Abdominal pain is a common complaint of children, especially in the age group between five and ten years. It is estimated that about 10 to 18 per cent of school-going children suffer from recurrent pain in the abdomen.

Symptoms

Abdominal pain in children may be mild or serious. It can be termed serious, if it is accompanied by diarrhoea and sickness or if it has lasted continuously for more than three hours or if it is accompanied by fever and the child's neck glands are found swollen and his throat red or if the pain persists for several days.

The character of abdominal pain vary according to the site of the pain and the underlying cause. Thus in case of colic, a frequent cause of this problem, the pain may be sudden and spasmodic. There may be faintness, nausea and perhaps vomiting. The patient lies on his back and folds the legs and presses them over the abdomen to put pressure on it, which gives a sense of relief.

Causes

There are numerous causes of abdominal pain in children. Some of these causes are trivial, while others are quite serious. Mothers should therefore, never dismiss a child complaining of Stomachache lightly. Although several organic disorders can lead to this problem; they together constitute hardly 10 per cent of all causes.

Some of the main causes of abdominal pain are worm infestations, intestinal tuberculosis, surgical conditions like appendicitis, urinary tract abnormalities and renal calculus. Some children develop abdominal pain due to the improper functioning of normal organs such as infantile colic, irritable bowels and dysm-enorrhoea in adolescent girls.

A sieable number of cases of abdominal pain can be due to emotional or psychological factors. IN such cases, the child is concentious, worrying nature and his worries show themselves in recurrent tummy pain. They are very real to him. The emotional factors could include rivalary, school problems and conflict with parents.

Treatment

The treatment of abdominal pain in children will depend upon the underlying causes. The only effective treatment for this problem, resulting from digestive disturbances, is a thorough cleansing of the digestive tract and adoption of a sensible diet thereafter. The best way to begin the treatment is to put the child on a diet of fresh fruit or vegetable juices for a day or two. Orange juice will be especially beneficial. It can be given diluted with warm water on 50 : 50 basis. If possible, the bowels should be cleansed daily with a small warm-water enema. If this is done, the symptoms will soon disappear. The child can thereafter be placed on an exclusive diet of fresh juicy fruits such as orange, apple, pear, grapes, pineapple and papaya for a further day or two. This may be followed by a restricted diet consisting of lightly-cooked vegetables, juicy fruits and buttermilk for about two or three days and thereafter he may be allowed to embark upon a well-balanced diet, suited for his age. The emphasis should be on whole grain cereals, fresh fruits and steamed or lightly-cooked vegetables. The patient should avoid acid-forming foods, very hot and very cold foods as well as concentrated sweets.

Certain home remedies have been found beneficial in the treatment of abdominal pain caused by digestive disorders. The most important of these is the use of ginger. It is extremely useful in stomach-ache resulting from dyspepsia, flarulence, colic, spasm and other painful affections of the stomach and the bowels, not accompanied by fever. Quarter teaspoon of fresh ginger juice, mixed with half a teaspoon of honey constitutes as an effective medicine for treating this condition in children. It should be taken twice daily.

Coriander (dhania) is another effective remedy for adbominal pain, arising from digestive disorders. A teaspoon of coriander juice, added to half a glass of fresh buttermilk may be given to the child twice daily in treating this condition. A chutney made from dry coriander, green chillies, grated coconut, ginger and black grapes, without seeds, is also useful in abdominal pain due to indigestion and can be given to the child in small quantities.

Bishop's weed (ajwain) is also a valuable remedy for stomach ache resulting from diarrhoea, dysentery, atonic dyspepsia, cholera, colic, flatulence and indigestion. Half a teaspoon of these seeds with a little rock salt may be given twice daily in treating this condition. The volatile oil extracted from the seeds is also useful and should be given in doses of one or two drops.

Application of hot fomentations over the site of the pain will give relief. Pain in the stomach can often be relieved by a general hot bath when other measures have failed. The temperature of the water should be increased after the patient enters the bath, as hot as can be borne, say 100 ^o to 120 ^o F. In several cases, drinking a couple of glasses of hot water will give relief. The temperature of the water should be as hot as can be swallowed without inconvenience. Cramps in the stomach can also be relieved in the same way. Application of radiant heat over the abdomen twice or thrice daily will also give great relief.

In case of recurrent abdominal pain arising from psychological and emotional factors, skilled help from a psychiatrist will be necessary to discover the cause of his worries and prescribe the methods of cope with every day problems.