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Stomachaches 101

Boy (9-11) holding stomach, grimacing

Kids often complain of stomachaches. Stomach pain can occur anywhere between the chest and groin. Most of the time, it’s not caused by a serious problem, but it can be uncomfortable for children. Below are some common questions I receive related to abdominal pain in children.

Why are tummy aches a common issue with kids?

Tummy aches, or abdominal pain, is one of the most common complaints in childhood due to the fact that the pain may be caused by many different conditions. Many of these conditions affect children more often than adults.

In what ways does physical pain in the stomach area affect children differently from adults?

Younger children do not localize pain nearly as well as adolescents or adults. Children also may respond to pain differently from adults. A good example of this is appendicitis. Whereas an adult will suffer abdominal pain relatively early into the course, a young child may experience no abdominal pain until much later. In some cases, the first symptom in a young child will be fever rather than pain.

What are the causes, signs and symptoms of abdominal pain in children?

The cause of abdominal pain is typically a self-limited minor condition, such as constipation, gastroenteritis or viral syndrome, although the list of potential causes would be quite long. Another common cause is “functional pain.” Typically, this kind of pain has been associated with a “nervous stomach,” or wanting attention. Irritable bowel syndrome, or IBS, is often a diagnosis made by a repetitive pattern of pain, sometimes associated with diarrhea or constipation that does not affect the child’s growth. The child’s exam is typically normal with this condition. Abdominal pain may also be associated with pneumonia, urinary tract infections and throat infections.

When should I contact a health care provider and how will they help manage my child’s pain?

Signs and symptoms associated with abdominal pain that should prompt attention are when the pain is associated with fever, persistent vomiting, blood in the stool or jelly-like appearance to the stool, or followed by trauma. Persistent or increasing intensity of the pain should also be considered for attention. Pain associated with other symptoms, such a painful or difficult urination, rashes, severe cough or shortness of breath may also be warning signs.

What home-care remedies can I use to help my child feel better?

Medications typically offer little, if any, help and may actually worsen the situation in many cases. Safe and sometimes effective remedies include a heating pad or warm bath, which may be helpful to dissipate gas in the abdomen. Offering small amounts of an electrolyte solution, such as Pedialyte or Gatorade, and temporarily avoiding solid foods when the pain is associated with vomiting may allow faster healing when related to infections such as viral gastroenteritis (stomach bug). If constipation is suspected, it may be helpful to increase fluids and fiber, while minimizing starchy foods. The best bet is to avoid most over-the-counter upset stomach remedies, as they are usually ineffective and may aggravate the condition.

When in doubt, contact your pediatrician or have your child evaluated at an appropriate pediatric health care facility.

Dr. Stan Spinner, Texas Children's Pediatrics and Texas Children's Urgent Care Chief Medical Officer