Symptom Definition
- Pain or discomfort located between the bottom of the rib cage and the groin crease.
- The older child complains of a stomachache.
- The younger child should at least point to or hold the abdomen (after 6-12 months old). Prior to 6 mo, the Crying protocols should be used.
Causes
- Indigestion: Indigestion or overeating causes many mild stomachaches
- Gastroenteritis: A viral infection of the intestines causes stomach cramps as well as vomiting and/or diarrhea
- Food Poisoning: Severe vomiting and/or diarrhea lasting less than 12 hours is often due to bacterial overgrowth in unrefrigerated foods
- Constipation: The need to pass a BM causes lower abdominal cramps
- Strep: A strep throat causes up to 10% of acute abdominal pain
- Serious Causes: These include appendicitis, kidney infections and intussuception
See More Appropriate Topic
- CONSTIPATION present and is the main symptom
- DIARRHEA present and is the main symptom
- URINATION PAIN present and is the main symptom
- VOMITING present and is the main symptom
(To go directly to these topics, click on the links following this document.)
Call Your Doctor Now (night or day) If
- Your child looks or acts very sick
- You suspect poisoning with a plant, medicine, or chemical
- Unable to walk or walks bent over holding the abdomen
- Pain mainly low on the right side
- Pain in the scrotum or testicle
- Severe pain anywhere
- Pain (or crying) present > 2 hours
- Blood in the bowel movements or vomiting blood
- Vomiting bile (yellow or green)
- Recent injury to the abdomen
- Age under 2 years
- Fever > 104°F (40°C)
Call Your Doctor Within 24 Hours (between 9 and 4) If
- You think your child needs to be seen
- Call Your Doctor During Weekday Office Hours If
- You have other questions or concerns
- Abdominal pains are a recurrent problem
Parent Care at Home
- Mild abdominal pain and you don't think your child needs to be seen
Home Care Advice for Mild Abdominal Pain
- Reassurance: A mild stomachache can be caused by something as simple as indigestion, gas pains or overeating. Sometimes a stomachache signals the onset of a vomiting illness from a virus. Watching your child for 2 hours will usually tell you the cause.
- Rest: Encourage lying down and rest until feeling better.
- Clear Fluids: Offer clear fluids only (e.g., water, flat soft drinks or 1/2 strength fruit juice).
- Prepare for Vomiting: Keep a vomiting pan handy. Younger children often refer to nausea as a "stomachache."
- Pass a BM: Encourage sitting on the toilet and trying to pass a BM. This may relieve pain if it is due to constipation or impending diarrhea.
- Avoid Medicines: Any drug could irritate the stomach lining and make the pain worse. Do not give any medicines for stomach cramps.
- Expected Course: With harmless causes, the pain is usually better or resolved in 2 hours. With gastroenteritis, belly cramps may precede each bout of vomiting or diarrhea. With serious causes (such as appendicitis) the pain worsens and becomes constant.
- Call Your Doctor If
Pain present > 2 hours
Your child becomes worse or develops any of the "Call Your Doctor" symptoms.
Parent Care for Pediatric Symptoms. Copyright © 2000. Barton D. Schmitt, MD, FAAP
Revised 6/22/00
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