What to Know About Stomach Pain (Abdominal Pain) in Children
Stomach pain in kids usually is not serious.
- Abdominal pain is one of the most common reasons for a parent to bring his or her child to medical attention.
- Symptoms and signs of stomach pain in children include gas (flatulence), rubbing around the belly button, especially if the pain is located low and down on the right side of the abdomen, you "just know" that the child is very sick, pale appearance, sweating, sleepiness or listlessness, vomiting; however, if it does not go away (Although, vomiting does not always go away.), diarrhea, fever, groin pain, urinary problems, and a rash. Moreover, stomach pain in children depends on if the pain comes and goes (intermittent), where the pain is located, whether the pain is acute or chronic, and how severe the pain is.
- Possible causes for a child's stomach pain range from trivial to life-threatening, with little difference in the child's complaints.
- Fortunately, abdominal pain in a child usually improves quickly.
- Stomach pain in children is serious if the child has a high fever, has had diarrhea for longer than 24 hours, or has been vomiting for longer than 24 hours.
- Each parent or caregiver faces the difficulty of deciding whether a complaint needs emergency care or not.
What Are the Symptoms and Signs of Stomach Pain in Children?
A parent or caregiver usually can notice pain in a child's abdomen. Infants and very young toddlers may cry, express pain facially, and curl up. Young children are usually quick to tell you what is wrong. Some teenagers may be reluctant to report pain, and you must try to get a clear explanation of what they are feeling. Ask about these conditions:
- Duration of the pain: Most simple causes of abdominal pain do not last long. Most of us have experienced gas pains or the stomach/gut flu, and recall that the pain was usually gone within 24 hours. Any abdominal pain that continues longer than 24 hours should be evaluated by a physician.
- Location of the pain: Most simple pains are located in the center of the abdomen. The child will rub around his or her belly button. Pain felt in other areas is more concerning. This is especially true of pain located low and down on the right side of the abdomen. Pain in that area should be considered appendicitis until proven otherwise.
- The appearance of the child: As a general rule, if the child looks very ill in addition to being in pain, medical help should be sought. Often, the caregiver "just knows" the child is very sick. When abdominal pain occurs, key things to look for include pale appearance, sweating, sleepiness, or listlessness. It is most concerning when a child cannot be distracted from the pain with play or refuses to drink or eat for several hours.
- Vomiting: Children vomit quite frequently with abdominal pain, but vomiting does not always indicate a serious problem. However, as with the duration of the pain, most simple causes of vomiting go away very quickly. The rule again is that vomiting for longer than 24 hours is a legitimate reason to call the physician.
- Nature of the vomiting: In infants and very young children, vomiting that is green or yellow is a reason to call the doctor. At any age, vomiting that appears to contain blood or darker material is a reason to seek emergency care.
- Diarrhea: Diarrhea is also common with abdominal pain and usually indicates that the cause is a virus. This can continue for several days but usually only lasts less than 72 hours (three days). Any blood in the stool is a reason to seek medical care.
- Fever: The presence of a fever does not always indicate a serious problem. Indeed, a normal temperature can be seen with the more serious causes of abdominal pain.
- Groin pain: One serious problem that a boy may describe as abdominal pain actually comes from somewhere else. It is testicular torsion, a condition in which a testicle twists on itself and cuts off its own blood supply. The child may be embarrassed to mention the location, so you should ask if there is any pain "down there." A testicular problem is usually easy to fix if treated early enough. So, if a child complains of pain in the groin area or testicles, seek medical emergency care.
- Urinary problems: Abdominal pain associated with any trouble urinating, such as painful or frequent urination, could indicate an infection and is a reason to seek medical care.
- Rash: Certain serious causes of abdominal pain also occur with a new rash. The combination of skin rash with abdominal pain is a reason to contact your doctor.
When Is Stomach Pain in Children Serious?
For a child with severe stomach pain, go to your nearest Emergency Department if the child has a high fever, has had diarrhea, or vomits longer than 24 hours.
Stomach pain left identified and treated early carries a good prognosis overall; however, pain that is left undiagnosed and untreated can be life-threatening. For serious conditions, treatment can be as extensive as hospital admission and surgery.
A parent or caregiver should work with the pediatrician and hospital early in the child's illness to ensure the child receives appropriate care.
What Causes Stomach Pain in Children?
