"My tummy hurts!"
It's a complaint every parent hears.
Pain in the belly is quite common in children, and there are many potential causes — from gas to a critical condition like appendicitis. So how can you tell if it's time to call your pediatrician or take your child to the ER for tummy pain?
Anil Kesavan, MD, a pediatric gastroenterologist at Rush University Medical Center, offers this reassurance: "On its own, abdominal pain in children is rarely life-threatening."
If your child also has a high fever, blood in the vomit or stool, or excruciating pain when you touch the belly, get help right away. And call the doctor if your child's tummy pain is accompanied by "red flag signs" that may indicate a chronic condition.
When to get help for abdominal pain
If your child has belly pain plus any of these "red flag signs," call your doctor:
- Unintentional weight loss or slower than normal weight gain
- Slow or stunted growth
- Persistent diarrhea or more than three loose stools a day for more than two weeks
- Persistent projectile vomiting or green vomit
- Recurrent fevers
- Recurrent joint pain
- A family history of celiac disease or inflammatory bowel disease
If pain is the only symptom and it either doesn't go away or it comes and goes, the cause could be constipation. Constipation usually means a child isn't getting enough fiber and water.
But there may be a behavioral component as well — especially in toilet-training toddlers. "They’ve learned bowel movements can hurt, so they start holding it in. The stool then gets harder, which causes more pain," Kesavan says.
Or some kids will tighten their sphincter while bearing down, so they are pushing against a closed passage.
In these cases, Kesavan partners with pediatric physical therapists in Rush's Program for Abdominal and Pelvic Health, who use exercises and biofeedback to get kids' muscles in sync.
School can be a big stressor. In many kids with IBS, their symptoms get better when summer rolls around.
IBS: a sensitive issue
Sometimes, constipation is a symptom of irritable bowel syndrome (IBS), a disorder in which the colon becomes stretched and hypersensitive, causing belly pain, cramping, bloating, and either constipation or diarrhea.
Many things can trigger IBS symptoms, including caffeine, lack of sleep, certain foods — even stress and anxiety. "School can be a big stressor," Kesavan says. "In many kids with IBS, their symptoms get better when summer rolls around."
Fortunately, IBS doesn't affect children's long-term health or growth. But if your child is missing a lot of school or activities, see a doctor.
"Although we can’t cure IBS," Kesavan says, "we can help kids get back to living and enjoying their lives."