Definition

• Pain or discomfort in the stomach (abdomen or belly)
• Pain found between the bottom of the rib cage and the groin crease
• The older child complains of stomach pain
• The younger child points to or holds the stomach

Health Information

Pain Scale

• Mild: Your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
• Moderate: The pain keeps your child from doing some normal activities. It may wake him or her up from sleep.
• Severe: The pain is very bad. It keeps your child from doing all normal activities.

Causes

• Eating Too Much. Eating too much can cause an upset stomach and mild stomach pain.
• Virus (such as Rotavirus). A virus can cause stomach cramps as well as vomiting and/or diarrhea.
• Food Poisoning. This causes sudden vomiting and/or diarrhea within hours after eating the bad food. It is caused by toxins from germs growing in foods left out too long. Most often, symptoms go away in less than 24 hours. It often can be treated at home without the need for medical care.
• Constipation. The need to pass a stool may cause cramps in the lower abdomen.
• Strep. Strep throat can cause up to 10% of new-onset stomach pain with fever.
• Serious Cause. Appendicitis. Suspect appendicitis if the pain is low on the right side and walks bent over. Other signs are the child won’t hop and wants to lie still.
• Stress or Worries. The most common cause of frequent stomach pains is stress. Over 10% of children have a “worried stomach”.

Care Advice

1. Overview:
   • Mild stomach pain can be caused by something simple. It could be from gas pains or eating too much.
   • Sometimes, stomach pain signals the start of a viral infection. This will lead to vomiting or loose stools.
   • Watching your child for 2 hours will help tell you the cause.
   • Here is some care advice that should help.
2. Rest:
   • Have your child lie down and rest until feeling better.
3. Clear Fluids:
   • Offer clear fluids only (such as water, flat soft drinks or half-strength Gatorade).
   • For mild pain, offer a regular diet.
4. Prepare for Vomiting:
   • Keep a vomiting pan handy.
   • Younger children often talk about nausea (a need to vomit) as stomach pain.
5. Pass a Stool:
   • Have your child sit on the toilet and try to pass a stool.
   • This may help if the pain is from constipation or diarrhea.
   • Note: For constipation, moving a warm wet cotton ball on the anus may help.
6. Do Not Give Medicines:
   • Any drug (like ibuprofen) could upset the stomach and make the pain worse.
   • Do not give any pain medicines or laxatives for stomach cramps.
   • For fever over 102° F (39° C), acetaminophen (Tylenol) can be given.
7. What to Expect:
   • With harmless causes, the pain is most often better or gone in 2 hours.
   • With stomach flu, belly cramps may happen before each bout of vomiting or diarrhea. These cramps may come and go for a few days.
   • With serious causes (such as appendicitis), the pain worsens and becomes constant.

Call Your Doctor If

• Pain becomes severe
• Constant pain lasts more than 2 hours
• Mild pain that comes and goes lasts more than 24 hours
• You think your child needs to be seen
• Your child becomes worse

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

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