Abdominal pain in children

Children often complain of stomach pain. It is one of the most common reasons parents take their child to a doctor or hospital emergency department.

Stomach pain can be hard to diagnose#

The doctor will ask you questions and then examine your child. Sometimes the cause is quite obvious, so no tests are needed. Many children with stomach pain get better in hours or days without special treatment, and often no cause can be found.

At other times the cause becomes clearer over time, and treatment can then be started. If pain or other problems persist, see your doctor.

There are many health problems that can cause stomach pain in children, including:

• bowel (gut) problems, such as constipation, colic or irritable bowel
• infections, such as gastroenteritis, kidney or bladder infections, or infections elsewhere in the body such as the ear or chest
• food-related problems, such as too much food, food poisoning or food allergies
• problems outside the abdomen, such as muscle strain or migraine
• surgical problems, such as appendicitis, bowel obstruction or intussusception (telescoping of part of the gut)
• period pain, which some girls can have before their periods start
• poisoning, such as spider bites or swallowing harmful substances

Repeated attacks of stomach pain#

Some children have repeated attacks of stomach pain, which can be worrying for parents. Often no health problem can be found.

Children may feel stomach pain when they are worried about themselves or the people around them. Think about whether anything might be upsetting your child at home, at school or kindergarten, or with friends. See your doctor for advice. A referral may be needed to a pediatrician (a doctor who specializes in children).

Appendicitis#

Appendicitis is one of the more common reasons a child may need surgery. The appendix is a small, dead-end tube leading from part of the bowel. If this tube gets blocked, it can become infected.

Appendicitis can happen at any age but is rare in young children. The pain often starts in the middle of the tummy and moves down to the lower right side. The tummy becomes sore to touch, and this is often worse with coughing or walking around. A child with appendicitis often shows signs of being unwell, such as fever, refusing food, vomiting or (sometimes) diarrhea.

If you are concerned your child may be developing appendicitis, see your doctor or go to the emergency department of your nearest hospital. An operation is often needed to remove the appendix, although in some cases the problem settles without surgery.

Diagnosis#

When the cause is obvious, no tests are needed. If tests are needed, they may include:

• blood tests
• a urine test
• a stool (poo) sample
• x-rays or other special tests
• review by a specialist doctor

If your child does have tests, the doctor should explain the results to you. Some results may take a number of days to come back.

Treatment#

Your child’s treatment will depend on what the doctor thinks is causing the pain. Treatment may be as simple as sending your child home with advice to rest, take fluids and eat a bland diet. Other options include hospital admission and surgery.

General suggestions for easing the pain include:

• make sure your child gets plenty of rest
• help your child drink plenty of clear fluids such as cooled boiled water or juice
• do not push your child to eat if they feel unwell
• if your child is hungry, offer bland food such as crackers, rice, bananas or toast
• place a hot water bottle or wheat bag on your child’s tummy, or run a warm bath, taking care not to scald yourself or your child
• give paracetamol if your child is in pain or miserable; remember that doses for children are often different to those for adults, so check the packet carefully for the right dose
• avoid giving aspirin

When to seek urgent help#

Go to your doctor or the emergency department of your nearest hospital straight away if your child has:

• severe or worsening pain, or pain that has moved position
• fever or chills
• become pale, sweaty and unwell
• been vomiting for more than 24 hours
• refused to eat or drink
• blood in their vomit or poo
• problems passing urine, or is producing less than four wet nappies a day
• a skin rash with the pain
• any other problem that concerns you

Key points#

• Stomach pain is one of the most common reasons parents take children to a doctor or emergency department.
• Many children with stomach pain get better in hours or days without special treatment, and often no cause can be found.
• Sometimes the cause becomes clearer with time, and treatment can then be started.
• Appendicitis is one of the more common reasons a child may need surgery.
• If the appendix tube gets blocked, it can become infected.

Where to get help#