHepatitis#SayNoToDiabetes#UniteToEndTB3D printing of organsAbdomenAbdominoplastyAbnormal Utrine BleedingACacidityACL injuriesAcoustic neuroma in childrenActBeforeTheAttackActive ChildrenAcute Abdomen and AppendicitisAcute LeukaemiaADHDadvanced heart checkAdverse drug eventsAIDSAir PollutionAlzheimer's diseaseAnkylosing SpondylitisApollo Breast Centreapollo concierge medicineapollo health checkupapollo health checkup packagesapollo heart centreApollo HospitalsApollo Hospitals Chennaiapollo hospitals concierge medicineapollo platinum health checkAppendicitisApricotsArthritisArthritis Awarenessarthritis treatmentarthritis treatment in indiaArtificial PancreasAsk Apolloask apollo concierge medicineAsthmaAthlete's FootAutismBaby AcneBaby Bottle Tooth Decayback painBack problemsBariatric Surgery BenefitsBeautyBeetroot benefitsbest Cancer hospital in Chennaibest hospital in indiabest hospitals in Chennaibest neurologistBiomedical Waste ManagementBirth Controlbladder Cancerbladder Cancer treatmentbladdercancerBlepharoplasty Eyelid RejuvenationBlood PrressurebloodpressureBone & JointBone Marrow Transplantbone specialistBonesbook an appointment onlinebrainBrain changeBreast CancerBreast cancer myths & factsbreastcancerBreastfeedingBronchitisBypass SurgeryCABGCalcium Rich Dietcaloriescan nanotechnology be the future of orthopedicscancerCancer CareCancer mythsCancer PreventionCancer riskscancer TreatmentCarbohydratesCardiaccardiac arrestCardiac riskCardio Vascular DiseasesCardiovascular DiseasesCardiovascular emergenciescareCartilageCataractCauses of Cancercauses of strokecavitiesCerebral StrokeCervical Disc ProlapseCesarean AwarenesscheckupChemotherapy Carechest painchickenpoxChickenpox In ChildrenchildChild careChild Healthchildbirthchildcarechildhood obesityChildrenChilliesChocolateChocolate BrownieChokingCholangitisCholesterolCholesterol ratioChronic Health ConditionsClean watercoldColds in PregnancyColon CancerColonoscopyColorectal CancerComfort Foods & HealthCommon coldcommon symptoms of strokeconcierge careconcierge doctorconcierge doctors near meconcierge healthcareconcierge medicineconcierge physicianCongenitalconstipationcontactlensescornealtransplantCoronary Artery Bypass GraftingCosmetic Ear SurgeryCosmetic SurgeryCosmetic Tooth ImplantsCPRCradle capCriggler NajjarCureDairy ProductsDark chocolate benefitsDehydrationDementiaDengueDengue feverDentalDental CareDental MythsDepressiondepression helpDepression Myths and Factsdepression signs and symptomsdepression symptomsDepression Vs SadnessDiabetesDiabetes mellitusDiabetic footdiagnose a strokeDiagnosisDiaper rashdiarrhoeaDietDieting mythsdiseasesDiwaliDrivingdyslexiaEar CareearpainearsEating DisorderseggsElbow InjuryEmergencyEmphysemaexamsExerciseExercise for bachacheExercises to prevent memory lossexperienceeyeEye careEye dropsEye exercisesEye FlueyecancerfathersfattyliverFertility TreatmentfertilizationfestivalsFibroidsFire accidentsFire carefitnessFitness AppsFitness blundersflatfeetFlax seedsFlip-flop foot problemsFluFlu VaccinationFoodFood additivesFood AllergiesFood for Brainfood guideFoot painFrozen shoulderfruitsfull body checkupfull body checkup cost in ApolloGastric problemsGastrointestinal BleedingGastrointestinal TractGeneticsGERDGluttonyGymGynaecologyGynecologyhairHair careHair lossHair RestorationHand hygieneHand washhappinessHazardous wasteHead injuryHeadacheHealthHealth & BeautyHealth care unithealth checkhealth check benefitshealth check uphealth checkup packagesHealth hazards of prolonged sittingHealth Managementhealth packagesHealth tipshealthcareHealthcare for womenHealthcare Service QualityHealthcare workers (HCWs)Healthcare-associated infections (HAIs)healthcheckhealthyHealthy backHealthy foodHealthy Hearthealthy heart programHealthy recipehealthyheartHeartHeart AttackHeart CareHeart checkHeart