Stomach ache in kids

Aug 10, 2018

My daughter has been complaining about stomach pain a lot lately and I struggle to find out what the caused is. Sometimes I think it’s anxiety that she can’t voice but the main reason for it in my opinion is food intolerances. I do Hair testing at my practice so I decided to get her hair tested and am waiting for results. Whatever foods and items in her environment are reactive for her will be cut out of her diet and removed (if that’s possible) for 6 months and then she will be retested. I’m confident her stomach ache will cease as I’ve seen it so many times in practice.

Here is an in depth article from The Royal Children’s Hospital about abdominal pain.

Abdominal pain

  • Abdominal pain is pain or cramping anywhere in the abdomen (tummy, belly or stomach). Children often complain of abdominal pain. It is one of the most common reasons children see a doctor. Most cases of abdominal pain are not serious and children often get better by themselves.

    Signs and symptoms of abdominal pain

    Abdominal pain can happen suddenly or develop slowly. Children often have other symptoms that are associated with the cause of the abdominal pain, such as:

    • vomiting
    • diarrhoea
    • fever.

    What causes abdominal pain?

    There are many things that can cause abdominal pain.

    • Bowel (gut) problems – such as constipation or irritable bowel.
    • Infections – such as gastroenteritis (which causes vomiting and diarrhoea/runny poo) or urine infections.
    • Mesenteric adenitis – the lymph nodes in the abdomen commonly enlarge due to viral infections.
    • Problems that may require surgery – such as appendicitis or a bowel obstruction.
    • Period pain – monthly pain can occur before or during a menstrual period.
    • Food related – too much food, food poisoning or food allergies and intolerances.
    • Some children get abdominal pain as a result of stress or anxiety.
    • Sometimes there is no identifiable cause for the abdominal pain.

    The causes of abdominal pain can be hard to determine. Sometimes the cause becomes more obvious with time, and then doctors can work out the best treatment.

    Care at home

    Here are some general ways to ease your child’s pain:

    • Help your child drink their usual amount of fluids. Getting your child to drink is important as it prevents dehydration (loss of water). See our fact sheet Dehydration.
    • If your child is hungry, let them eat what they want or offer bland foods such as crackers, rice, bananas or toast. Do not force your child to eat if they feel unwell. They will start eating again when they feel better.
    • Encourage sitting on the toilet. Sometimes doing a poo helps to ease the pain.
    • Rubbing a child’s tummy or having a distraction, such as reading a book, can sometimes ease the pain.
    • Give paracetamol or ibuprofen if your child is in pain or is miserable. See our fact sheet Pain relief for children. If ibuprofen causes a stomach upset, offer your child some food or milk.

    When to see a doctor

    Many children with abdominal pain get better quickly without any treatment and there is no need to see a doctor. If your child’s pain or problems persist for more than 24 hours, or you are worried about your child, take them to your GP.

    Take your child to the GP or hospital as soon as possible if your child:

    • has severe pain (despite pain medication) or the pain has moved
    • has pain that returns frequently and regularly
    • does not want to move
    • has a fever (temperature over 38.5 degrees)
    • is pale, sweaty, lethargic (hard to wake) and unwell
    • is refusing to drink fluids
    • is vomiting for more than 24 hours and not keeping fluids down, or their vomit is green in colour
    • has blood in their vomit or faeces (poo)
    • has problems passing urine (doing a wee)
    • is a baby, and has less than four wet nappies a day
    • has pain or lumps in their groin
    • has a skin rash which is sore or painful
    • has had a recent injury (for example, falling onto bike handlebars).

    Treatment for abdominal pain

    Treatment may be as simple as going home to rest, drink fluids and eat a bland diet. At other times, your child may be admitted to hospital or may need an operation (surgery).

    Sometimes tests are needed to help work out the cause of the pain. These may include:

    • blood tests
    • a urine test
    • a stool (poo) sample
    • X-rays of the abdomen
    • ultrasound.

    Some results can take a number of days. Your GP will receive a letter advising them how to obtain the test results, or a hospital appointment will be made for you to return to get the test results.

    Repeated attacks of abdominal pain

    Some children get repeated attacks of abdominal pain, which can be very worrying for parents. Often no health problem can be found. Children may have abdominal pain when they are worried about themselves or people around them.

    Think about whether there is anything that is upsetting your child at home, at school, kindergarten or with friends. See your GP for advice. Your child may need a referral to a paediatrician, gastroenterologist (a doctor who specialises in stomach problems) or psychologist.

    Key points to remember

    • Many children get abdominal pain and most get better by themselves.
    • Make sure your child drinks plenty of fluids to prevent dehydration.
    • Often no cause can be found, and sometimes a cause becomes more obvious with time.
    • If your child has abdominal pain and looks unwell, take your child to your GP or local hospital as soon as possible.

    For more information

    Common questions our doctors are asked

    How can I tell if my child has appendicitis? 

    Appendicitis can be difficult for doctors to diagnose, but a sign that your child may have appendicitis is that they have severe pain starting around their belly button and moving to the right side of their abdomen. Most children with appendicitis will be very reluctant to move. See your GP if you are worried.

    My child has been diagnosed with mesenteric adenitis. What does this mean?

    Mesenteric adenitis occurs when the lymph nodes in the abdomen enlarge in response to an infection – most commonly a viral infection. This results in stomach pain. Mesenteric adenitis is diagnosed clinically (without the need for blood tests or imaging). It is important that children who are diagnosed with mesenteric adenitis are reviewed to determine if it is developing into appendicitis.

    Why is it so difficult to work out the cause of my child’s ongoing stomach aches? 

    Stomach aches are difficult to diagnose in all ages. Children differ in their ability to describe the type, severity and location of their pain, which can make this process even harder. Many problems from the chest down to the groin may be interpreted by children as stomach aches, making it very difficult to find out the true cause. Your child’s doctor will examine and investigate your child in order to rule out anything serious, while trying to find the underlying cause.

    The doctor says my child has abdominal migraine. What is this?

    As the name suggests, abdominal migraine is a migraine experienced in the abdomen instead of the head. A child with abdominal migraine will often have tummy pain along with nausea/vomiting, loss of appetite and pale skin. There is no headache involved and the child is well between episodes. There is still quite a lot that is unknown about abdominal migraine, but the risk factors and triggers are thought to be similar to traditional migraines (e.g. having a family member with migraines, being stressed or overtired, chemicals in food). See our fact sheet Migraine headache.

    Developed by The Royal Children’s Hospital Emergency department,. We acknowledge the input of RCH consumers and carers.

    Reviewed May 2018.

    https://www.rch.org.au/kidsinfo/fact_sheets/Abdominal_pain/