Causes of Stomach Pain in Children

It can be hard to share what abdominal pain feels like, particularly if your child doesn’t have the words to describe it. Always remember that pain is subjective and may change over time depending on the cause.

Pain in the abdomen may be described as:

• general
• localized
• constant
• worsening
• intermittent
• sharp
• dull
• achy
• cramping
• like “butterflies in your stomach”
• queasy

Your child may use different words to describe the pain. You may have to translate the best you can.

For example, maybe your child has localized sharp pain that comes and goes. They might say, “Ouch! It hurts sometimes … right here!”

Here’s how to tell if your child is experiencing abdominal discomfort, even if they don’t yet have the words to tell you.

Infants and toddlers

With the youngest kids, you’ll primarily need to go by mood. Your tiny tot may be grumpy, crying, otherwise unhappy, or acting in an unusual way.

Watch your child’s body language. Are they grabbing their abdomen? Are they refusing their favorite snacks? Do they have other symptoms, like vomiting or diarrhea, that might mean they’re in distress? These are all clues.

Of course, you can always try to ask a toddler what’s wrong, but know their answer might not tell the whole story. If your own intuition is telling you something is up, call your pediatrician for guidance.

Children

As children grow, so does their ability to tell their parents what’s bothering them. It may start by you noticing that their body language is off, or that they’re not eating as usual. Your child may say plainly that their stomach hurts or point to the location of the pain.

Ask questions:

• Where does it hurt?
• What does it feel like?
• How long has it been bothering you?
• Does anything else not feel well?

Prompting your child to share more details can help you get a clearer picture of the exact type of pain they’re having. It can also let you know what next steps you might need to take. If your child has a hard time with this, assure them they’re doing the best they can. You want them to tell you what’s wrong, so you can help them.

Teens

Teens are the most reliable narrators of all children for their pain. That said, your teen may be distracted or even worried about what’s wrong.

Use the same questioning technique that you do for younger kids to help identify the type, area, frequency, and duration of the pain.

Your older child may even be able to log or keep track of more chronic issues. Your child’s doctor can use this information to help diagnose the cause.

The causes of abdomen pain range from the more benign, like gas, to the more serious, like appendicitis. But a lot of conditions fall somewhere in between. It’s best not to assume the best- or worst-case scenario. Instead, focus on the type of pain and other symptoms.

Indigestion and gas

Yes, kids can get indigestion just like adults. It can be from eating certain foods, like ones that are fatty, greasy, or acidic. Or, it could be from eating too quickly or consuming carbonated beverages. Your child may even complain of a burning sensation in their upper abdomen.

Symptoms of indigestion include:

• burping
• bloating
• feeling overly full
• reflux, or burping up liquid or food
• nausea
• flatulence

Constipation

Maybe your child’s abdomen hurts because they haven’t had a bowel movement in a while. They may have cramping in their lower abdomen, look bloated or distended, or say that they don’t feel like they can poop. In some cases, your child may even have some diarrhea, which happens when softer stool makes its way around hardened stool.

Other symptoms might include:

• fewer than two bowel movements in a week
• lumpy, dry, or hard stools
• straining to go to the bathroom
• delaying a bowel movement — dancing around or clenching buttocks, for example

Gastroenteritis and food poisoning

Several types of viruses and bacteria can cause food poisoning or a “stomach bug.” Norovirus is one of these viruses. The Centers for Disease Control and Prevention (CDC) says it’s extremely contagious and can be transmitted through:

• contact with people who have the virus
• consuming contaminated water or food
• touching contaminated surfaces

The virus causes acute gastroenteritis, which is inflammation of the stomach and intestines. Your child may feel queasy or say they need to throw up. They may also have lower abdominal cramping with diarrhea.

Symptoms include:

• vomiting
• diarrhea
• nausea
• abdomen pain or cramping
• fever
• headache
• body aches
• dehydration, including decreased urination, dry mouth, and dizziness

Food intolerance

A food intolerance is a reaction your child has to eating certain foods. It’s different from a food allergy, which is when the immune system itself reacts to food. Instead, it causes unpleasant but not severe or life threatening symptoms.

