‘My Tummy Hurts’

Abdominal pain is a frequent complaint in children and it can be a challenge for parents to know when to be worried. Common causes of abdominal pain in children include overeating, food intolerance, constipation, infections and anxiety. Other less common causes include reflux, inflammatory bowel disease and irritable bowel syndrome. Appendicitis should always be considered because it is a surgical emergency.

Constipation is also often to blame for lower abdominal pain in children. Constipation may be due to stool withholding or inadequate dietary fiber and water. Treatment consists of dietary changes and/or use of a stool softener along with scheduled toilet time.

Urinary tract infections are another cause of lower abdominal pain, particularly in young females. Patients often describe burning with urination and the need to urinate frequently. Fever and vomiting may be present. Urinary tract infections are diagnosed with a urine sample and treated with an antibiotic.

Strep throat can also cause abdominal pain, usually in children over age 3. Strep throat is an infection caused by bacteria called streptococci. Children most often have fever and sore throat, but abdominal pain can be present. A throat swab is required to test for strep and the treatment is an antibiotic.

Emotional distress or anxiety is a common cause of recurrent abdominal pain in school-aged children. The pain will be associated with a stressful event, and there are usually no other associated complaints. This diagnosis may be made once other conditions have been ruled out.

Appendicitis is a serious cause of abdominal pain in children. The pain usually starts around the belly button and then moves to the lower right side and may be severe. Children may also have fever and loss of appetite. The treatment for appendicitis is surgery.

If you are concerned about your child’s abdominal pain, please speak to your doctor. It is helpful to report any associated symptoms such as fever, vomiting or diarrhea, sore throat, or urinary complaints. The doctor will also want to know the location, frequency and severity of the pain. Depending on the history and physical exam findings, further lab tests or imaging may be required.

Dr. Erin H. Stubbs is a board-certified pediatrician at CMC Myers Park Pediatrics.