- Infections: Viruses or bacteria can cause abdominal pain, typically from stomach flu or gut flu (called gastroenteritis). Viral infections tend to go away quickly, while bacterial infections may need an antibiotic to get better.
- Food poisoning: Food poisoning (which has symptoms like those of stomach/gut flu), food allergies, eating excessive food, or gas production – any of these can cause bloating and temporary discomfort. Usually, the onset is rapid after eating.
- Poisoning: This can range from simple problems (such as eating soap) to more serious issues like swallowing iron pills, magnets, coins, botulism from spoiled food, or an overdose of medications (such as acetaminophen poisoning [Tylenol]).
- Surgical problems: These include appendicitis or blockage of the bowels.
- Medical causes: Things outside the abdomen can cause abdominal pain. For example, a child can have abdominal pain from complications of diabetes or from a black widow spider bite.
How Is Stomach Pain in Children Diagnosed?
Abdominal pain in children has several potential causes, affecting multiple organ systems, each requiring a unique set of diagnostic tests. The doctor will obtain a thorough history and examine the child, which likely will include a rectal exam to evaluate the presence of blood. From this information, the doctor may order additional tests.
- Blood probably will be drawn and sent to a laboratory for blood cell counts (complete blood count, CBC), liver function tests, blood cultures, amylase/lipase levels, and/or lead levels. A urine sample may be obtained and sent for urinalysis and culture.
- A stool sample may be obtained to check for blood, bacteria, or parasites.
- Imaging studies (X-rays and related studies) may be taken to evaluate the abdomen. Other tests may include:
- Special tests may be ordered based on the child's condition, including barium enema or swallow, anal manometry, or a pelvic exam.
- A specialist such as a gastroenterologist or a general or pediatric surgeon may be consulted.
What Medicine Treats Stomach Pain in Children?
Abdominal pain in children can often be treated with home care. Assure the child is getting enough rest, give fluids to avoid dehydration, avoid solid food, aspirin, antibiotics (unless prescribed by a doctor), and herbal supplements. Acetaminophen (Tylenol) can be given if the child has a mild fever.
What Natural Home Remedies Treat Stomach Pain in Children?
A parent or caregiver must be observant and should contact appropriate help at the appropriate time. Monitor a child especially closely during recovery until the child is better. A teenager may not want to be bothered but still should be monitored.
- Rest: A child with active abdominal pain often will benefit from resting. Lying face down may help relieve gas pain, but the optimal position is that which feels best to the child.
- Diet: People can survive a long time without solid food but need to keep up with liquids. Dehydration takes time to develop, so forcing fluids is not always necessary. A child who is actively vomiting will not be able to hold down a large amount of liquid. Doctors recommend giving small amounts (1-2 ounces) at a time (every 15-20 minutes typically) until the child can handle more. Avoid tinted, carbonated, caffeinated, fatty, or excessively salty or sugary liquids (such as dark colas, tea, coffee, milk, sports drinks, and fruit juices).
- Fluids: Do not give water or boiled milk to infants, because it can cause serious problems with the salt content of their bodies. Also, milk is harder for a sick stomach to digest. Doctors recommend various dehydration liquids. For example, Pedialyte can be bought over-the-counter without a prescription. Try to get the infant back on the usual feedings as soon as possible. Good choices for older children include ginger ale or simple soup broth. Avoid milk, fruit juices, heavily carbonated beverages, coffee, and sports drinks (such as Gatorade) in patients with diarrhea, since the stomach may not tolerate these fluids. If an older child asks for soft drinks, avoid those with caffeine. Shaking the fizz out of carbonated beverages may make them more tolerable for an ill child.
- Solid foods: The child will let you know when it is time to get back on solid food. Start them slowly, first try toast or crackers then advance to regular foods as they tolerate the feedings. Bananas, apple sauce, plain toast, or cooked rice are also suitable foods for introduction after a full liquid diet.
- Medications: You can use acetaminophen (Aspirin Free, Children's Silapap, Panadol, Liquiprin, or Tylenol) to control fever. Most doctors still avoid aspirin in children. Avoid antibiotics unless prescribed by a doctor. Physicians do not recommend herbal medicines or other home remedies. If you use them and later see a physician, be sure to tell the physician exactly what you gave the child because such information could affect the treatment recommendations.
Reviewed on 9/16/2022
Causes of acute abdominal pain in children and adolescents. UpToDate. Updated: Aug 30, 2019.