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Abdominal pain is one of the most common reasons parents visit their pediatrician or the emergency room. In most cases, it is a transient and mild symptom, related to a cold, constipation, or an eating disorder. However, there are cases where the pain may be a sign of a more serious condition that requires immediate medical evaluation.

What are the possible causes?

Depending on the age of the child, abdominal pain can be caused by different conditions. The most common are:

• Viral gastroenteritis.
• Constipation.
• Urinary tract infections.
• Food intolerances or gastrointestinal disorders.
• Stress or psycho-emotional factors, especially in older children.

However, there are also surgical conditions, such as acute appendicitis, intussusception in infants and young children, or testicular torsion in adolescents, which may initially manifest with abdominal pain and require immediate treatment.

When should parents worry?

The intensity of the pain is not always the best indicator of severity. The duration, location, and accompanying symptoms are more important.

Immediate medical evaluation is necessary when:

• the pain is severe, continuous, or worsening,
• is located mainly in the lower right abdomen,
• is accompanied by fever, persistent vomiting, or blood in the stool,
• the child is very sleepy, pale, or has difficulty moving,
• the abdomen is hard and particularly tender to the touch,
• the child refuses to eat or drink and shows signs of dehydration.

Particular attention is needed in infants, as they often cannot describe the pain and the clinical picture can evolve quickly.

What can parents do?

Calm observation is the first and most important step. It is useful to note:

• when the pain started,
• where it is located,
• if it moves,
• if it is accompanied by fever, vomiting or diarrhea,
• when the child last had a bowel movement or urination.

Until examined by a doctor, it is not recommended to administer painkillers or antibiotics without medical advice, as they may alter the clinical picture and delay the diagnosis. Also, if there is a suspicion of a surgical condition, it is advisable to avoid taking food or fluids until evaluated by a specialist.

How is it treated?

Treatment depends solely on the cause. In most cases, conservative treatment with hydration, appropriate nutrition and monitoring is sufficient. However, when a surgical condition, such as acute appendicitis, is diagnosed, early intervention is crucial to avoid complications and ensure the child’s rapid recovery.

The message to parents

Abdominal pain is a common symptom, but it should not be underestimated when it persists or is accompanied by worrying signs. Early evaluation by a pediatrician or pediatric surgeon allows for the correct diagnosis and appropriate treatment, providing safety for both the child and the family.