Tummy pain

GP Referrals Consultations by Specialist Children Consultant Surgeon

This is the commonest referral in my practice. The possible causes are many but I have summarised the most important ones here:

• Gastro-enteritis
• Infant colic
• Food allergy
• Acid reflux
• Helicobacter infestation
• Appendicitis
• Urine infections UTI
• Intestinal obstruction
• Hydronephrosis – blocked kidneys
• Peptic ulcer
• Abdominal migraine
• Worm infestations
• Ovarian cysts
• Gall stones
• Mesenteric cysts
• Wilms tumour
• Meckels diverticulum

But by far the biggest category is NSAP- non specific abdominal pain. I see perhaps 200 children every year with this problem where children get repeated attacks of  severe abdominal pain or colics, which can sometimes result in  weeks or even months off school.

A careful evaluation is a must to pick up those that need surgery, thankfully a minority. Some do have a psychosomatic component and I do not hesitate to mention this openly and honestly to the parents.

(Meckel's Scan in Children: A review of 183 cases referred to two Paediatric surgery specialist centres over 18 years. Pediatr Surg Int. 2013 May;29(5):511-7. doi: 10.1007/s00383-013-3270-3. C Sinha, D Misra)

Dr Devesh Misra
Consultant Paediatric Surgeon and Paediatric Urologist