Although tummy aches are a common complaint in children – the reason for five to 10 percent of all visits to a doctor or emergency facility – they seldom turn out to be a cause for serious concern.
Most of the time, tummy pains are caused by a viral infection and disappear in a couple of days. A study from the University of Indiana showed that only one or two out of a hundred children had problems serious enough to require specific treatment or surgery.
Look for the signs
There are some signs, however, that you should bring to your healthcare provider's attention to help figure things out. Oddly enough, severity of pain is not necessarily the most important issue. Gas trapped in a loop of bowel may cause sudden, inconsolable screaming in a child who writhes on the floor but has no fever, does not vomit and recovers by relaxing in a warm bath. Worrisome signs that may be more serious problems:
- A pattern of increasing pain over several hours that makes the child reluctant to stand up straight, let you touch his belly, or move;
- Abdominal pain associated with high fever;
- Vomiting, especially of brown, green, or yellow material or blood;
- A distended abdomen: one that is tense and swollen, protruding more than normal for your toddler;
- Pain with urination;
- Blood or pus in urine or dark brown urine, and
- Blood, darkened stools that look like currant jelly, or pus in stool.
If your child has any of the symptoms above you should bring them to your healthcare provider's attention immediately.
Recurring abdominal pain
If recurring tummy aches wake the child at night and are associated with weight loss, this can signal a chronic inflammation or infection in the bowel.
Recurring complaints that come up only in stressful situations (such as going to a new school or day care or leaving on a trip) and are accompanied by no other symptoms are a way of expressing tension. The child and the situation need investigation, not the tummy.
Pain plus rash
Abdominal pain accompanied by a rash on the buttocks and/or legs that resembles bruising can be caused by a condition called Henoch-Schonlein Purpura. You may never have heard of it, but it is surprisingly common. Nobody knows for sure what causes this condition, but it seems to be related to a bacterial or viral infection. Inflammation of the small blood vessels can lead to bleeding in the skin as well as the bowel and kidneys. While it's not life threatening, your pediatrician will want to watch your child carefully over several days.
Food sensitivity, especially lactose intolerance, can cause cramping and gas. There is frequently (but not always) a family history of problems digesting milk. If you suspect this is the problem, eliminate milk and milk products (or whichever food you think is responsible) for a week. If the symptoms disappear, reintroduce it. If symptoms return when milk is introduced, talk to your healthcare provider about adjusting your child's diet to eliminate milk while providing enough calcium.
Unusual causes of belly aches
It may surprise you to learn that strep throat can sometimes occur not with throat pain, but with a fever and belly pain. Sometimes a child thought to have appendicitis has actually been diagnosed a strep infection instead.
Urine infections and pneumonia
Can sometimes cause abdominal pain as well. Pediatricians check urine samples and chest X-rays if they’re not convinced that a bellyache is in the belly. Be alert to other complaints that come from other areas even if the main concern is the tummy.
Trust your instincts
If you think your child is really sick, let your healthcare provider know, even if there is nothing specific you can put your finger on.