What is abdominal pain in children?

Abdominal (tummy) pain is common in children and babies. Abdominal pain is felt in the area between the bottom of your child’s ribs and their pelvis.

There are many different causes of abdominal pain in children. Most episodes are not serious and will get better on their own within a few days.

This page is about abdominal pain in children under the age of 12 years. You can also read about abdominal pain in older children and adults.

What symptoms are related to abdominal pain in children?

Abdominal pain may:

• come on quickly or slowly
• be steady or get worse
• change or move over time
• come and go
• be mild or severe

Noticing the pattern and location of the pain can help your doctor make a diagnosis.

Children with tummy pain may have other symptoms, such as:

• vomiting
• diarrhoea
• constipation
• fever

You may notice behaviours in your baby or young child that suggest they might be in pain. These can include:

• crying
• being unable to get comfortable
• wanting to stay still
• not wanting to play
• refusing food or drinks
• becoming fussy or grumpy
• certain facial expressions

How can I help my child explain their pain symptoms?

Young children and babies may not be able to tell an adult where they feel pain, or what it feels like. When trying to work out your child’s symptoms, it can help to ask simple questions, such as:

“Can you point to where it hurts?”

“Did you wake up with the pain?”

“When did you last go to the toilet?”

What causes abdominal pain in children?

Abdominal pain can have many different causes in children. Some are common, while others are rare.

Abdominal pain can be short-term (acute), or caused by a long-term or ongoing (chronic) condition.

Constipation

Constipation is common in children and can cause abdominal pain. Children who are constipated generally have:

• infrequent bowel movements (poos)
• large stools (poos)
• difficulty doing a poo

Gastroenteritis

Gastroenteritis, or ‘gastro’, is caused by an infection in your gut — usually a viral infection. These infections are easily spread between people, especially between children.

Symptoms of gastroenteritis are:

• vomiting
• diarrhoea
• fever
• abdominal pain

Children and small babies can easily become dehydrated from gastroenteritis. Babies under 6 months old who have gastro should be seen by your doctor .

Food poisoning

Food poisoning is caused by germs that grow in food which has been poorly prepared or stored. The symptoms are like those of gastroenteritis.

Again, babies and small children are more at risk of dehydration than older children and care should be taken to ensure they stay hydrated.

Lactose intolerance

Lactose intolerance is when you can’t easily digest lactose — a sugar found in milk and dairy products. It causes abdominal pain, bloating, wind and diarrhoea after having food or drink containing lactose.

Lactose intolerance in children may be temporary, such as after a bout of gastroenteritis, or it may be permanent. It is very rare in babies.

Colic

Colic is the name for when babies cry a lot and are unsettled for long periods. It’s very common, especially in very young babies.

The cause of colic is not fully known, but it appears to be harmless — other than the distress it causes to you and your child. While it can seem as though babies with colic may have abdominal pain, most often there is no medical cause for their crying.

Babies with colic often cry and fuss in the late afternoons and evenings. See here for more information on colic in babies and when to visit the doctor.

Urinary tract infections

Urinary tract infections (UTI) are common in children.

Abdominal pain can be one of the symptoms, along with:

• pain or burning when urinating (weeing)
• urinating more often than normal
• smelly urine
• fever
• vomiting
• being generally unwell

Appendicitis

Appendicitis is an emergency. If you think your child may have appendicitis, you should take them immediately to a doctor or hospital. A burst appendix can be life-threatening.

Appendicitis symptoms are:

• pain around the belly button area that moves to the lower right side of the abdomen
• loss of appetite
• nausea and vomiting
• pain when moving — children with appendicitis may try to keep very still

Intussusception

Intussusception is when a part of your bowel slides into the next part of the bowel, like a telescope. It’s a serious condition, often causing a blockage (bowel obstruction).

Children with intussusception may have:

• severe abdominal pain and distress that comes and goes
• bleeding from their bottom or ‘red currant jelly’-like poos
• vomiting
• extreme tiredness that may come and go

Your child may seem well between episodes of pain.

