Child Has Been Experiencing Abdominal Pain (by Belly Button...no Where

Posted on Wed, 12 Aug 2020

Question: Child has been experiencing abdominal pain (by belly button...no where else) for nearly 3 weeks. Child had watery stool during first week. After tests, xrays reveled intestine was full of stool. So after 1st week child was put a mild laxative and went under an essential liquid and higher fiber diet. Stool was passed but stomach pain remained, never subsided or got better. This is now mid way through 3rd week. Child is now on probiotic, mild laxative some medication for pain but no change. Stool is being passed but in small amounts and no change to her condition. Don't know what to do. Could there be an obstruction, early sign of appendix (although no pain when the right is pressed). There is no vomiting as well. The stomach around the belly button is firm to touch and child (~7yrs) is of light frame.

Answered by Dr. Sumanth Amperayani (44 minutes later)

Brief Answer:
Suggestions on pain abdomen

Detailed Answer:
I understand your concern.
What you describe is very common in kids.
We need to worry about abdominal pain in kids only if there is -
1. Abdomen is rock hard and distended.
2. Green or bilious vomiting.
3. Blood in stools.
4. Red hives like rash over the body.
5. Joint pains and joint swelling.
6. Completely stoppage of motion and flatus for straight 7 days.
Now coming to the most common reason - it could be mesenteric adenitis.
Please be informed that basically Mesenteric adenitis is not a diagnosis by itself and it is just a finding.
As to the answer to the question of - how long it lasts - it depends upon what caused it.
Causes of mesenteric lymphadenitis include viral and bacterial gastroenteritis, inflammatory bowel disease etc; but viral infection is most common
Mesenteric lymphadenitis is an inflammatory condition of the mesenteric lymph nodes that can present with acute or chronic abdominal pain. Because the nodes are usually in the right lower quadrant, mesenteric lymphadenitis sometimes mimics appendicitis and intussusception.
Acute mesenteric lymphadenitis is a self-limited condition.
Treatment involves supportive care including pain management and adequate hydration.
Abdominal pain occurring with mesenteric lymphadenitis typically resolves within one to four weeks, however, some people may have symptoms for up to 10 weeks.

Best regards - Dr Sumanth Amperayani

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Sumanth Amperayani (15 minutes later)

Hi thanks. So you don't think this warrants a ER visit? The doctors constantly refer to the amount of stool in her intestine. She has gone many times since and I've greatly reduced her food diet. Without another x-ray I can't see how it will take more than 2 weeks for the empty. I keep getting that the cause is constipation (which I'm sure was some of the reason but after two weeks on a laxative?). Although your prognoisis doctor, seems quite promising, I'd like to state that her abdomen is rather firm to my touch. It does feel rock solid. They had done urine and tcell count and found nothing unusual, other than the x-ray showing full (which is all relative too..what is normal to odd). If it does end up being what you suspect, what should the doctors check for and how do I convince them that may be the case?

Answered by Dr. Sumanth Amperayani (7 minutes later)

Brief Answer:
Suggestions on pain abdomen

Detailed Answer:
I do not think if it is really rock hard doctors would miss that.
If you want to convince them you can show the interaction which I have done now with you and then try to convince them.
When the blood count is normal I do not think there is anything for you to worry about in this regard.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Sumanth Amperayani (1 hour later)

Thanks. So need for alarm....which was my immediate concern. My child is not

So just to conclude:

With all things considered, the symptoms could likely be the result of mesenteric lymphadenitis__even with the normal blood work results...correct? And not necessarily due to an "intestine" full of stool (constipation related)? Espeically when taking into account, two weeks on a laxative with a modified diet.

And if that is a likely possibility (mesenteric), I should follow your previous suggestions and consult further with child's doctor on that possibility? Correct?

Answered by Dr. Sumanth Amperayani (2 minutes later)

Brief Answer:
Yes please

Detailed Answer:
Yes please.
Continue constipation management as such.

Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Raju A.T