 Plain of stomach pain and this is the most common reason that parents bring them to emergency. So usually what happens that you know toddlers and adolescents, they have stomach pain on and off and then it goes away with some kind of treatment and the parents get concerned you know when they should be concerned about the child and what they need to do about this stomach pain which is coming so frequently to the child. So today we are going to you know understand what is stomach pain or chronic or recurrent stomach pain in children and what we can do about it. So if you look at the definition, chronic pain is something that which has been ongoing for at least one to two months and if you look if you say it is recurrent then you know if the child is having more than three episodes or when it is affecting the daily activity of the child then it is recurrent. Obviously you know if the episodes have been ongoing for three months then we can say it is a recurrent or chronic abdominal pain. So in that case there are certain factors or things that the parents need to remember you know to look into you know what is causing this pain and how it can be helped. So let's look into the causes of this abdominal pain. So you know they are actually divided into organic causes and functional causes. Now organic causes is that if there is underlying disorder in any of the organ system involved usually you know whenever there is an underlying organic cause the child will have some kind of warning signs and these warning signs are very important. So if your child is you know vomiting very frequently or having constipation diarrhea or you know unable to sleep if you see significant behavioral change if the child is not able to carry out the daily activity or if there is alternation in bowel and bladder habits for example the child has started staining the pants or you know having incontinence or if you see you know any amount of blood in stool or urine then obviously these are the warning signs which suggest that there is an underlying organic cause. Now let's look what are the organic causes. So most commonly that we see in toddlers and adolescent children which have frequent or recurrent abdominal pain the two most common causes constipation and food allergies and yes I would like to emphasize on these causes because nowadays our kids are very much exposed to you know processed food food containing a lot of preservatives and this is something which is affecting them in a big pain. Secondly if you look as compared to the past nowadays the activity level of the kids have gone down a lot. So most of the time you'll see small kids spending their time on you know mobile phones watching tablets similarly older kids as well they have little time for physical activity and they are mostly engrossed in their tablets or computers. So this is something which is a really really contributing big time to these common factors and food allergy is coming big time in our country as well because of exposure of too many food products obviously the pollution level has gone up which goes into your soil as well so whatever you eat is not actually very very healthy. So there are certain factors you know which needs to be looked into and then there are other causes for example like infection you know your common gastroenteritis kidney or bladder infection then there are causes related to food poisoning there are causes related to you know excessive drug overdose then there are certain surgical causes you know which may give rise to severe endowment pain and besides that there are other stomach conditions for example like chronic condition like pancreatitis inflammatory bowel disease but they will be associated with other you know factors as well you know disease modalities to be able to diagnosis disease. Now besides the organic disorders there are functional disorders which can give rise to abdominal pain in children the most common functional disorder is functional dyspepsia which is now again very commonly seen in kids in common language we call it stomach upset most kids you will know will complain of you know burning pain and this is not associated with any bowel movements so this stomach upset bloating or feeling of burning is usually called functional dyspepsia then there are other causes like irritable bowel syndrome abdominal migraine and you know other functional disorders so these are certain causes which as a parent you need to remember that you know if the child is having recurrent or chronic abdominal pain they might be suffering from one of these problems. So how do we diagnose these stomach pain so basically whenever you are worried you should consult your doctor or specialist even when the child goes to the hospital a couple of tests are being done based on the underlying pathology these usually include blood tests, stung line and urine tests and X-ray or ultrasound depending on as I said earlier all the underlying cause if needed the child may need an endoscopy to look at any specific you know organ or any specific pathology now it's very important to keep a pain diary because that is very very helpful in charting out these recurrent abdominal pain which comes on and off and usually you know as a parent also it also helps you so what you need to know in the pain diary is how bad the pain how long it lasted did it affect it any of the activity like sports or you know play time or school was there any trigger involved was it related to any food or you know any stress and what was the location of the pain and finally did it get relieved by anything so these are certain things as a parent that you can do because this is very very helpful in diagnosing and knowing this recurrent abdominal pain. Now what is the treatment which will be advised so treatment is obviously based on the underlying pathology but at home as a parent what you can do to the child who's having abdominal pain is try and keep the child hydrated offer them plenty of fluid or juices or you know clear liquids like coconut water don't push the child to eat I know most of the parents get worried when the child is not eating but you know once the pain settles the child automatically wants to eat so if the child feel hungry then offer them bland food like dalya kechli or some side dish of you know toast or something and important thing is allow the child to have plenty of rest if needed you can give a simple dose of paracetamol to help with the abdominal pain but if you see any of the following you know warning signs then I think you should always rest your emergency so what are the warning signs that you see and you should take the child immediately to emergency or to the doctor so if the child besides having the stomach pain is having fever high fever with chills is repeatedly vomiting having blood in their stool or are not able to pass urine or if anything that concerns you regarding the child then the best thing is to take the child to the nearest emergency or to the nearest hospital in the end I would like to conclude that recurrent stomach pain in children is critical provided you take the right advice at the right time