Abdominal Pain, Age 11 and Younger
Abdominal Pain, Age 11 and YoungerSkip to the navigationTopic OverviewAbdominal pain
in children is a common problem. About 1 out of 3 children is seen by a
doctor for abdominal pain by the time they are age 15, but only a small number of
these children have a serious problem. Complaints of abdominal pain
are more common in children younger than 11 years and are often caused by
changes in eating and bowel habits. Most cases of abdominal pain are not
serious, and home treatment is often all that is needed to help relieve the
discomfort. Abdominal pain in children is often frightening and
frustrating for parents. Many times it is hard to find the exact cause of a
child's abdominal pain. Pain without other symptoms that goes away completely
in less than 3 hours is usually not serious. In children, abdominal
pain may be related to
injury to the abdomen or
an illness, such as
an upset stomach, an
ear infection, a
urinary tract infection, or
strep throat. Abdominal symptoms can also occur from an infection passed on by animals or while traveling to a foreign country. Constipation is a common cause of
abdominal pain in children. Some more serious causes of abdominal pain in
children include
appendicitis,
lead poisoning, or problems with the intestines, such
as
intussusception or
malrotation. Girls who start having menstrual periods
may have abdominal pain each month, and the pain may be more severe in some
months than others. Generalized pain occurs in half of the abdomen or more. Localized pain is located in one area of the abdomen. Babies and toddlers often react
differently to pain than older children who can talk about their pain. A baby
may become fussy, draw his or her legs up toward the belly, or eat poorly.
Older children may be able to point to the area of the
pain and describe how severe it is. Abdominal pain can occur one
time, or it can occur repeatedly over several months.
Recurrent abdominal pain (RAP) is a condition that
affects children ages 4 to 11. Check your child's symptoms to decide if and when your child should see a doctor. Check Your SymptomsDoes your child have pain or cramping in the belly? This also includes injuries to the belly. How old are you? Less than 3 months Less than 3 months 3 months to 11 years 3 months to 11 years 12 years or older 12 years or older Has your child had surgery on the chest or belly in the past 2 weeks? Yes Recent abdominal surgery No Recent abdominal surgery Has your child swallowed or inhaled an object? Yes Swallowed or inhaled object No Swallowed or inhaled object Does your baby seem sick? A sick baby probably will not be acting normally. For example, the baby may be much fussier than usual or not want to eat. How sick do you think your baby is? Extremely sick Baby is very sick (limp and not responsive) Sick Baby is sick (sleepier than usual, not eating or drinking like usual) Moderate Moderate dehydration Are the symptoms severe, moderate, or mild? Moderate Moderate dehydration Is your child having trouble drinking enough to replace the fluids he or she has lost? Little sips of fluid usually are not enough. The child needs to be able to take in and keep down plenty of fluids. Yes Unable to drink enough fluids No Able to drink enough fluids Does your child have pain in the belly? How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine? 8 to 10: Severe pain Severe pain 5 to 7: Moderate pain Moderate pain 1 to 4: Mild pain Mild pain Does the belly feel hard when you touch it? Normally the belly is soft and has some "give." A hard, rigid belly may be a sign of a more serious problem. Yes Abdomen is hard (rigid) to the touch No Abdomen is hard (rigid) to the touch Does pressing on the belly cause severe pain? Yes Pressing on abdomen causes severe pain No Pressing on abdomen causes severe pain Has the pain: Gotten worse? Pain is increasing Stayed about the same (not better or worse)? Pain is unchanged Gotten better? Pain is improving How long has your child had pain? Less than 4 hours Less than 4 hours 4 hours but less than 1 day (24 hours) 4 hours but less than 1 day (24 hours) More than 3 days More than 3 days Does the belly hurt all over or mostly in one area? Pain that is most intense in just one area is likely to be more serious than a bellyache that hurts all over. Mostly in one area Localized pain Yes Pain in lower right part of belly No Pain in lower right part of belly Does your child have pain with a new bulge in the belly button or groin? Yes Pain with new bulge in navel or groin No Pain with new bulge in navel or groin Is your child nauseated or vomiting? Nauseated means you feel sick to your stomach, like you are going to vomit. Within the past week, has your child had an injury to the abdomen, like a blow to the belly or a hard fall? Yes Abdominal injury within past week No Abdominal injury within past week Since the injury, has there been any bleeding from the rectum, urethra, or vagina? Yes Bleeding from rectum, vaginal or urethra since injury No Bleeding from rectum, vaginal or urethra since injury Is there a belly wound that is deeper than a scratch? Do you think that the injury may have been caused by abuse? Yes Injury may have been caused by abuse No Injury may have been caused by abuse Has your child vomited since the injury? Is there pain just below the ribs? Pain just below the ribs after an injury can be a symptom of serious damage to the liver or spleen. Do you think your baby has a fever? Did you take a rectal temperature? Taking a rectal temperature is the only way to be