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Abdominal Pain in Children: 7 Possible Causes

Children of all ages experience abdominal pain occasionally. But the causes of tummy ache in infants can be different than what may be causing your child's abdominal pain as they get older.

Here are some causes of stomachaches in children (also see "Abdominal Pain in Infants: Possible Reasons Your Baby's Tummy Hurts"):

  1. Constipation often is blamed for abdominal pain. While it's rarely a problem in younger infants, constipation is a common cause of pain in older children, especially in the lower part of the abdomen. Bowel problems are more likely when a child's diet lacks plenty of fluids, fresh fruits and vegetables, and fiber-rich whole grains.

  2. Urinary tract infections (UTIs) are much more common in 1- to 5-year-old children, especially girls, than in infants. UTIs may produce pain in the abdomen and the bladder area, as well as pain and burning when urinating. Children with UTIs typically urinate in small amounts but more frequently than usual, have blood in their urine and wet themselves. They may or may not have a fever. If your child has these symptoms, see your pediatrician for an exam and urine tests. If they have a UTI, antibiotics can eliminate both the infection and the abdominal pain.

  3. Strep throat is a throat infection caused by Streptococci bacteria that occurs frequently in children over 2 years old. Symptoms that include a sore throat, fever and abdominal pain. This is because swallowed bacteria can cause irritation of the bowels. Children can also get perianal strep, which is a strep infection around their anus. This can cause pain, constipation (because they don't want to poop) as well as abdominal pain. Your pediatrician can examine your child for either type of infection and may swab their throat or anus to check for the bacteria. If the results are positive for strep, your child will need to be treated with an antibiotic.

  4. Appendicitis is very rare in children under age 3 and uncommon under 5 years old. When a child does have appendicitis, they may complain of a constant stomachache in the center of the abdomen. Later, the pain moves down and over to the right side. Children with appendicitis typically stop eating; they won't even feel like eating their favorite food.

  5. Lead poisoning most often occurs in toddlers living in an older house (built before the 1960s) where lead-based paint has been used. If they eat small chips of paint off the walls and woodwork, the lead is then stored in their bodies and can create many serious health problems. Also be aware of toys, dishes or other products with unacceptable lead content. (Recalls are posted on the U.S. Consumer Product Safety Commission website.) Symptoms of lead poisoning include not only abdominal pain, but also constipation, irritability (the child is fussy, crying, difficult to satisfy), lethargy (they are sleepy, don't want to play, have a poor appetite) and convulsions.

    If your child is exposed to lead paint, has eaten paint chips or been exposed to toys with cracking, peeling or chipping paint and has any of the above symptoms, call your pediatrician for a blood test.
  6. Milk allergy is a reaction to the protein in milk. It can produce cramping abdominal pain, often accompanied by vomiting, diarrhea, blood in the stool and skin rash. Children may also have a milk intolerance or sensitivity. This means their body does not make enough of the enzyme required to digest milk sugar, which can lead to stomachaches, bloating and diarrhea.

  7. Emotional upset in school-age children sometimes causes recurrent abdominal pain that has no other obvious cause. (See "Disorders of the Gut-Brain Interaction: Functional Abdominal Pain.") Although this pain rarely occurs before age 5, it can happen to a younger child who is under unusual stress. The pain tends to come and go over a period of more than a week and often aligns with activity that is stressful or unpleasant. In addition, there are no other associated findings or complaints (fever, vomiting, diarrhea, coughing, lethargy or weakness, urinary tract symptoms, sore throat or flulike symptoms). There also may be a family history of this type of illness.

    Try to find out if there's something troubling your child at home or school or with siblings, relatives or friends. Have they recently lost a close friend or a pet? Has there been a death of a family member, or another stressful event like divorce or separation? If your child has trouble expressing their thoughts or feelings, you can use toys or games to help the child act out their problems. Your pediatrician can also refer you to a child therapist, psychologist or psychiatrist.

When to see the pediatrician for your child's abdominal pain

Fortunately, most stomachaches disappear on their own and are not serious. However, if your child's complaints continue or worsen over a period of three to five hours, or if they have a fever, severe sore throat or extreme and lasting change in appetite or energy level, you should notify your pediatrician immediately. These symptoms may indicate a more serious disorder.

Last Updated
Adapted from Caring for Your Baby and Young Child: Birth to Age Five 7th edition (Copyright © 2019 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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