Abdominal Pain, Age 11 and Younger
Abdominal pain in children is a common problem. About 1 out of 3 children is seen by a doctor for abdominal pain by the time they are age 15, but only a small number of these children have a serious problem.
Complaints of abdominal pain are more common in children younger than 11 years and are often caused by changes in eating and bowel habits. Most cases of abdominal pain are not serious, and home treatment is often all that is needed to help relieve the discomfort.
Abdominal pain in children is often frightening and frustrating for parents. Many times it is hard to find the exact cause of a child's abdominal pain. Pain without other symptoms that goes away completely in less than 3 hours is usually not serious.
In children, abdominal pain may be related to injury to the abdomen or an illness, such as an upset stomach, an ear infection, a urinary tract infection, or strep throat. Constipation is a common cause of abdominal pain in children. Some more serious causes of abdominal pain in children include appendicitis, lead poisoning, or problems with the intestines, such as intussusception or malrotation. Girls who start having menstrual periods may have abdominal pain each month, and the pain may be more severe in some months than others.
Generalized pain occurs in half of the abdomen or more. Localized pain is located in one area of the abdomen. Babies and toddlers often react differently to pain than older children who can talk about their pain. A baby may become fussy, draw his or her legs up toward the belly, or eat poorly. Older children may be able to point to the area of the pain and describe how severe it is.
Abdominal pain can occur one time, or it can occur repeatedly over several months. Recurrent abdominal pain (RAP) is a condition that affects children ages 4 to 11.
Check your child's symptoms to decide if and when your child should see a doctor.
Check Your Symptoms
You can get dehydrated when you lose a lot of fluids because of problems like vomiting or fever.
Symptoms of dehydration can range from mild to severe. For example:
- You may feel tired and edgy (mild dehydration), or you may feel weak, not alert, and not able to think clearly (severe dehydration).
- You may pass less urine than usual (mild dehydration), or you may not be passing urine at all (severe dehydration).
With cramping pain in the belly:
- The pain may hurt a little or a lot.
- The amount of pain may change from minute to minute. Cramps often get better when you pass gas or have a bowel movement.
- The pain may feel like a tightness or pinching in your belly.
- The pain may be in one specific area or be over a larger area. It may move around.
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
- Your age. Babies and older adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
- Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
- Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Severe dehydration means:
- The child's mouth and eyes may be extremely dry.
- The child may pass little or no urine for 12 or more hours.
- The child may not seem alert or able to think clearly.
- The child may be too weak or dizzy to stand.
- The child may pass out.
Moderate dehydration means:
- The child may be a lot more thirsty than usual.
- The child's mouth and eyes may be drier than usual.
- The child may pass little or no urine for 8 or more hours.
- The child may feel dizzy when he or she stands or sits up.
Mild dehydration means:
- The child may be more thirsty than usual.
- The child may pass less urine than usual.
Severe dehydration means:
- The baby may be very sleepy and hard to wake up.
- The baby may have a very dry mouth and very dry eyes (no tears).
- The baby may have no wet diapers in 12 or more hours.
Moderate dehydration means:
- The baby may have no wet diapers in 6 hours.
- The baby may have a dry mouth and dry eyes (fewer tears than usual).
Mild dehydration means:
- The baby may pass a little less urine than usual.
A baby that is extremely sick:
- May be limp and floppy like a rag doll.
- May not respond at all to being held, touched, or talked to.
- May be hard to wake up.
A baby that is sick (but not extremely sick):
- May be sleepier than usual.
- May not eat or drink as much as usual.
If you're not sure if a child's fever is high, moderate, or mild, think about these issues:
With a high fever:
- The child feels very hot.
- It is likely one of the highest fevers the child has ever had.
With a moderate fever:
- The child feels warm or hot.
- You are sure the child has a fever.
With a mild fever:
- The child may feel a little warm.
- You think the child might have a fever, but you're not sure.
