Mom, My Tummy Hurts

Your child wakes up in the middle of the night complaining of tummy pain. Some questions you may ask include, “Do you feel like you are going to vomit? When did you last have a BM? Is there any diarrhea? Exactly where does it hurt?”

Now what do you do?

Abdominal pain involves more than just the stomach area and is one of the most common reasons children see health care professionals. It includes the entire area from the lower rib cage to the groin. Reasons for abdominal pain range from very trivial to life threatening. Trying to figure out if your child needs to be seen can often be a tricky situation.

Causes of abdominal pain:

• The abdominal area may involve the intestines, bladder, kidneys, spleen, pancreas, gallbladder, appendix and uterus/ovaries in females or testicles in males.
• Causes might be infections, food-related illnesses, poisonings, surgical needs, constipation, stress or many other medical conditions most likely from overeating, gas pains or indigestion.

Signs of abdominal pain that can be treated at home:

• Most simple causes occur around the belly button. The pain comes and goes and lasts less than 24 hours, usually resolving in less than 2 hours.
• These children can often get up and play between episodes of mild pain and they look okay to the parents.
• Vomiting or diarrhea generally begins within a few hours if this is a virus.

Treatment: Home care would include rest; preparing for vomiting to begin; giving the child nothing to eat until they are not vomiting for approximately 6 hours; and most importantly, continue giving sips of clear liquids (nothing red) even if vomiting to prevent dehydration. A warm towel on your child’s tummy may make the pain go away. It is important not to give your child medications for stomach cramping as it may mask the symptoms of something more serious or cause more problems.

Signs of abdominal pain that require contact with your physician:

• Any child lying down, unable to walk or a child that is complaining of pain mainly over the right lower abdomen.
• A child under 3 with severe attacks of abdominal pain that makes child cry and draw knees toward chest, alternating with a normal happy child may be significant.
• Any boy with any groin pain, especially involving the testicles.
• Any child with blood in the stool or vomit.
• Any child with a very swollen abdomen, having moderate to severe pain.
• A child with constant moderate pain (pain that interferes with activities) for over two hours.
• Any child with recent abdominal trauma.
• Your child looks or acts very sick.
• Any poisonings of plant, medication or chemical.

Recurrent abdominal pain:

One of the frequently seen concerns for children with recurrent abdominal pain is related to stress, otherwise known as “worried stomach”. This recurrent type of pain often occurs in children between 4 and 12 years. Fifteen percent of all children are affected by this and is often associated with anxiety, depression, headaches, vomiting, missed school or missed social activities. It is important to help the child determine where this stress stems from (i.e. bully at school, poor grades, anxieties or issues at home). You can teach your child relaxation techniques like deep breathing, thinking about something pleasant or even listening to relaxing music. It is also important to have your child find someone to whom they are comfortable talking. Sometimes it is important to see a doctor for treatment.

Abdominal pain is a symptom almost all parents will be faced with at one time or another. It can be very confusing to know if your child needs care immediately or if waiting for an hour or two will allow it to just go away. Always know you can call the St. Louis Children’s Hospital Answer Line Nurses at 314.454.KIDS if you have any questions or concerns.

Written by Michelle Petterchak, a pediatric nurse with the St. Louis Children’s Hospital Answer Line. For more information, call 314.454.KIDS.