Stomach aches affect most children at one time or another. Most of the time, the cramps, nausea and/or pain associated with this symptom stem from a relatively minor disorder that quickly passes along with the accompanying stomach ache. However, stomach aches may be a symptom for a variety of illnesses, and sometimes can indicate a more serious condition that requires medical care.

Children who have a stomach ache often experience other associated symptoms, including diarrhea, fever, nausea and vomiting, and poor appetite. They may also experience pain in other body parts, such as the back, chest, pelvis, rectum, scrotum or legs.

There are many different potential causes of stomach aches, including appendicitis, constipation, infections, food-related problems, medications, stress and injury.  

Most stomach aches are the result of minor illnesses that quickly pass with little or no treatment. Once the underlying condition disappears, the child’s stomach ache is likely to subside as well. However, some cases are more severe and may require medical treatment in the form of medications or surgery.

Mothers who breastfeed rather than bottle-feed their baby reduce the infant’s risk of influenza or other infections that may trigger stomach problems. Encouraging children to wash their hands regularly can reduce the likelihood that the child will become ill with a viral infection or other contagious disorder that may cause stomach pain.

Parents are urged to contact a physician, preferably a pediatrician, immediately if their child’s stomach ache is severe and lasts more than one hour, or is accompanied by blood in the stool or urine, recent history of surgery or abdominal injury.

Stomach aches are a common ailment of childhood. They can be triggered by many different factors. Most stomach aches are relatively minor, and may be caused by temporary factors such as stress or indigestion. Others may be more serious, including inflammation of the appendix (appendicitis), inflammation of the colon (colitis) or hepatitis.

A child’s abdomen is the region between the chest and the hips. It houses the stomach and intestines, as well as a number of other important organs. These include the bladder, kidneys, liver, spleen, pancreas, gallbladder, appendix and adrenal glands. Girls also have a uterus and ovaries in the abdomen.

A membrane called the peritoneum holds all of the contents of the abdomen in place. Three layers of abdominal muscles also support the abdomen.

Children who have a stomach ache experience a discomfort that varies widely, depending on the disorder that is causing the stomach ache. Some may have cramps and nausea, while others may experience pain that is limited to one area or that travels to other areas of the body. Pain can be mild or severe and may come and go or remain steady. Some stomach aches are sharp while others feel dull.

Although most stomach aches do not require medical care, some do. A physician will perform a complete physical examination and compile a thorough medical history when diagnosing the source of a stomach ache. Blood tests, urine tests, imaging tests and other procedures may be used to further pinpoint the source of a stomach ache.

Children who have a stomach ache may cry often or exhibit signs of excessive fussiness or irritability. Infants with stomach aches may also be fussy and may refuse to eat or drink. Stomach aches are often accompanied by other pain in the back, chest, rectum, scrotum or legs.

Other symptoms commonly associated with stomach aches include:

• Diarrhea
• Fever
• Nausea and vomiting
• Pain during urination and bowel movements
• Poor appetite

Colic is an excessive fussiness that is characterized by incessant crying, and may be associated with abdominal pain in infants under 3 months of age. Its cause is unknown.

There are many different potential causes of stomach aches. In some cases, the condition that triggers the stomach ache is located in the stomach. However, a disorder in another area of the abdomen can also trigger stomach discomfort. Emotional factors can also cause stomach aches.

Some of the conditions that may cause stomach aches include:

• Appendicitis. An inflammation of the appendix (a small, finger-shaped pouch in the lower right abdomen) often causes pain that begins in the belly button and moves to the lower right abdomen. Loss of appetite, fever and vomiting are often associated with appendicitis.
  
  
• Constipation. Children may have this condition if their stools are small, dry and hard and it is painful to defecate. The stomach ache is likely to come and go and to feel like cramps. Changes in diet, such as increasing fiber and water intake, and use of gentle laxatives often cure or prevent constipation.
  
  
• Diarrhea. Characterized by frequent and runny, watery bowel movements that can be caused by a number of conditions, including influenza. Children with diarrhea often feel sick to their stomachs.
  
  
• Food-related problems. Overeating or eating certain types of foods (i.e., too spicy, sweet or greasy) can upset the stomach, a condition known as indigestion. In addition, food poisoning, food allergies and lactose intolerance (inability to digest the sugar lactose found in milk and other dairy products) may trigger stomach discomfort.
  
  
• Infection. Various infections can cause stomach aches. The most prominent is gastroenteritis, a condition usually caused by a virus that lasts between 24 and 48 hours. Symptoms include mild and intermittent stomach discomfort. In some cases, diarrhea and vomiting may also be present. Other infections that may cause stomach aches include urinary tract infections, strep throat, hepatitis, pneumonia, mononucleosis and ear infections.
  