Pain in children 3 years and older
- Severe pain (8 to 10): The pain is so bad that the child can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain. No one can tolerate severe pain for more than a few hours.
- Moderate pain (5 to 7): The pain is bad enough to disrupt the child's normal activities and sleep, but the child can tolerate it for hours or days.
- Mild pain (1 to 4): The child notices and may complain of the pain, but it is not bad enough to disrupt his or her sleep or activities.
Babies can quickly get dehydrated when they lose fluids because of problems like vomiting or fever.
Symptoms of dehydration can range from mild to severe. For example:
- The baby may be fussy or cranky (mild dehydration), or the baby may be very sleepy and hard to wake up (severe dehydration).
- The baby may have a little less urine than usual (mild dehydration), or the baby may not be urinating at all (severe dehydration).
Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in children are:
- Diseases such as diabetes, cystic fibrosis, sickle cell disease, and congenital heart disease.
- Steroid medicines, which are used to treat a variety of conditions.
- Medicines taken after organ transplant.
- Chemotherapy and radiation therapy for cancer.
- Not having a spleen.
Blood in the stool can come from anywhere in the digestive tract, such as the stomach or intestines. Depending on where the blood is coming from and how fast it is moving, it may be bright red, reddish brown, or black like tar.
A little bit of bright red blood on the stool or on the toilet paper is often caused by mild irritation of the rectum. For example, this can happen if you have to strain hard to pass a stool or if you have a hemorrhoid.
Certain medicines and foods can affect the color of stool. Diarrhea medicines (such as Pepto-Bismol) and iron tablets can make the stool black. Eating lots of beets may turn the stool red. Eating foods with black or dark blue food coloring can turn the stool black.
If you take a medicine that affects the blood's ability to clot, such as aspirin, warfarin (Coumadin), enoxaparin (Lovenox), or clopidogrel (Plavix), it can cause some blood in your stools. If you take a blood thinner and have ongoing blood in your stools, call your doctor to discuss your symptoms.
Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.
Symptoms of shock in a child may include:
- Passing out.
- Being very sleepy or hard to wake up.
- Not responding when being touched or talked to.
- Breathing much faster than usual.
- Acting confused. The child may not know where he or she is.
It is easy for your diabetes to become out of control when you are sick. Because of an illness:
- Your blood sugar may be too high or too low.
- You may not be able take your diabetes medicine (if you are vomiting or having trouble keeping food or fluids down).
- You may not know how to adjust the timing or dose of your diabetes medicine.
- You may not be eating enough or drinking enough fluids.
Temperature varies a little depending on how you measure it. For children up to 11 years old, here are the ranges for high, moderate, and mild according to how you took the temperature.
Oral (by mouth), ear, or rectal temperature
- High: 104 F (40 C) and higher
- Moderate: 100.4 F (38 C) to 103.9 F (39.9 C)
- Mild: 100.3 F (37.9 C) and lower
Armpit (axillary) temperature
- High: 103°F (39.5°C) and higher
- Moderate: 99.4 F (37.4 C) to 102.9 F (39.4 C)
- Mild: 99.3°F (37.3°C) and lower
Note: For children under 5 years old, rectal temperatures are the most accurate.
Many prescription and nonprescription medicines can cause belly pain or cramping. A few examples are:
- Aspirin, ibuprofen (such as Advil or Motrin), and naproxen (such as Aleve).
- Iron supplements.
An illness plan for people with diabetes usually covers things like:
- How often to test blood sugar and what the target range is.
- Whether and how to adjust the dose and timing of insulin or other diabetes medicines.
- What to do if you have trouble keeping food or fluids down.
- When to call your doctor.
The plan is designed to help keep your diabetes in control even though you are sick. When you have diabetes, even a minor illness can cause problems.
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
- Call your doctor now to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care in the next hour.
- You do not need to call an
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.
Seek Care Today
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
- Call your doctor today to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care today.
- If it is evening, watch the symptoms and seek care in the morning.
- If the symptoms get worse, seek care sooner.
