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  • Abdominal Pain

    Definition

    • Pain or discomfort in the stomach (abdomen or belly).
    • Pain found between the bottom of the rib cage and the groin crease.
    • The older child complains of stomach pain.
    • The younger child points to or holds the stomach.
    • Before 12 months of age, use the Crying care guides.

    Causes

    • Eating Too Much. Eating too much can cause an upset stomach and mild stomach pain.
    • Virus (such as Rotavirus). A virus can cause stomach cramps as well as vomiting and/or diarrhea.
    • Food Poisoning. This causes sudden vomiting and/or diarrhea within hours after eating the bad food. It is caused by toxins from germs growing in foods left out too long. Most often, symptoms go away in less than 24 hours. It often can be treated at home without the need for medical care.
    • Constipation. The need to pass a stool may cause cramps in the lower abdomen.
    • Strep. A strep throat can cause up to 10% of new onset stomach pain with fever.
    • Serious Cause. Appendicitis. Suspect appendicitis if pain is low on the right side and walks bent over. Other signs are the child won’t hop and wants to lie still.
    • Stress or Worries. The most common cause of frequent stomach pains is stress. Over 10% of children have a “worried stomach”. These children tend to be sensitive and too serious. They often are model children. This can make them more at risk to the normal stresses of life. Examples of these events are changing schools, moving or family fights. The pain is in the pit of the stomach or near the belly button. The pain is real.

    Pain Scale

    • Mild: Your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
    • Moderate: The pain keeps your child from doing some normal activities. It may wake him or her up from sleep.
    • Severe: The pain is very bad. It keeps your child from doing all normal activities.

    When to Call Us for Abdominal Pain

    Call 911 Now (your child may need an ambulance) If:

    • Not moving or too weak to stand
    • You think your child has a life-threatening emergency

    Call Us Now (night or day) If:

    • Your child looks or acts very sick
    • Can’t walk or walks bent over holding the stomach
    • Pain low on the right side
    • Pain or swelling in the scrotum (Male)
    • Could be pregnant (Female)
    • Severe pain
    • Constant pain (or crying) for more than 2 hours
    • Blood in the stool or vomiting blood
    • Vomiting bile (green color)
    • Recent injury to the stomach
    • Age less than 2 years
    • Fever over 104° F (40° C)
    • You think your child needs to be seen urgently

    Call Us Within 24 Hours (between 9 am and 4 pm) If:

    • You think your child needs to be seen, but not urgently
    • Mild pain that comes and goes (cramps), but lasts more than 24 hours
    • Fever is present

    Call Us During Weekday Office Hours If:

    • You have other questions or concerns
    • Stomach pains are a frequent problem

    Parent Care at Home If:

    • Mild stomach pain

    Care Advice for Mild Stomach Pain

    What you should know:

    • Mild stomach pain can be caused by something simple. It could be from gas pains or eating too much.
    • Sometimes, stomach pain signals the start of a viral infection. This will lead to vomiting or loose stools.
    • Watching your child for 2 hours will help tell you the cause.
    • Here is some care advice that should help.

    Rest:

    • Have your child lie down and rest until feeling better.

    Clear Fluids:

    • Offer clear fluids only (such as water, flat soft drinks or half-strength Gatorade).
    • For mild pain, offer a regular diet.

    Prepare for Vomiting:

    • Keep a vomiting pan handy.
    • Younger children often talk about nausea (a need to vomit) as stomach pain.

    Pass a Stool:

    • Have your child sit on the toilet and try to pass a stool.
    • This may help if the pain is from constipation or diarrhea.
    • Note: For constipation, moving a warm wet cotton ball on the anus may help.

    Do Not Give Medicines:

    • Any drug (like ibuprofen) could upset the stomach and make the pain worse.
    • Do not give any pain medicines or laxatives for stomach cramps.
    • For fever over 102° F (39° C), acetaminophen (Tylenol) can be given.

    What to Expect:

    • With harmless causes, the pain is most often better or gone in 2 hours.
    • With stomach flu, belly cramps may happen before each bout of vomiting or diarrhea. These cramps may come and go for a few days.
    • With serious causes (such as appendicitis), the pain worsens and becomes constant.

    Call Your Doctor If:

    • Pain becomes severe
    • Constant pain lasts more than 2 hours
    • Mild pain that comes and goes lasts more than 24 hours
    • Your child becomes worse

    Extra Help – Worried Stomach:

    • Help your child talk about events that trigger the stomach pain. Talk to your child about how to cope with these the next time around.
    • Help your child worry less about things he or she can’t control.
    • To treat the pain, help your child get very relaxed. Laying down in a quiet place and taking slow deep breaths may help. Then try to relax all the muscles in the body. Think about something pleasant. Listening to CDs that teach how to relax might also help.
    • Make sure your child gets enough sleep.
    • Make sure that your child doesn’t miss any school because of stomach pains. Stressed children tend to want to stay home when the going gets rough.
    • Caution: Your child should see his doctor for an exam. Do this before concluding frequent stomach pains are from worrying too much.

    Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

    Author and Senior Reviewer: Barton D. Schmitt, M.D.
    Copyright 1994-2013 Barton D. Schmitt, M.D.

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