Stomach pain in kids: When to worry

As many parents know, children and stomach aches seem to go hand in hand. Stomach pain in kids can be caused by a variety of common reasons such as eating too much, needing to go to the bathroom, or anxiety or worry about an upcoming event. However, if your child complains of stomach pain frequently, it can be difficult to know the best ways to help and when to call the doctor.

Megha S. Mehta, M.D., a pediatric gastroenterologist at Children's Health℠ and Assistant Professor at UT Southwestern, explains when parents should worry about stomach pain and when a little rest and hydration is all your child may need.

What can cause stomach pain in a child?

The most common causes of stomach pain in children include:

• Indigestion

• Infection or stomach bug

• Constipation

• Stress or anxiety

• Irritable bowel syndrome or functional abdominal pain

• Appendicitis (causes acute or sudden pain)

The symptoms your child has can vary based on what's causing your child's stomach to hurt. These symptoms may include cramping, diarrhea, gas, bloating, nausea or vomiting. One of the most important symptoms to note is where your child is feeling pain in their stomach.

"One of the first questions we ask children is where their stomach hurts," explains Dr. Mehta. "Location of the pain can help doctors determine what is causing the pain, in addition to other characteristics such as severity of pain, when it occurs, what makes it better or worse and accompanying symptoms."

Stomach pain around the belly button

Stomach pain around the belly button is usually nothing to worry about. It's one of the most common stomach pain complaints among kids.

"Children often rub their bellies when they hurt and complain about general pain around the belly button," says Dr. Mehta. "This type of stomach pain is typically caused by stress or eating something that didn't quite agree with them."

If your child is complaining about abdominal pain around the belly button, you can:

• Encourage them to lay down and rest

• Check to see if they need to poop

• Offer a glass of water

• Try distracting them by reading a book together or playing a quiet game

Stomach pain in the lower right part of the abdomen

Appendicitis is a serious medical emergency that can cause sudden, severe pain in the lower right part of your child's stomach. If your child complains of sudden onset severe stomach pain that moves to the lower right side of the belly, watch for other symptoms of appendicitis including:

• Fever

• Nausea

• Vomiting

• Loss of appetite

Contact your child's pediatrician immediately if you suspect your child has appendicitis. Early diagnosis decreases risk of a ruptured appendix or serious complications.

Stomach pain on the left side of the abdomen

If your child is complaining about a tummy ache on the left side of their stomach, it could be caused by something as simple as constipation to a more severe condition like pancreatitis. Dr. Mehta reminds parents not to panic just because their child is experiencing pain.

"Your child's pediatrician can work with you to better understand the pain and symptoms your child experiences to ensure they receive an accurate diagnosis – and more importantly, find relief,” says Dr. Mehta.

Stomach pain in the upper abdomen

If your child is complaining about pain in their upper abdomen, they may be experiencing indigestion (gas pain). Signs of indigestion include:

• Pain in the middle of the upper belly

• Nausea

• Bloating

• Burping

• Heartburn

"Indigestion can be the cause of pain in a child’s upper belly, especially if it happens after eating certain foods," says Dr. Mehta.

If your child has pain in the upper right side of their abdomen, this could be a sign of gallstones. Gallstones are more common in adults than in children, but some children may be more at risk for developing gallstones. Children at higher risk include children with obesity, sickle cell disease or other blood disorders and children who have a family history of gallstone disease.

Stomach pain in infants

With infants, you can’t necessarily have them describe the type and location of their tummy pain, so you may have to pay special attention to when your child seems uncomfortable and to any other symptoms they’re having, including fever, vomiting, diarrhea or extreme pain.

“If an infant is vomiting a lot, has a fever or is clearly in a lot of pain, seek medical care. It could be a stomach bug or something more serious such as intestinal blockage or accidental ingestion,” says Dr. Mehta. “Your doctor can obtain a thorough history and physical exam to help you determine if or when you need to be concerned.”

Other more common causes of stomach pain in infants include:

• Constipation. If your baby hasn’t pooped in a few days, they may have pain in their lower belly. Make sure your baby is well hydrated. You can offer 1-2 ounces of apple or prune juice if your baby is more than 2 months old. You can also offer other age-appropriate “p” foods like pears, prunes or peas for older infants. When in doubt, talk to your pediatrician.

• Gas pain. Babies can swallow air when they breastfeed or cry. Burping your baby often and keeping them upright to feed can help. You can also avoid giving them foods that can give them extra gas like broccoli.

• Gastrointestinal reflux (GERD). Reflux causes babies to spit up and can lead to an upset tummy or burning in the throat. Many babies outgrow reflux. But until then, keeping a baby upright after feeds and burping often can help.

• Colic. There’s no cure for colic. But massaging, rocking or swaddling a baby can help soothe a baby with colic.

• Stomach flu (gastroenteritis). You’ll generally know if this is the cause of stomach pain because it also causes vomiting and diarrhea.

What can I give my child for stomach pain?

Stomach pain usually goes away on its own after your child:

• Rests

• Has a bowel movement

• Passes gas

• Recovers from a stomach virus

There's no specific treatment for an upset stomach, but you can help relieve your child's symptoms. Trusted home remedies for stomach pain in kids include:

• Offering plenty of clear liquids to keep your child hydrated

• Offering ibuprofen or acetaminophen to relieve pain

• Using a heating pad to ease cramps and pain

• Give a tummy massage with gentle soothing motions

• Offering a bland diet, like crackers and soups

• Giving your child stool softeners, like MiraLAX® to ease constipation (see other ways to prevent and treat constipation in kids)

• Giving your child upset stomach medicine for children, like Pepto kids

• Mixing a probiotic in your child's water, which may help stop diarrhea

• Peppermint is a natural substance that can be very soothing for the tummy. You can offer peppermint tea or fresh peppermint leaves to chew (avoid artificial peppermint candy)

Chronic stomach pain in children

Chronic stomach pain in kids is pain that lasts for more than two weeks.

If your child is complaining about stomach pain often – and they don’t have other symptoms – it could be due to a longer-term condition. Conditions that can cause ongoing, chronic stomach pain in kids include:

• Irritable bowel syndrome

• Crohn’s disease

• Functional abdominal pain caused by stress, anxiety or depression

“Functional abdominal pain is quite common. The mind and gut are very connected and stress can lead to pain that is very real for kids. Functional abdominal pain is even more common in high-achieving kids or kids who don’t always know how to express their emotions,” says Dr. Mehta.

When should I take my child to the doctor for stomach pain?

Stomach pain in children by itself is usually nothing to worry about. But, if your child has any of the following other symptoms, schedule an appointment with your child's pediatrician:

• Constipation that is becoming frequent

• Recurrent stomach pain with no clear cause

• Blood in stool

• Diarrhea

• Fever and cough

• Pain when urinating

• Unexplained weight loss

• Looks or acts sick

• Pain that is waking your child up from sleep or is starting to affect their daily lives

• Jaundice

Your child's pediatrician can help you know if you need more immediate medical attention.

When to go to the ER for stomach pain in kids

If your child has any of the following symptoms, call 911 or take your child to the emergency room (ER):

• Severe pain in the stomach

• Loss of consciousness

• Fatigue or ill appearing

• Difficulty breathing

• Dehydration

• Blood in vomit or green-colored vomit

Learn more

Children's Health Primary Care is here to care for all aspects of your child's health, from treatment of common illnesses to treatment of chronic conditions.

Our Pediatric Gastroenterology program also offers specialized care to help treat, manage and improve digestive health. When stomach pain in kids becomes chronic, our Chronic Abdominal Pain Clinic offers help and hope.