Make an Appointment
Based on your answers, the problem may not improve without medical care.
- Make an appointment to see your doctor in the next 1 to 2 weeks.
- If appropriate, try home treatment while you are waiting for the appointment.
- If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
- Try home treatment to relieve the symptoms.
- Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
Pain in children under 3 years
It can be hard to tell how much pain a baby or toddler is in.
- Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
- Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
- Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.
Most of the time, a child's abdominal pain will get better with home treatment and the child will not need a visit to a doctor.
Home treatment for abdominal pain often depends on other symptoms that are present with the pain, such as diarrhea, nausea, or vomiting. See the Related Information section of this topic for information on some of these other symptoms.
Try the following, one at a time in the order listed, if your child has mild abdominal pain without other symptoms:
- Have your child rest when he or she has mild stomachaches. Most symptoms will get better or go away in 30 minutes.
- Have your child sip clear fluids, such as water, broth, tea, or fruit juice diluted with water.
- Have your child try to pass a stool.
If the measures above do not work, you may also try these:
- Serve your child several small meals instead of 2 or 3 large ones.
- Serve mild foods, such as rice, dry toast or crackers, gelatin, or applesauce. Do not give your child spicy foods, other fruits, or drinks that have caffeine or carbonation until 48 hours after all symptoms have gone away. These foods may make your child's stomachache worse.
- Do not give your child any medicines without talking to the doctor first. Medicines may mask the pain or make it worse.
Symptoms to watch for during home treatment
Call your doctor if any of the following occur during home treatment:
- Pain increases or localizes to one section of the abdomen.
- Other symptoms develop, such as diarrhea, nausea, vomiting, or fever.
- The belly feels hard or looks very swollen.
- Symptoms become more severe or frequent.
Abdominal pain in children can often be prevented.
- Abdominal pain in children is often caused by irregular bowel habits. Become familiar with your child's normal bowel patterns. Also, be aware of the size and consistency of your child's stools. This will help to determine whether constipation is a problem. For information on preventing constipation and establishing toilet training, see the topic Constipation, Age 11 and Younger.
- Try to make sure your child has regular eating habits. Overeating is a common cause of abdominal discomfort. Have your child eat slowly and stop when he or she feels full. For more information, see the topic Healthy Eating for Children.
- Swallowing air (aerophagia) can cause abdominal pain and a swollen abdomen. Your child may also have a lot of belching or flatus. Limit chewing gum and carbonated beverages to help prevent this. Many children swallow air when they are anxious or frightened.
Preparing For Your Appointment
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your doctor diagnose and treat your child's condition by being prepared to answer the following questions:
- Has your child had an injury to the abdomen?
- How long has your child had the pain?
- What was your child doing when the pain started?
- Has your child had similar episodes of abdominal pain before? What were these episodes like? How were they treated?
- Is the pain constant, or does it come and go?
- Is the pain localized to one area or generalized over the whole belly?
- How severe is the pain? What has your child's activity level been?
- Can your child describe the pain? Is the pain cramping, a steady ache, or sharp and burning?
- What makes the pain better? What makes the pain worse?
- Does your child have other symptoms, such as nausea, urinary problems, constipation, or diarrhea?
- Is your child vomiting? If so, describe how much, how often, and how long.
- Does your child have a fever?
- Has your child recently traveled outside of his or her native country?
- Has your child drunk any untreated well, stream, or lake water?
- Does your child have any health risks?
Other Works Consulted
- Campo JV, et al. (2004). Recurrent abdominal pain, anxiety, and depression in primary care. Pediatrics, 113(40): 817–823.
|Primary Medical Reviewer||William H. Blahd, Jr., MD, FACEP - Emergency Medicine|
|Specialist Medical Reviewer||David Messenger, MD|
|Last Revised||May 9, 2013|
Last Revised: May 9, 2013
Author: Healthwise Staff
Medical Review: William H. Blahd, Jr., MD, FACEP - Emergency Medicine & David Messenger, MD
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