Common triggers include:

• milk and dairy products
• chocolate
• additives like monosodium glutamate (MSG)
• tomatoes
• eggs
• citrus
• strawberries
• soy
• nuts
• wheat
• fish

Your child may be irritable and have acid reflux or bloating with a food intolerance. According to the Healthy Eating Advisory Service, they may also not have any pain until a few hours to 2 days after eating trigger foods. Your child’s discomfort may be relative to how much of the trigger food they ate.

Other possible symptoms may include:

• heartburn
• colic
• vomiting
• diarrhea
• trouble sleeping
• skin issues, like hives, rashes, or eczema

Stress

As an adult, you can probably recall having “butterflies in your stomach” at one point or another. Children may also have this sensation when they are under stress. In fact, any extreme feelings may upset a child’s stomach, including sadness, anger, happiness, and nervousness.

Your child may describe general vague abdominal discomfort or nausea when feeling stressed.

Other symptoms may include:

• headache
• trouble sleeping
• feeling worried, angry, or annoyed
• acting out of character
• withdrawing from previously enjoyed activities

Menstrual pain

The average age for menstruation is around 12 to 13 years old, according to the American College of Obstetricians and Gynecologists. But there’s a range, from younger to older. So if your child is in puberty and having mild to moderate lower abdominal cramping, it may be that menstruation is around the corner.

Other menstrual symptoms may include:

• breast tenderness
• cramping in the lower abdomen or lower back
• headache
• dizziness
• nausea
• diarrhea

It is also possible to have more severe menstrual pain, which is associated with conditions like endometriosis.

Groin pain

The groin muscles are located where the lowest part of the trunk or abdomen meets the legs or thighs on both sides of the body. Pain in this area can result from strains or tears from overstretching, lifting heavy objects, or some other injury such as a sports hernia.

Discomfort can range from mild to more stabbing pain. It’s localized to the immediate area of the groin.

Other symptoms may include:

• pain that started with lifting, stretching, or injury
• swelling
• bruising
• trouble walking
• pain radiating down the leg

Abdomen pain can also be a sign that you need to see your doctor. For some causes of more severe abdomen pain, your child may need antibiotics to clear an infection or surgery to correct obstructions. If you suspect any of the following conditions, get in touch with your child’s doctor immediately.

Appendicitis

The appendix is a small pouch that is attached to the colon. It can become inflamed, causing appendicitis. Without treatment, the inflamed appendix can burst and lead to further complications.

Abdominal pain with appendicitis tends to start suddenly around the belly button. Then, the pain eventually moves down to the lower right quadrant of the abdomen. So if your child has sharp, localized pain that moves to the right, keep watch.

Other symptoms of appendicitis can include:

• pain that gets worse with movement, coughing, and sneezing
• pain that is more severe than other types your child may have experienced before
• worsening pain
• no appetite
• nausea
• vomiting
• fever
• abdominal swelling

Intestinal obstruction

A bowel obstruction, also called a blockage, can have different causes, such as:

• swallowed objects
• malformations of the intestine
• inflammatory bowel disease (IBD)

Sometimes a part of your child’s intestines may fold into the intestinal section directly next to it. This creates what’s called intussusception. Without treatment like enema or surgery, an obstruction can progress and be fatal within just 2 to 5 days.

Your child may experience pain that comes and goes or cramping pain.

Other symptoms of an intestinal obstruction can include:

• nausea
• vomiting bile, which is green
• pulling legs into the chest
• blood in stool
• malaise

Urinary tract infection

Urinary tract infections (UTIs) are somewhat common in kids, especially those assigned female at birth. A 2021 review suggests that the majority of infections are caused by E. coli bacteria.

Your child may have sharp or dull pain in the lower abdomen, around the bladder and kidneys. They could also have flank pain, which is pain on the sides or back of the trunk between the pelvis and ribs.

Other symptoms of UTIs may include:

• fever
• foul-smelling urine
• blood in the urine
• pain with urination
• urgent need to urinate
• urine accidents

Babies may present differently with UTIs and have symptoms that include fever, vomiting, jaundice, or sepsis.