HealthHeart Valve Diseasesheartdiseaseheel painHelp loved ones fight depressionherniaHigh Blood PressureHip FractureHIVHoli CareHormoneshospitals in ChennaiHow to deal with cutsHuman developmenthydratedHydrocephalusHypertensionHypothyroidismhysterectomyIBSImmune systemIndia Water WeekInfant diarrhoeainfant teethinginfectionInfertilityINSULINIntensive Care UnitIntraocular LensesInventionIrritable bowel syndromeJaundiceJaundice in babiesJuvenile DiabetesKeratoconuskidneyKidney StonekidneycancerkidsKnee ArthroscopyKnee painlarynxLeukemiaLifestyleLifestyle changesLifestyle diseasesLight Induced TraumaLimb length discrepancyLiver cancerLiver TransplantlivertransplantloyaltyLung CancerLung InfectionLung transplantationlungcancerlungsLymphomamalariaMangoMedical & Fitness ParametersMedication errorsMedication safetyMediterranean DietMelanomaMemory lossMenopausemenstrual cycleMenstrual HygienemenstruationMental Disordersmental healthMiddleearMintMonsoonmosquitomotherMotherhoodmothersmouthmulti speciality hospital in Chennaimulti specialty hospitalmultispeciality hospitalmultispeciality hospital near meMuscleacheMythsnanotechnologyNasal allergiesNatural childbirthNauseaNeck painNerveNeurological Disordersneurologistneurologist in Indianeurology doctorsNoisy earNose BleedNose reshapingnosebleedNosebleedsNutritionOats with dried fruitsObesityObesity & mental healthObesity in pregnancyOcular LesionsOffice safetyOpen heart surgeryOral Healthoralcanceroralhealthorgandonationorthopaedic doctororthopedicorthopedic arthritisorthopedic doctororthopedic hospitalorthopedic near meorthopedic surgeonorthopedicsOsteoporosisOvarian CancerOvereatingpancreasPancreatic Islet TransplantationparentingParkinson'sPatient-SafetyPCODPeanut butterPediatricPediatric CarePediatric Liver TransplantPelvic PainPeptic Ulcerperceptionperiodspersonal protective equipment (PPE)pharynxPhysiotherapyPICUpilesPlastic SurgeryplasticsurgeryPneumoniaPolycystic OvaryPolycystic Ovary DisorderPolycystic Ovary SyndromePostpartum depressionpregnancyPregnancy WorkoutsPremature BabypreventionPreventive Carepreventive health check upPreventive HealthcarePreventive MedicineProactive Healthcareprofessional help in depressionpsychiatristPsychological FactorsPsychologyPsychotherapyRadiosurgeryRadiotherapyRare CancersReadingRecipeRefractive errorsregular health checkRetinoblastomaRheumatoid ArthritisRight postureRight to sightRisk Factorsrisk of suffering strokesRobotic Heart SurgeryRobotic SurgeryRoseRoutine checkSalt intakeSarcoidosisSatisfactionSciaticaSeafoodself-examinationsexual healthSigns of depressionSinus Corrective SurgerySinusitisSinusitis in childrensittingskinSkin and Hair ProtectionSkin CancerSkin careSkin RashskincancerskincareSleepSleeping pillsSleeve GastrectomySlip DiscsmokingSnake BitesSoft tissue sarcomaSore musclesspecialist hospitalspinachspinespringsquintStandard PrecautionsStay hydratedSTD'sStem CellSTIstomachStomach CancerstomachcancerStrawberryStress eatingstressorsStretch marksStrokesummerSummer foodsSunburnSunstrokesuper speciality hospitalSuperfoodssurgerySweet toothSwimmer’s earsymptoms of depressionsymptoms of strokeSystematic reviewtechnologyTennis ElbowThalassemiaThreadliftThroat InfectionThroatcancerthyroidcancerToddler SwimmingTomatoestransplantTravellingtreatment for stroketreatment for stroke at Apollo hospitalstreatment for stroke in IndiaTuberculosisUrinary IncontinenceUrinary Tract InfectionUrological ProblemsUrologyUTIvaccinationvaccineVitamin DWalkingWalking aidwaterWater Birthweightlosswellnesswhat is OsteoporosiswindpipewinterWinter AchesWinter PregnancywomenWomen's HealthWomen's Health TabooswomenhealthWorld Health DayWorld Hepatitis DayWorld Liver DayWorld Malaria DayWorld Parkinson's DayWorld Tuberculosis DayWorld Water DayYeast infectionYogaYogic VisualizationZikavirus
in Child & Care

