The abdominal region includes the most vital organs of the body, like the stomach, liver, intestines, and pancreas. Abdominal pain is often an indicator of a problem in these organs or the groin.
Abdominal pain or stomach ache is often not a serious ailment, and children, including teenagers, experience it at some point. However, severe and recurrent pain accompanied by other symptoms will require medical attention. In this post, we present the various reasons behind abdominal pain in teenagers, along with the treatment options.
Types Of Abdominal Pain In Teenagers (Boys And Girls)
The intensity and location of the abdominal pain indicates the types of abdominal pain (1).
- Generalized pain: The pain is in more than half of the abdominal area. This type of pain may be associated with indigestion, gas, or a viral infection. Sometimes, generalized pain could become severe, thus indicating blockage or other severe problem in the intestines.
- Localized pain: This pain is restricted to one part of the abdomen. It is usually associated with problems in one organ, such as stomach, gallbladder, or appendix.
- Cramping or cramp-like pain: Generally, this pain does not indicate a serious problem. It may be because of bloating or gas and might be followed by diarrhea. Cramp-like pain can be worrisome if it is accompanied by fever, occurs frequently, or lasts more than 24 hours. Women can also experience this type of pain during menstrual periods.
- Colicky pain: This pain usually starts and ends suddenly, occurring in a wave-like pattern. Usually severe in intensity, this type of pain may be associated with kidney stones or gallstones.
Associated Signs And Symptoms
- Sore throat
- Body ache
- Changes in bowel movements
When To See A Doctor
- Change in bowel pattern
- Abdominal discomfort for more than a week
- Blood in stool
- Fever (> 100.4 °F)
- Sore throat
- Chest, neck, or shoulder pain
- Prolonged vaginal bleeding
- Weight loss
- Prolonged loss of appetite
- Diarrhea for than five days
- Bloating for more than two days
- Burning or pain during urination
Home Care Tips To Manage Abdominal Pain
If your child experiences abdominal pain with other symptoms, it is advised to visit a healthcare practitioner to identify the cause of abdominal pain. Do not give any over-the-counter medicine to your child without talking to your doctor. However, for mild abdominal pain, you may try the following tips at home to relieve pain (1).
- Sip water: Keep slowly sipping water or other fluids. Warm liquids may help relieve pain.
- Avoid solid food: Avoid solid food or food that is hard to digest for the first few hours or till you see your doctor.
- Eat specific food items after vomiting: If the teen has been vomiting, then avoid consuming solid food for at least six hours. You may give your child mild food items such as rice, apple juice, or crackers. Do not give your child dairy products.
- Avoid citrus food items during indigestion: If your child is experiencing heartburn or indigestion with pain in the upper part of the abdomen, then avoid citrus, greasy, or fatty foods. You may also avoid tomato products, caffeine, and carbonated drinks.
Causes Of Abdominal Pain In Teenagers (Boys And Girls)
Abdominal pain can be caused by a variety of conditions. Minor causes can include food poisoning, constipation, acid reflux, food allergies (lactose intolerance), irritable bowel syndrome, and stomach flu. The severe causes of pain can include the following (1) (3) (4).
- Appendicitis: It is an inflammation of the appendix and occurs quite frequently in adolescents. In this condition, pain usually migrates from the middle section of the abdomen to the right lower part. Other symptoms can include nausea, vomiting, abdominal swelling, or low-grade fever (5).
- Gastroenteritis (stomach flu): It is a very common condition and is caused by bacterial or viral infection. Common infection-causing viruses include rotavirus, Norwalk virus, adenovirus, enterovirus while common bacterial agents include Escherichia coli, Salmonella, Shigella, Yersinia, and Campylobacter (4). Other symptoms can include diarrhea, vomiting, fever, or headache.
- Constipation: Constipation occurs when there is difficulty in bowel movements due to hard stool or bowel movements are less frequent (less than three per week). Pain due to constipation is usually on the left side of the abdomen (4). Other symptoms can include pain and straining in the rectum area during bowel movements, bloating, or rectal bleeding (6).
