As a parent, when should you worry about your child’s tummy ache? Should you go to the doctor or straight to hospital? To help decide, ask yourself the same questions a doctor would consider in making a diagnosis.

Did the pain begin suddenly or build over a long time?

Generally speaking, pain that is new warns of a more worrisome problem. A new pain appearing suddenly requires close attention. Get advice as soon as possible.

Has the pain been coming and going over days and weeks?

If your child has mild, off-and-on tummy ache, see your family doctor during a regular non-urgent appointment.

How much does it hurt?

If pain wakes your child from sleep or interferes with play or favourite activities, get it checked. The more severe the pain, the more concerned you should be.

Are there other symptoms besides pain?

Poor appetite, fever, vomiting or diarrhea give clues about abdominal pain. All can accompany other common infections or more serious conditions. Carefully consider how sick your child appears, especially with vomiting. Get medical help immediately if your child is vomiting blood, has blood in bowel movements, has a high fever, or eats or drinks so little that there is decreased urination.

When does pain strike?

The timing of your child’s pain may also give clues about the cause. Abdominal pain that comes regularly before piano lessons or resolves after school on Friday probably has an obvious cause! Certain foods may also bring on stomach pain. Avoiding them may be all that is required. Be a detective. See if you can find out what brings on the pain.

What are common causes of abdominal pain in children?

Upset tummy

‘Stomach flu’ or gastroenteritis is one common cause of tummy trouble in kids. Diagnosis is easier if a friend or family member is showing similar symptoms. Usually, the first signs are reduced appetite, low fever and vomiting. Diarrhea often appears in the following days – about the time that the next group of family members start getting sick!

Appendicitis

Appendicitis is a fairly common and potentially serious cause of abdominal pain in children. It may begin with various vague symptoms. Usually, there is loss of appetite and vomiting. Your child may complain of pain around the belly button. Fever often accompanies symptoms. Pain steadily increases, then moves to the lower abdomen on the right side. Often children complain that pain increases if the tummy is jiggled, as when the car is driven over bumps. They often lie quietly, curled up. Unfortunately, appendicitis doesn’t always follow a classic pattern – if you suspect that your child has appendicitis, see a doctor immediately.

Constipation

Perhaps the most common cause of non-acute tummy pain in childhood is constipation. This is described as cramping pain, sometimes severe, in the lower part of the belly. The pain comes and goes. Both child and parent often report regular bowel movements. Fever or vomiting suggests a different problem.

Children often become constipated thanks to poor bowel habits. Any child will tell you that having a B.M. is a terrible inconvenience to a busy schedule of playing with friends, watching television, playing on the computer or riding bikes. Resisting the urge allows the bowel to hold increasing amounts of stool. The bowel enlarges. Ultimately, the child may lose bowel control and soil underpants. If your child has this problem, see your doctor.

Good bowel habits are necessary to prevent chronic constipation in children. Encourage younger children to answer ‘nature’s call’ promptly. Reward them when they do. Ample water, fibre in the diet and regular exercise also help.

Abdominal pain is common in children. It may be minor but can also signal a serious problem. A good rule for parents: if you are not sure what is causing the pain or feel worried – see your family doctor.

My Tummy Hurts! What parents should know about children’s abdominal pain