A Parent's Guide To Children's Stomach Pain: Causes & Treatment - Romper
Of all the ailments that children get, tummy troubles seem to top the list of aches and pains. Either their stomach is rumbling, gurgling, growling — and in some more serious instances, hurting. But trying to identify what the issue is can be difficult for parents, especially when your kid can't quite explain the aching they're experiencing or even pinpoint the exact spot where it's painful. Although a call to the pediatrician is always advisable, this children's stomach pain guide can help you know when it's just gas or when you need to get to a doctor ASAP.
What can cause stomach pain in a child?
IN THIS SECTION, DEFINE STOMACH VS. ABDOMINAL PAIN
Your child comes to you and tells you that they have a tummy ache. But before you can try to make your child feel better, you have to know what causes stomach pain in kids — and unfortunately, it can be a lot of things. "To be honest, there are very few things we see in a pediatric office that can't cause abdominal pain," Dr. Zeyad Baker, M.D. a board-certified pediatrician at Baker Health tells Romper. "So even you think of a virus like the flu, abdominal pain might not come up immediately, but abdominal pain is one of the top five symptoms."
Since children's stomach pain can be attributed to so many medical reasons, you'll need to ask your child to show you where the discomfort is first. "Since it can be tricky for kids to articulate exactly what the pain feels like, it's a good idea to ask them to point to where it hurts," advises Dr. Harvey Karp, M.D., a board-certified pediatrician. "This can give you a clue to what the problem might be."
Location is important because it can mean the difference between stomach pain and abdominal pain, and they're two completely separate issues. "Stomach pain is specific to the stomach (like reflux or gastritis), whereas there are many cases of abdominal pain," Dr. Sarah Lazarus, DO, FAAP, a children's emergency department physician points out. Abdominal pain can be attributed to a whole host of organs, such as the liver, gallbladder, pancreas, as well as the small and large intestines.
"Most of the time, kids with stomachaches point to the belly button, which could be a sign of an upper or lower problem," Karp adds. "Generally speaking, pain around the navel is less worrisome than belly pain that's further from the belly button."
If your kid is having discomfort in their abdominal area, here are some possible reasons for children's stomach or abdominal pain:
Appendicitis
You don't hear too much about the appendix — that is, until you get appendicitis. The jury is still out on how effective an organ it is — the appendix is thought to either be utterly useless by some medical professionals, or it might perhaps offer some sort of immunity protection, according to one study. When it comes to kids, though, appendicitis is one of the most common culprits of abdominal pain and is the number one surgical emergency. "With appendicitis, pain starts by the belly button and usually moves to the lower right side of the tummy within a couple of hours," says Karp. "There's also usually fever, lack of appetite, fast pulse, and listlessness." If you think that your child might have appendicitis, call your pediatrician immediately or head to the emergency room. There is a quick way to check if your child might have appendicitis, according to Karp. Have your child hop on one foot — if they hop once and have a sudden sharp pain in the lower abdomen, that can often be a sign of appendicitis.
Treatment: surgery
Food poisoning
Your child ate some suspicious looking scrambled eggs and now their stomach is feeling pretty sick. Food poisoning might be the reason for their aches and pains. "Kids with food poisoning can have tummy cramps and pass loose stools three or more times a day," says Karp. While a stool sample is the only real way to confirm if your child has food poisoning, symptom management — such as giving your child plenty of electrolyte-boosting fluids and letting them rest — can help, along with offering the BRAT diet (bananas, rice, applesauce, and toast) when they're ready to eat again. And let your child's pediatrician know about the incident so they can help you monitor your child's symptoms and offer solutions.
Treatment: Rest, hydration, BRAT diet, and eating smaller meals
Intussusception
One of the more major reasons why your child could be having stomach pains is intussusception. The condition occurs when part of the intestine folds into itself, similar to how you close a telescope. It's serious — and it's scary. "If your younger child has severe abdominal cramping, crying, vomiting, is pulling up legs in pain and/or has bloody stools, this is concerning for intussusception and they should be evaluated," advises Lazarus. "Intussusception can cause a blockage and may require surgical evaluation." This condition is diagnosed using an X-ray and/or ultrasound, so if your child is presenting these symptoms, you should speak with their doctor right away or take them to the emergency room.
Treatment: surgery
Stress
Your child wakes up in the morning with a stomachache. Coincidentally, they also have a math exam that morning in school, too. Could the cause of their pain be due to nerves? Absolutely, says Baker. "We see a lot of functional abdominal pain in kids," she says. "That's just due to stress and anxiety and it causes stomach pain." Depending on your child's age, ask them to describe the pain they're experiencing. While other stomach ailments might feel like sharp pain, tummy issue related to stress are not quite as painful. "Vague, wiggly, butterfly-like belly pain in a child's tummy can indicate nervousness or stress," adds Karp.
Treatment: Speaking with your child and/or therapy
Constipation
Do you know when was the last time your child had a proper poop? Another cause of stomach pain in kids can be constipation or just good ol' gas. "Pain around the navel is usually gas or constipation," says Karp. But how do you know if your kid is clogged up? "When a child is constipated, they experience fewer bowel movements, their stool is infrequent (less than every other day), hard, dry, and pellet-like every few days." Constipation can also cause your child to wet the bed, too. If there is no vomiting, diarrhea, or high fever, (and your child is happy or playful in between the periods of pain), it can be a sign that the problem isn't severe and is most likely gas or constipation.