Abdominal Pain In Children

Abdominal Pain in children

Abdominal pain in children is perhaps the most commonly reported symptom in paediatric practice. Since this symptom can be caused by a vast array of underlying conditions, it is of paramount importance that relatively non-emergent conditions like viral gastroenteritis, constipation and functional abdominal pain be differentiated from surgical emergencies like appendicitis, torsion or volvulus.

If a child has fever and vomiting along with abdominal pain, it should always be taken seriously, especially if the pain is in the right lower quadrant. Similarly, abdominal pain associated with blood and mucus in stools, or a visible mass in the abdomen signifies an important pathology. Other important features that can alert the parents are constipation, persistent vomiting, rapid breathing, jaundice, blood in stool or vomitus and a low/absent urine output.

The symptom complex of abdominal pain

  • Where is it located?
    Most children point to the belly button, which is indicative of a diffuse process like constipation, especially if fecaliths (hard stony mass of faeces in the intestinal tract) are palpable. Pains in the right or left lower quadrant or those radiating to the back should be evaluated for appendicitis, colitis and pancreatitis respectively. Pain in the upper part of mid abdomen, especially aggravated or relieved by eating food, is related to the digestive process and might involve the stomach or duodenum. Pain in the suprapubic region, which is exacerbated by a full bladder, is indicative of inflammation in the urinary tract.Pain in the groin, especially in boys, is a symptom that almost always requires an urgent evaluation. Testicular torsion is a condition in which the testis twists on its own support and cuts off the blood supply. Though the condition is extremely painful, the child might be embarrassed. So, it is always prudent to examine the genitalia in a child complaining of pain.
  • What is the duration?
    Transient pain relieved on burping or during hiccups is commonly experienced by children and is not of much significance. Sharp shooting pain on the right side of the abdomen, which happens spasmodically and is usually associated with vomiting, is characteristically associated with gallstones. A similar spasmodic, colicky pain in the lower abdomen, which might be unbearable at times, is indicative of a stone lodged in the urinary tract. Recurrent episodes of abdominal pain interspersed with periods of wellness are well described in paediatric literature and should be evaluated accordingly.
  • What is the child’s appearance?
    This question can be answered easily by the caregivers. A child who is vomiting or sweating profusely and does not seem to be his/her normal self should be rushed to a physician. Excessive sleepiness, inability to retain food or water and a fast heart rate are other pointers to the severity of illness. If a child with abdominal pain can be distracted or is able to eat and drink despite the pain, the underlying pathology might not be sinister.

Diagnosing the abdominal pain
Sometimes, the diagnosis can be made on the basis of a detailed history and examination by the paediatrician. For example, abdominal pain associated with a rash over the buttocks is indicative of a purpura (red or purple discolourations on the skin) or vomiting and abdominal pain associated with diarrhoea, which is pathognomonic of a viral gastroenteritis.

Imaging studies like X-rays, although getting outdated rapidly, are still useful in certain conditions like intestinal obstruction and perforation, to make a rapid clinical diagnosis. Contrast studies like barium scans can be done to rule out stones, growths and strictures in aerodigestive and urinary tracts. Barium enema has been the gold standard for both diagnosis and treatment of intussusception, for decades. Saline enemas have also been used successfully. Newer modalities such as air enemas and ultrasonographically guided enemas have emerged recently.

Ultrasonography (USG) is considered by many experts to be the imaging test of choice in children. Ultrasonography is non-invasive, rapid, and can be performed at the bedside. It does not require oral contrast, which is an advantage for patients who may require surgery. It also spares the paediatric patient exposure to radiation. Diagnosis of appendicitis, gallstones, abdominal lymph nodes or stones in the urinary tract can be made easily by USG.

In recent years, CT has become the test of choice for paediatricians and surgeons alike when USG fails to give a definitive diagnosis. Every variation, from triplecontrast (intravenous, oral, and rectal) CT scanning to non-contrast, unenhanced CT, has been used. CT offers the advantage of greater accuracy, the ability to identify alternative diagnoses, and in some studies, lower negative laparotomy rates. Although CT appears to be better than ultrasonography in making the diagnosis of appendicitis in children, it is slower, requires oral contrast in most centres, and exposes the young child to significant radiation. If the child is vomiting, keeping the oral contrast in the gastrointestinal tract can be a challenge, and antiemetics may be required.

Blood investigations are mainly supportive but sometimes can be useful diagnostic aids. For example, amylase and lipase levels can diagnose acute pancreatitis, while a high total leucocyte count in an appropriate clinical setting can diagnose acute appendicitis with a high degree of reliability.

A urine analysis should be done to rule out a urinary tract infection, which should then be confirmed by a urine culture. Nonspecific elevation of the urinary leukocyte counts may be seen with inflammatory processes elsewhere in the body.

The treatment of abdominal pain is tailored to the cause. It ranges from giving plenty of fluids to rehydrate a child with gastroenteritis, to giving antibiotics to a child with urinary tract infection. Most of the diarrheal illnesses in children are viral and do not require an antibiotic, except when they are associated with blood in stools (dysentery). Medication for constipation in children should always be ante grade and include non-absorbable sugars and mild stimulants. Children with pancreatitis usually require admission in a high dependency unit and require close monitoring of their laboratory parameters. Treatment is mainly supportive till the child recovers.

Treatment of certain other conditions is purely surgical e.g. intussusception, volvulus, pyloric stenosis, testicular torsion, gallstones or stones in the urinary tract.

The prognosis for abdominal pain in children is as diverse as the causes themselves. Abdominal pain left identified and treated early carries a good prognosis overall; however, pain undiagnosed and untreated can be life threatening. Consequently, early in the child’s illness, a parent or caregiver should work with the paediatrician and the hospital to ensure the child receives appropriate care.

Leave a Reply

Your email address will not be published. Required fields are marked *