Inguinal hernia complications

A hernia happens when tissue bulges through an abnormal weak spot into another part of the body. Some babies and children get inguinal hernias, which can cause a swelling in their groin.

Sometimes, a hernia can become trapped. This is a medical emergency as blood flow may be cut off, causing tissue in the hernia to die.

Symptoms of a trapped inguinal hernia can include:

• swelling, redness and pain around the hernia
• abdominal pain
• nausea and vomiting
• bloating

Testicular torsion

Testicular torsion is when one of your testicles twists, reducing blood flow to the testicle. It’s a medical emergency and needs surgery to save the testicle. It’s more common in adolescents and babies.

Symptoms of testicular torsion are sudden pain and swelling in the scrotum, and one testicle sitting higher than the other. Pain is usually in the testicle but may be in the abdomen. Other symptoms include nausea and vomiting.

Swallowed object

Young children frequently put things in their mouths and can end up swallowing them. Most swallowed objects pass out of the body without any help. But some objects can cause problems.

Button batteries and magnets can cause serious and life-threatening complications. If you suspect your child has swallowed a button battery or magnet, go to the nearest hospital emergency department or call the Poisons Information Centre on 13 11 26.

Symptoms of a swallowed object can include:

• drooling
• reduced eating and drinking
• pain with swallowing
• vomiting
• abdominal pain
• dark bowel motions

How is the cause of abdominal pain diagnosed in children?

Sometimes it can be difficult to diagnose the cause of abdominal pain in children. It can take time to work out the reason for your child’s pain.

Your doctor will ask you and your child questions about their pain. They will also ask about any other symptoms and your child’s health in general.

They will put your child at ease before carefully examining them.

Sometimes tests will be needed, such as:

• blood tests
• urine tests
• stool (poo) tests
• ultrasound scans
• x-rays

Most children with abdominal pain don’t need any tests.

When should my child see a doctor?

Most children will have abdominal pain at some point. For most, it won’t be a serious illness.

Take your child to the doctor or hospital emergency department as soon as possible if:

• they have severe abdominal pain
• their pain is made worse by movement
• the pain wakes them from sleep, doesn’t go away or is getting worse
• they are pale and sweaty
• they are tired and listless
• they have pain or swelling in their groin or testicles (in a male baby)
• they are not drinking or have signs of dehydration

Also take your child to the doctor as soon as possible if they have abdominal pain and:

• a fever

• problems or pain when passing urine (doing a wee)
• ongoing vomiting or diarrhoea
• a skin rash that is painful
• a recent fall or tummy injury

When to seek urgent care

Go straight to the hospital emergency department if there is:

• vomit that is green or bloody
• poo that is black or red (may have blood in it), including bloody diarrhoea

How is abdominal pain treated in babies and children?

Often, no specific treatment is necessary, other than self-care at home.

Self-care at home

If you are taking care of a child with a sore tummy:

• Make sure that they rest.
• It's very important that they drink enough clear fluids — encourage them to take small sips often.
• If they don’t want to eat, don’t push them.
• If they are hungry, give them bland food, such as crackers, bananas or toast.

Medicines

Pain relief medicines may be recommended — usually paracetamol at the recommended dose for their age and weight. Ask your pharmacist what’s best for your child.

Antibiotics are not normally recommended for problems such as gastroenteritis, as most infections will be due to a virus.

Oral rehydration solutions can be used to help prevent and treat dehydration.

Other treatments

Sometimes other treatments are needed in hospital, such as:

• fluids given through a nasogastric tube (tube inserted through your child’s nose that goes into their tummy)
• intravenous fluids (fluids given through a drip)
• an operation (surgery)

Resources and support

If you need advice on what to do for your child, call healthdirect on 1800 022 222 (known as NURSE-ON-CALL in Victoria) to speak with a registered nurse, 24 hours, 7 days a week.

Or you can call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.=

For more information and support, try these resources:

• Royal Children’s Hospital Melbourne
• Sydney Children’s Hospitals Network