  
• Injury to the abdomen. An abdominal injury can cause stomach ache. In some cases, this may be a sign of abdominal bleeding, a serious health threat. Children may suffer an abdominal injury from being punched or injured in sports, motor vehicle accidents or other mishaps.
  
  
• Medications. Use of some medications can upset the stomach. These include certain pain relievers (e.g., ibuprofen) and antibiotics (e.g., clindamycin).
  
  
• Stress. Emotional upset and anxiety are common sources of stomach aches. Children may be especially vulnerable when moving to a new community or experiencing turmoil at home or school. Depression is also a frequent source of chronic stomach aches (recurrent abdominal pain).
  
  
• Vomiting. Children may feel sick to their stomachs prior to, during and after vomiting. Motion sickness may irritate the stomach causing nausea and vomiting.
  
  
• Menstruation. Menstruating girls may experience abdominal cramps days before and during their monthly period.
  
  
• Irritable bowel syndrome (IBS). IBS causes chronic (long-term) or recurring abdominal pain. Both children and adolescents may have IBS, and some adults with IBS can recall IBS symptoms that were experienced during childhood.

Less common causes of stomach aches include giardiasis (infestation of the intestinal tract with a micro-organism), hernias (protrusion of an organ through a muscular wall), sickle cell anemia (inherited disorder of the red blood cells), pancreatitis (inflammation of the pancreas), peptic ulcers (open sore inside the stomach), inflammatory bowel disease (chronic inflammation of the intestines) and intussusception (telescoping of part of the intestine into another part).

Most stomach aches are the result of minor illnesses that quickly pass with little or no treatment. Once the underlying condition disappears, the child’s stomach ache is likely to subside as well.

There are many home remedies that may help relieve a child’s discomfort until the stomach ache runs its course. Children may find stomach pain is reduced by simple techniques such as placing a hot water bottle that contains warm water or a heating pad on the abdomen or getting more rest. Pain relievers can also be used to treat stomach aches, but only if approved by a physician. Aspirin is not recommended for use in children because of the potential development of the rare Reye syndrome. Because so many stomach aches are related to stress and anxiety, a parent’s simple understanding and willingness to listen to a child’s concerns can often go a long way toward relieving this type of stomach ache.

In some cases, stomach aches may be more persistent and require the care of a medical professional. Treatments for stomach aches vary widely, depending on the nature of the condition causing the stomach upset. For example, some forms of bacterial infection will be treated with medications such as antibiotics. Other conditions, such as appendicitis, may require surgery. Stress that causes stomach aches is treated by making lifestyle changes or participating in psychological counseling.

Mothers who breastfeed instead of bottle-feeding reduce their baby’s risk of influenza or other infections that may trigger stomach problems. In addition, burping babies under 2 months of age after every meal is essential to preventing stomach aches. Burping forces air bubbles out of the stomach and esophagus. If this air remains trapped, it can cause stomach pain.

Encouraging children to wash their hands regularly can reduce the likelihood that the child will become ill with a viral infection or other contagious disorder that may cause stomach pain. If the child is unable to wash, hand sanitizers make an excellent substitute.

The risk of constipation in children can be reduced by drinking plenty of liquids and eating a high-fiber diet rich in fruits, vegetables, whole-grain breads and cereals. Increasing the amount of exercise a child performs also helps to encourage bowel movements and prevent constipation.

Parents are urged to contact a physician immediately if their child’s stomach ache is severe and lasts more than one hour, or is accompanied by any of the following:

• Pain in the lower right side accompanied by fever, which may indicate appendicitis
  
  
• Blood in the stool or urine
  
  
• Recent history of surgery or abdominal injury
  
  
• Reason to suspect that the child has been poisoned

Symptoms accompanying stomach aches that require less urgent medical attention include low-grade fever, sore throat or diarrhea that occurs more than twice during the course of the stomach problem. In addition, stomach pain that gets steadily worse over several hours also requires medical attention.

Preparing questions in advance can help parents have more meaningful discussions with their child’s physicians regarding the child’s conditions. Parents and children may wish to ask their doctor the following questions related to stomach aches:

1. How will I know whether my child’s stomach ache requires treatment?
   
   
2. What symptoms should I look for that might indicate the cause of my child’s stomach ache?
   
   
3. What is likely causing my child’s stomach ache?
   
   
4. How will you diagnose my child’s stomach ache?
   
   
5. How can I help relieve my child’s symptoms?
   
   
6. Can I give my child a pain reliever or fever reducer to reduce discomfort?
   
   
7. Is it possible that my child’s stomach ache will recur?
   
   
8. How can I help prevent a stomach ache in my child?
   
   
9. What dietary changes should I make to prevent stomach aches in my child?
   
   
10. How can I help my child if stress is the source of his/her stomach aches?