711 Shields Road   ·    Dalton, Georgia 30720    ·     (706) 278-6628   ·   Fax (706) 272-3832   

ABDOMINAL PAIN

Abdominal pain, (stomach ache), is a very common reason for children to see the doctor from age 3 up.

There are many causes of stomach ache including constipation, urinary tract infection, intestinal infections with viruses, bacteria and parasites, ulcers, psychological stress factors, school avoidance, and other more rare conditions.

Constipation:

The most frequent cause of abdominal pain is constipation. Constipation can be obvious, in the case of a child who has large, hard, infrequent bowel movements. However, some children who are indeed constipated, continue to have soft bowel movements once or twice daily. Sometimes, they even appear to have diarrhea! They may at times soil their undergarments.

Children get constipated for two main reasons. First, they generally don’t eat as much fiber as they really need. Second, they generally do not take time out to have a bowel movement when they feel the urge to go, because they either are too involved in a fun activity, or because they are in school and don’t want to call attention to themselves or to use the school bathrooms. So they therefore ‘hold it’.

How do I help my child with stomach ache?

First, it is important to have a good physical exam and possibly a urine test, to look for any physical or emotional cause other than constipation. If the history and examination are consistent with possible constipation, then it is best to proceed with a simple trial of treatment for presumed constipation, and see if that helps.

Emptying out any impacted bowel movement in the rectum. For children age 3 and up this can be done using either a 10 mg Dulcolax suppository rectally once daily for three days, or a pediatric Fleet enema rectally, once daily for three days.

Giving Milk of Magnesia twice daily for 2 weeks. The dose would be as follows:

                  Age 3 - 5: 1-1/2 to 2 teaspoons twice daily for 2 weeks

                  Age 5 - 7: 2 to 3 teaspoons twice daily for 2 weeks

                  Age 8 and up: 1 tablespoon twice daily for 2 weeks

Sitting twice a day on the commode at home for five minutes to try and have a bowel movement. For children age 6 or under, reward them with a star on a chart for sitting and trying, and give two stars for a successful bowel movement. See our Grab Bag handout for suggestions on rewards for the stars.

Increasing the amount of fiber in the diet. For the long haul, we don’t want for your child to need medications to control the bowel movements. So, it is important for your child to eat plenty of fiber daily. Good ways to get fiber into young children include a bran muffin daily, adding 1 - 2 tablespoons of All Bran cereal to your child’s favorite cereal, increasing apples, prunes, peas and celery in the diet.

You should call the office nurse in 10 days, and let her know how your child is doing. If pain continues, then other tests or treatments will be considered. Almost always, a reason can be identified. Sometimes the cause of abdominal pain is physical, sometimes it is psychological or stress-related. At any time, you should notify us if there is blood in the bowel movements, vomiting, diarrhea, or if pain is worsening or waking your child out of his or her sleep at night.

copyright 1997 MCM