- Urinary tract infection: This condition is very common among teenagers, especially in girls. Apart from abdominal pain, symptoms can include side pain or back pain, fever and chills, pain or burning during urination, foul-smelling urine, cloudy urine, or presence of blood in the urine (7).
- Stress: Emotional distress (stress, anxiety, depression, or other psychological issues) in school-aged children can also cause recurring abdominal pain. This pain, also known as functional abdominal pain has no other identifiable cause. In addition, no other symptoms such as nausea, vomiting, fever, weakness, or diarrhea are observed in those teenagers (8).
- Food reactions (intolerance): Certain food items when consumed can cause reactions. One such condition is lactose intolerance. Consumption of dairy products in lactose intolerant teenagers may cause abdominal pain, bloating, gas, or diarrhea.
- Gastroesophageal reflux disease (GERD): It occurs when the contents of the stomach come back (acid reflux) and irritate the food pipe (esophagus). Teenagers with GERD can experience heartburn, bad breath, wearing down of teeth, vomiting, pain in the chest or upper abdomen, or pain during swallowing (9).
- Kidney stones: Kidney stones are hard solid mass of minerals and elements that lodge in the kidneys. Usually, these stones pass through urination, but might sometimes remain in the kidneys thus causing discomfort. The pain due to kidney stones starts suddenly in the back or the sides and is severe and persistent. Other symptoms may include nausea and vomiting (10).
- Trauma or injury: Any blunt trauma or injury in the abdominal area can not only cause pain but also perforations, and hematoma (bleeding) in internal organs (4).
- Gallbladder disease: In this condition, the bile duct is blocked, often due to the presence of gallstones. The pain is usually experienced in the upper right part of the abdomen and after meals while other symptoms include fever and jaundice. It is more common in adults than adolescents. The increasing obesity among teenagers has increased the risk of gallstone formation (11).
- Inflammatory bowel disease (ulcerative colitis and Crohn’s disease): This condition mostly peaks in the age group of 15 to 35 years. The inflammation in the gastrointestinal tract can cause abdominal pain, weight loss, or diarrhea. Teenagers with ulcerative colitis can also experience blood-laden diarrhea (12).
- Irritable bowel syndrome: It is a chronic disorder that affects the large intestine or colon. The symptoms include chronic abdominal pain, bloating, diarrhea, loss of appetite, or change in bowel movements (13).
- Peptic ulcers: It is an open sore wound that appears in the stomach or upper part of the small intestine. An infection by Heliobacter Pylori bacteria has been identified as the most common cause of these ulcers. The symptoms can include burning stomach pain, loss of appetite, frequent burping, or vomiting (14).
Lower abdominal pain in teenage boys
Apart from the above causes, teenage boys can experience abdominal pain due to the following condition (4).
- Testicular torsion: It occurs most frequently in teenage boys as an emergency condition that requires immediate medical attention. Testicular torsion occurs due to the twisting of the spermatic cord, thus blocking the supply of blood to the testicle. The symptoms may include severe pain in the scrotum, abdominal pain, enlarged testicles, and swollen, red and tender scrotum (15).
Lower abdominal pain in teenage girls
- Dysmenorrhea (Cramps and pelvic pain with menstruation): This condition is associated with painful cramps during menstruation and is the most common problem in girls among all age groups. Characteristic symptoms may include pain in the lower abdomen, pelvic pain, pain that radiates to the lower back and thighs, nausea, vomiting, and headache. This pain usually lasts for eight to 72 hours and occurs with the start of the menstrual flow (16).
- Mittelschmerz (Ovulation pain): This pain occurs in the lower abdomen around mid-menstrual cycle (between seven and 24 days) and is associated with an increase in luteinizing hormone (LH) levels. It is usually felt in the lower right part of the abdomen and the intensity may vary from mild to severe (17).
- Endometriosis: The symptoms of endometriosis often start during adolescence. The condition is defined as the presence of endometrial tissue outside of the uterus. It can present symptoms such as back pain, flank pain, nausea, headache, fatigue, and urine urgency (18).
- Ovarian torsion: This condition occurs mostly due to ovarian tumors or cysts and can cause acute abdominal pain. The pain usually occurs on one side and right-sided pain is more common than left-sided pain. Other symptoms can include nausea, vomiting, fever, and presence of palpable mass (19).