Treatment: Miralax (or its generic equivalent), mint or chamomile tea, hydration and a fiber-rich diet
Reflux
If your child suffers from Gastroesophageal reflux disease (GERD), they might experience stomach pain along with it. GERD, a condition where stomach acid flows back into the esophagus, can cause a burning sensation as well as an icky feeling in the tummy, too. "If you have abdominal pain that comes and goes and it's been there for months, you think of a more chronic picture, think celiac disease, irritable bowel syndrome or bowel disease, irritable bowel syndrome and GERD," says Baker.
Treatment: medication, sleeping with their head elevated or on their left side, antacids, surgery
Strep throat
A sore, itchy throat aren't the only symptoms of strep — your child might experience stomach pain, too. "Abdominal pain is incredibly common in children and can be caused by almost anything, even strep throat," explains Lazarus. While pain when swallowing, fever, and red and swollen tonsils are the most common symptoms of strep throat, stomach pain, nausea and vomiting occur, too — especially in children, per the Centers for Disease Control and Prevention (CDC).
Treatment: Antibiotics and/or over-the-counter (OTC) pain relievers
Urinary tract infection
While you might not associate urinary issues with stomach pain, the two can sometimes be intertwined. "If your child points low on their belly (in the colon territory), they could have a urinary tract infection," says Karp. But it doesn't always stop at infections, either. "With lower abdominal pain in a female, you start to entertain gynecologic possibilities like ovarian cysts, or an ovarian torsion, where the ovary and sometimes the fallopian tube twists on the tissues that support them," adds Baker. These medical issues can come with severe pain in the pelvic region along with nausea and vomiting and can be diagnosed with a pelvic ultrasound.
Treatment: Antibiotics
Stomach virus
All it takes is for one wave of sickness to spread through school and your kid will come home with a stomach virus. When your child complains of tummy troubles, more often than not, gastroenteritis might be the reason. "The most common thing we see for abdominal pain is a stomach virus," says Baker. "They hit hard and fast and you usually get a little fever, a little diarrhea, and a little vomiting." Typically, a stomach bug will peak in the first 24 hours and slowly get better after that. Hydration can help your child feel better and get over the bug.
Treatment: Hydration, rest, probiotic (like Cultrelle), and small meals consisting of light, bland foods
Lactose intolerance
Sometimes dairy can do a one-two punch to your child's stomach. If your pediatrician suspects that lactose intolerance is to blame for your child's belly aching, then they might put your child on a diet. "Lactose intolerance is a huge one," says Baker. "We treat that empirically, meaning if we suspect lactose intolerance based on the history, we just tell them zero dairy for 30 days and then see if that works or not."
Treatment: Dairy-restrictive diet for one month to see if symptoms improve
How to relieve your child's upset stomach
As you might imagine, tending to your child's tummy troubles is easier said than done. "There is not one specific remedy for abdominal pain because different remedies are required for different causes of abdominal pain," says Lazarus. But once the cause of children's stomach pains has been positively identified, then there are steps you can take to alleviate your child's discomfort.
- Rest
- Hydration
- Small meals consisting of bland foods
- OTC pain meds that your pediatrician has approved first
- Warm compress on tummy
- Massage
There are some home remedies you can try, such as massaging some of the ickiness away. "Tummy rubs can work wonders on nervous bellies, indigestion, gas, and constipation," he says. Start by using your fingertips to "draw" an oval underneath your child's belly button. Move your fingers clockwise, which follows your child's digestive tract. Next, walk your fingers diagonally, making an X from one side of their stomach to the other, repeating as needed.
When to call the doctor about your child's stomach or abdominal pain
"If your child has pain jumping up and down three times, has persistent vomiting, has high fevers, bloody diarrhea, is not urinating at least 3-4 times daily, has severe belly pain, right lower quadrant pain, or testicular pain, you should call your doctor and they may ask for you to be evaluated in an urgent care or emergency room setting," says Lazarus.
Adds Karp: "If belly pain is very severe (causing crying), associated with fever or green/yellow vomiting, is accompanied by weight loss, and your child is listless, contact your child's physician immediately." The timing and duration of your child's stomach pain is critical, too. "If your child's belly pain is severe and has lingered more than an hour, or is mild, lasting more than a couple of hours but is recurring for over one week should be a cause for concern and warrant a call to the doctor."
Stomach pain in children is very common and more often than not, it's nothing too serious. Still, it's always best to monitor your child's belly pain to ensure that it doesn't get worse.
And if child does start exhibiting other symptoms, call their doctor or head to the ER for further examination and treatment. That way, you can get your child healthy again — and help get rid of the sick feeling in the pit of your own stomach.
Studies cited:
Gadiparthi, R., Waseem, M. (2022) "Pediatric Appendicitis," StatPearls, https://www.ncbi.nlm.nih.gov/books/NBK441864/
Jones, M., Lopez, R., Deppen, J. (2022) "Appendicitis," StatPearls, https://pubmed.ncbi.nlm.nih.gov/29630245/
Switaj, T., Winter, K., Christensen, S. (2015), "Diagnosis and Management of Foodborne Illness," https://pubmed.ncbi.nlm.nih.gov/26371569/
Experts:
Dr. Zeyad Baker, M.D. a board-certified pediatrician at Baker Health
Dr. Harvey Karp, M.D., a board-certified pediatrician
Dr. Sarah Lazarus, DO, FAAP, a children's emergency department physician
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