Infection

Various infections may also cause abdomen pain. For example, strep throat may cause nausea, vomiting, or an upset stomach. The feeling may be a vague or generalized pain versus something sharp.

Other signs of infection can include:

• fever
• swollen lymph nodes
• headache
• lethargy
• sore throat

Anaphylaxis

Unlike food intolerance, a food allergy can be life threatening if it leads to anaphylaxis. While early symptoms may be mild, things can escalate quickly into more severe symptoms, even with exposure to a small amount of an allergen.

Children may experience nausea, vomiting, diarrhea, or abdomen pain. The key is to watch for other symptoms. Once you identify what’s going on, act fast and call 911 or local emergency services.

Symptoms of anaphylaxis include:

• hives, flushed skin, or pale skin (pallor)
• difficulty swallowing or feeling like there’s a lump in your throat
• wheezing or trouble breathing
• hoarseness when talking
• runny nose or sneezing
• swollen lips or tongue
• increased heart rate
• dizziness or lightheadedness
• loss of consciousness

Intestinal problems (like hernia)

There are various types of hernia. A hernia may cause similar pain to a groin injury. But according to the American Academy of Orthopaedic Surgeons, the pain may be more severe.

The difference here is that the injury isn’t just to the muscle. Instead, a hernia happens when the intestines press through an area of weakened muscle or connective tissue in the groin.

Other symptoms can include:

• bulge or swelling in the area of the hernia
• pain that gets better with rest
• pain that gets worse with twisting or movement

You may notice your child has pain that keeps coming back or never seems to go away. Chronic abdomen pain can be upsetting for kids and parents alike, so it’s important to work with your pediatrician to determine the root cause and course of treatment.

A 2018 review defined chronic abdomen pain as pain that happens in at least 3 episodes over a 3-month period and that disrupts a child’s usual everyday activities.

Causes

Your pediatrician will use your child’s health history, symptoms, and other information to help make a diagnosis for the chronic pain.

In general, chronic issues can include intestinal conditions, IBD, or functional origin, meaning there’s no known cause.

Other causes may include:

• irritable bowel syndrome (IBS)
• celiac disease
• ulcerative colitis
• Crohn’s disease

A mild stomach ache may not be a reason for concern, but your child may display other signs that mean you need medical help.

Young children may not be able to tell you what’s going on. Use your child’s mood and your own gut feeling when deciding whether or not to go to the emergency room.

• Intensity. If your child is inconsolable or says that their pain is severe, it may be serious. Even if the pain is intermittent, play it safe by getting it checked out.
• Location. Is the pain in the lower right portion of your child’s abdomen? This may be a symptom of appendicitis, which may require surgery. An earlier warning sign with the appendix is pain around the belly button.
• Vomit. Not just any vomiting, though. You’re looking for certain colors. If you see blood in the vomit, it could be something as simple as a nose bleed, but it’s still important to rule out anything worse. Green vomit is the other color of concern and could signal an intestinal blockage.
• Stool. As with vomit, if you see blood in your child’s stool, along with abdomen pain, it might mean an infection, IBD, or some other issue that needs a doctor’s care.
• Urine. If your child says it hurts to urinate, this may be a sign of a UTI, which needs antibiotics to clear up.
• Allergy signs. Anaphylaxis can also cause stomach issues. Be on the lookout for wheezing, difficulty breathing, swelling of the lips or tongue, hives, pallor, or other signs of an allergic reaction, particularly if your child has a history of allergies. Don’t just go to the ER — call 911.
• Other signs. If your child is losing weight, is lethargic, has symptoms of infection, or complains of anything else that’s out of the ordinary, don’t hesitate to call your doctor.

Your child is bound to experience pain around their stomach area at some point. In many cases, abdominal pain may be mild and not a cause for concern, especially if your child doesn’t have any other concerning symptoms.

However, if your child’s abdominal pain seems severe and is accompanied by fever, nausea, vomiting, or signs of an allergic reaction, get help right away.

Familiarizing yourself with common conditions and warning signs will help you feel empowered. Call your healthcare professional whenever you need help deciding the next steps.