- Ectopic pregnancy: Ectopic pregnancy occurs outside of the uterus (usually inside fallopian tubes) and can be life-threatening. In sexually active teenagers, ectopic pregnancy can present symptoms such as severe sharp lower abdominal pain, cramping on the affected side of the pelvis, abnormal uterine bleeding, and amenorrhea (absence of menstruation) (16).
- Pelvic inflammatory disease (PID): This condition refers to the infection and inflammation of the upper genital tract, including the uterus and fallopian tubes. In adolescents, multiple sexual partners and increased incidence of sexually transmitted diseases (STDs) increase the risk of PID (20). The symptoms include lower abdominal pain, abnormal findings in pelvic examination (uterine tenderness/cervical motion tenderness), abnormal vaginal or cervical discharge (16).
- Threatened abortion: According to the World Health Organization, threatened abortion is defined as a pregnancy-related bloody vaginal discharge or frank bleeding during first half of the pregnancy without the dilation of the cervix. Symptoms can include lower abdominal pain and vaginal bleeding (21).
Diagnosis Of Abdominal Pain
The diagnosis may require a series of laboratory tests and examinations. Your healthcare practitioner may consider the following factors including age, history of pain, any trauma, associated symptoms, family history, and gynecological history (4).
Diagnosis may also require physical examination including abdominal examination, and rectal and pelvic examination. Other laboratory investigations may include the following (1).
- Blood, stool, and urine tests to check for infectious agents (bacteria, virus, or parasite)
- Ultrasound of the abdomen
- Abdominal X-ray
- CT scan
- Colonoscopy or sigmoidoscopy (tube through the rectum into the colon to look into intestines and colon)
- ECG (electrocardiogram)
- Upper endoscopy (tube through the mouth into the esophagus, stomach and upper small intestine to detect any problems)
- Upper gastrointestinal (GI) and small bowel series (set of X-ray to check for any ulcers, abnormalities, inflammation, or blockages)
Treatment Of Abdominal Pain In Teens
Treatment of abdominal pain depends on the underlying condition or disease. The following treatment methods are used to treat the causes of pain.
- Doctors can recommend antibiotics to your child in case of infections.
- Inflammatory diseases are often treated or managed with anti-inflammatory agents or immunosuppressors. Pain relievers or analgesics can also be given to relieve severe pain.
- Teenagers with constipation may be recommended stool softeners or laxatives. For acid-reflux associated conditions, your child may be prescribed antacids or H2 blockers.
- Teenagers experiencing functional abdominal pain due to emotional distress may be advised counseling or psychological therapy.
- In addition, doctors may also suggest changes in the child’s dietary habits to relieve symptoms related to food reactions or intolerance and bowel movements.
- In other cases such as appendicitis, ovarian or testicular torsion, abdominal trauma, or intestinal blockages, surgery works as the best option.
Risks Factors For Abdominal Pain In Teens
The following factors might increase the risk of abdominal pain.
- Age: Some conditions such as appendicitis, gastroenteritis, or testicular torsion that cause abdominal pain are more prevalent in teenagers and older children.
- Family history: Owing to previous medical history in families, your child may be more prone to gynecological conditions (endometriosis or dysmenorrhea), inflammatory diseases, and food reactions.
How To Prevent Abdominal Pain?
Abdominal pain might not always be preventable. However, you can encourage your child to follow these precautions to minimize the risks of certain conditions that lead to stomachache (1).
- Stay hydrated, and drink plenty of water in a day.
- Eat small and frequent meals.
- Be physically active and do age-appropriate exercises regularly.
- Avoid consumption of food items that can cause indigestion or gas.
- Consume high-fiber and well-balanced diet. Include fruits, vegetables, and whole grains in all meals.
Abdominal pain can occur because of minor or serious problems. The causes of abdominal pain are numerous and present similar symptoms. Therefore, definite diagnosis of such pain can be difficult. Fortunately, most causes can be treated or managed at home. However, if your child experiences any severe symptoms, visit your healthcare practitioner.
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