Recurrent pain abdomen is not only caused by worm infestations.most kids are advised only antiworm medicine years after years without any relief of the symptoms.the causes are manifold and one should think of other etiology in following situations.
1.if pain is severe enough to hamper sleep.play and school attendance and other daily routines.
2.if having repeated vomitings. Loose stools.weight loss .loss of appetite .large fatty stools or severe constipation.urinary problems.appearance of rashes.pigmentation.jaundice.abnormal behaviour.increasing pallor.abdominal distension.excessive flatus.abdominal distension.fever .family history of pain abdomen or some related symptoms.
In these accompanying symptoms proper investigations and treatment should be done.
3.if pain abdomen is simple and not severe and occurs during particular day time or in morning hrs before heading for school .or when alone or in highly ambitious kids to remain at the top in class and not associated with above symptoms then psychogenic pain could be thought of and proper counselling will benefit a lot.
The causes of recurrent pain abdomen r manifold
1.worm infestation in india is common.
2.acute gastroenteritis is not cause of recurrent pain abdomen. In Chronic or recurrent gastroenteritis we have to think of malabsorptions.giardiasis .luminal amebiasis etc.
2.urinary tract infection:is I feel the commonest cause .so all such kids with or without urinary symptoms of burning.frequent urine .urgency etc ur r/m& c/s should be done in all in every age group.uti can present only with vomitings and loss of appetite in any age group even in adults.
3.gastritis in kids is much less common.
4.gall bladder and renal stones.
5.celiac dis if having severe constipation or repeated loose stools. Oily bulky stools.halted weight and height I. E. Failure to thrive.
6.porphyria if repeated rashes and pigmentation occurs with poor response to antispasmodics and pain killers rather aggravation on these medicines mostly.the pain is precipitated by sunlight.stress and during sickNess.
7.food or milk allergy; nowadays becoming common and is usually associated with vomitings and loose stools.to avoid the allergen is the cure.
8.abdominal epilepsy : abnormal behaviour .loss of consciousness during the pain episode demands EEG which is diagnostic.
9.familial mediterranean fever: occurs mainly in Mediterranean region in afflicted families and is genetic it manifests with fever & peritonitis in periodic manner.
10.typhoid.malaria.jaundice .pancreatitis. pids etc
11.hyperuriceMia with and without renal stones recently a 10 yrs old girl was diagnosed hyperg
Uricemia as cause of severe pain abdomen and responded only to hypouricemic drug.its 1st such case reported so far.
12.referred pain from hip joints. colitis .appendicitisetc.
13.diabetic keto acidosis. Renal artery ste
Nosis so BP should always be measured .
14.tuberculosis .now not so common.
15.abdominal trauma.
16.constipation etc.
Dr s kumar.Child specialist.
Mbbs.md.mrcpch (london)
Rainbow clinic and hosp.beside nifft gate.hatia.ranchi.jhàrkhand.
7250725044/7004780897.
1.if pain is severe enough to hamper sleep.play and school attendance and other daily routines.
2.if having repeated vomitings. Loose stools.weight loss .loss of appetite .large fatty stools or severe constipation.urinary problems.appearance of rashes.pigmentation.jaundice.abnormal behaviour.increasing pallor.abdominal distension.excessive flatus.abdominal distension.fever .family history of pain abdomen or some related symptoms.
In these accompanying symptoms proper investigations and treatment should be done.
3.if pain abdomen is simple and not severe and occurs during particular day time or in morning hrs before heading for school .or when alone or in highly ambitious kids to remain at the top in class and not associated with above symptoms then psychogenic pain could be thought of and proper counselling will benefit a lot.
The causes of recurrent pain abdomen r manifold
1.worm infestation in india is common.
2.acute gastroenteritis is not cause of recurrent pain abdomen. In Chronic or recurrent gastroenteritis we have to think of malabsorptions.giardiasis .luminal amebiasis etc.
2.urinary tract infection:is I feel the commonest cause .so all such kids with or without urinary symptoms of burning.frequent urine .urgency etc ur r/m& c/s should be done in all in every age group.uti can present only with vomitings and loss of appetite in any age group even in adults.
3.gastritis in kids is much less common.
4.gall bladder and renal stones.
5.celiac dis if having severe constipation or repeated loose stools. Oily bulky stools.halted weight and height I. E. Failure to thrive.
6.porphyria if repeated rashes and pigmentation occurs with poor response to antispasmodics and pain killers rather aggravation on these medicines mostly.the pain is precipitated by sunlight.stress and during sickNess.
7.food or milk allergy; nowadays becoming common and is usually associated with vomitings and loose stools.to avoid the allergen is the cure.
8.abdominal epilepsy : abnormal behaviour .loss of consciousness during the pain episode demands EEG which is diagnostic.
9.familial mediterranean fever: occurs mainly in Mediterranean region in afflicted families and is genetic it manifests with fever & peritonitis in periodic manner.
10.typhoid.malaria.jaundice .pancreatitis. pids etc
11.hyperuriceMia with and without renal stones recently a 10 yrs old girl was diagnosed hyperg
Uricemia as cause of severe pain abdomen and responded only to hypouricemic drug.its 1st such case reported so far.
12.referred pain from hip joints. colitis .appendicitisetc.
13.diabetic keto acidosis. Renal artery ste
Nosis so BP should always be measured .
14.tuberculosis .now not so common.
15.abdominal trauma.
16.constipation etc.
Dr s kumar.Child specialist.
Mbbs.md.mrcpch (london)
Rainbow clinic and hosp.beside nifft gate.hatia.ranchi.jhàrkhand.
7250725044/7004780897.
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