Abdominal pain is a common reason for children to see their pediatrician. We like to divide the problem into acute and chronic causes. Let’s look at a few of each type.

Acute abdominal pain means the problem has occurred suddenly and recently developed. Common reasons include food intolerance, infection, and constipation.

Regarding lactose intolerance: foods with lactose, mainly cow’s milk products, can cause pain when the intestine can no longer break down the milk sugar lactose. People are usually not born with this problem since the significant sugar of breast milk is lactose. As we age, we may slowly lose the enzyme in our intestine. The bacteria in our gut form gas when they break down the lactose.

Food allergies can also lead to abdominal pain. It can be challenging to identify the source. Often, an allergist can help.

There are many bacteria and viruses that can cause abdominal pain. Whether or not your child has a fever, vomiting, or diarrhea can help clarify the source. Many of these infections are intestinal, but not always. Strep throat, for example, can sometimes seem more like an abdominal infection than a throat infection. There are plenty of others. And some illnesses that aren’t infections can lead to abdominal pain. A migraine headache is a very common one.

The most serious causes of acute pain include intestinal blockages. Intussusception, where the intestine slides into itself, and volvulus, where the intestine twists around itself, are fortunately rare.

Once abdominal pain becomes recurrent – that is, it seems to happen over and over again -- we start to think about some different causes. Actually, lactose intolerance and food allergies are usually chronic problems before they finally come to a pediatrician’s attention. The most common cause is overwhelmingly constipation. Children may withhold stool for various reasons. Sometimes, it’s because when they’re being toilet trained, they graduate to a regular toilet and can no longer reach the floor to push properly. Children should always have something under their feet when they poop. The higher their knees are, the easier it will be. Diet, of course, is essential. Not drinking enough and not eating enough fiber can lead to difficulty passing stool. There is a long list of other problems that cause chronic abdominal pain. It can take the expertise of a specialist who needs to look with a special camera (endoscope) to diagnose some of these problems. As you can tell, a child with abdominal pain needs proper attention. Please don’t assume your child is making it up or that the problem will go away on its own. And if constant vomiting or diarrhea are part of the picture, you need to seek help right away.

Robert B. Golenbock, MD, is currently retired. He has cared for children in the Danbury area for 43 years, including at the Center for Pediatric Medicine. The CPM is located at 107 Newtown Rd, #1D, Danbury, CT, 06810. For more information, please call (203) 790-0822 or visit https://centerforpediatricmedct.com.