Abdominal Pain in Children
Children often complain of a “tummy ache.” This is pain in the stomach or belly. Abdominal pain is very common in children. In many cases there’s no serious cause. But stomach pain can sometimes point to a serious problem, such as appendicitis, so it is important to know when to seek help.
Causes of abdominal pain
Abdominal pain in children can have many possible causes. Any problem with the stomach or intestines can lead to abdominal pain. Common problems include constipation, diarrhea, or gas. Infection of the appendix (appendicitis) almost always causes pain. An infection in the bladder or urinary tract, or even infection in the throat or ear, can cause a child to feel pain in the belly. And eating too much food, food that has gone bad, or food that the child has a hard time digesting can lead to abdominal pain. For some children, stress or worry about some upcoming event, such as a test, causes them to feel real pain in their bellies.
Call 911 if your child:
Has blood or pus in vomit or diarrhea, or has green vomit
Shows signs of bloating or swelling in the belly
Repeatedly arches his back or draws his or her knees to the chest
Has increased or severe pain
Is unusually drowsy, listless, or weak
Is unable to walk
When to call your child's healthcare provider
Children may complain of a tummy ache for many reasons. Many cases can be soothed with rest and reassurance. But if your child shows any of the symptoms listed below, call the healthcare provider:
Abdominal pain that lasts longer than 2 hours
Fever (see Fever and children, below)
Inability to keep even small amounts of liquid down
Signs of dehydration, such as no urine output for more than 8 hours, dry mouth and lips, and feeling very tired
Pain during urination
Pain in one specific area, especially low on the right side of the belly
Treating abdominal pain
If a healthcare provider’s attention is needed, he or she will examine the child to help find the cause of the pain. Certain causes, such as appendicitis or a blocked intestine, may need emergency treatment. Other problems may be treated with rest, fluids, or medicine. If the healthcare provider can’t find a physical reason for your child’s pain, he or she can help you find other factors, such as stress or worry, that might be making your child feel sick. At home, you can help the child feel better by doing the following:
Have your child lie face down if he or she appears to be suffering from gas pain.
If your child has diarrhea but is hungry, feed him or her a regular diet, but avoid fruit juice or soda. These are high in sugar and can worsen diarrhea. Sports drinks such as electrolyte solutions also may contain lots of sugar, so be sure to read labels. Water is fine.
Avoid severely limiting your child's diet. Doing so may cause the diarrhea to last longer.
Have your child take any prescribed medicines as directed by your healthcare provider.
Check with your healthcare provider before giving your child any over-the-counter medicines.
Preventing abdominal pain
If your child is prone to abdominal pain, the following things may help:
Keep track of when your child gets the pain. Make note of any foods that seem to cause stomach pain.
Limit the amount of sweets and snacks that your child eats. Feed your child plenty of fruits, vegetables, and whole grains.
Limit the amount of food you give your child at one time.
Make sure your child washes his or her hands before eating.
Don’t let your child eat right before bedtime.
Talk with your child about anything that may be causing him or her worry or anxiety.
Fever and children
Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.
For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.
Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.
Infant under 3 months old:
Ask your child’s healthcare provider how you should take the temperature.
Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider
Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider
Child age 3 to 36 months:
Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider
Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider
Child of any age:
Repeated temperature of 104°F (40°C) or higher, or as directed by the provider
Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.
January 19, 2018
Causes of Acute Abdominal Pain in Children and Adolescents, UpToDate
Adler, Liora C., MD,Fraser, Marianne, MSN, RN,Image reviewed by StayWell art team.,Turley, Ray, BSN, MSN