sure that a baby this age does not have a fever. If you don't know the rectal temperature, it's safest to assume the baby has a fever and needs to be seen by a doctor. Any problem that causes a fever at this age could be serious. Yes Rectal temperature taken No Rectal temperature taken Is it 100.4°F (38°C) or higher? Yes Temperature at least 100.4°F (38°C) No Temperature at least 100.4°F (38°C) Do you think your child has a fever? Did you take your child's temperature? How high is the fever? The answer may depend on how you took the temperature. High: 104°F (40°C) or higher, oral High fever: 104°F (40°C) or higher, oral Moderate: 100.4°F (38°C) to 103.9°F (39.9°C), oral Moderate fever: 100.4°F (38°C) to 103.9°F (39.9°C), oral Mild: 100.3°F (37.9°C) or lower, oral Mild fever: 100.3°F (37.9°C) or lower, oral How high do you think the fever is? Moderate Feels fever is moderate Mild or low Feels fever is mild How long has your child had a fever? Less than 2 days (48 hours) Fever for less than 2 days From 2 days to less than 1 week Fever for more than 2 days and less than 1 week 1 week or longer Fever for 1 week or more Does your child have a health problem or take medicine that weakens his or her immune system? Yes Disease or medicine that causes immune system problems No Disease or medicine that causes immune system problems Does your child have shaking chills or very heavy sweating? Shaking chills are a severe, intense form of shivering. Heavy sweating means that sweat is pouring off the child or soaking through his or her clothes. Yes Shaking chills or heavy sweating No Shaking chills or heavy sweating How much blood is there? More than a few drops. Blood is mixed in with the stool, not just on the surface. More than a few drops of blood on stool or diaper A few drops on the stool or diaper A few drops of blood in stool or diaper Does your child have diabetes? Is your child's diabetes getting out of control because your child is sick? Yes Diabetes is affected by illness No Diabetes is affected by illness Is the plan helping get your child's blood sugar under control? Yes Diabetes illness plan working No Diabetes illness plan not working How fast is it getting out of control? Quickly (over several hours) Blood sugar quickly worsening Slowly (over days) Blood sugar slowly worsening Do you think that a medicine could be causing the belly pain? Think about whether the belly pain started after you began using a new medicine or a higher dose of a medicine. Yes Medicine may be causing abdominal pain No Medicine may be causing abdominal pain Have your child's symptoms lasted longer than 1 week? Yes Child's symptoms have lasted longer than 1 week No Child's symptoms have lasted longer than 1 week Many things can affect how your body responds to a symptom and what kind
of care you may need. These include: - Your age. Babies and older
adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.
- Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.
- Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be
able to take care of this problem at home. - Try home treatment to relieve the
symptoms.
- Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.
With cramping pain in the belly: - The pain may hurt a little or a lot.
- The amount of pain may change from minute to minute. Cramps often get better when you pass gas or have a bowel movement.
- The pain may feel like a tightness or pinching in your belly.
- The pain may be in one specific area or be over a larger area. It may move around.
Babies can quickly get dehydrated when they lose fluids because of problems like
vomiting or fever. Symptoms of dehydration can range from mild to
severe. For example: - The baby may be fussy or cranky (mild dehydration),
or the baby may be very sleepy and hard to wake up (severe
dehydration).
- The baby may have a little less urine than usual
(mild dehydration), or the baby may not be urinating at all (severe
dehydration).
You can get dehydrated when
you lose a lot of fluids because of problems like vomiting or fever. Symptoms of dehydration can range from mild to severe. For
example: - You may feel tired and edgy (mild dehydration), or
you may feel weak, not alert, and not able to think clearly (severe
dehydration).
- You may pass less urine than usual (mild
dehydration), or you may not be passing urine at all (severe
dehydration).
Severe dehydration means: - The baby may be very sleepy and hard to wake
up.
- The baby may have a very dry mouth and very dry eyes (no
tears).
- The baby may have no wet diapers in 12 or more hours.
Moderate dehydration means: - The baby may have no wet diapers in 6 hours.
- The
baby may have a dry mouth and dry eyes (fewer tears than usual).
Mild dehydration means: - The baby may pass a little less urine than usual.
Severe dehydration means: - The child's mouth and eyes may be extremely dry.
- The child may pass little or no urine for 12 or more
hours.
- The child may not seem alert or able to think clearly.
- The child may be too weak or dizzy to stand.
- The
child may pass out.
Moderate dehydration means: - The child may be a lot more thirsty than
usual.
- The child's mouth and eyes may be drier than
usual.
- The child may pass little or no urine for 8 or more hours.
- The child may feel dizzy when he or she stands or sits up.
Mild dehydration means: - The child may be more thirsty than
usual.
- The child may pass less urine than usual.
If you're not sure if a child's fever is high, moderate, or
mild, think about these issues: With a high fever: - The child feels very hot.
- It is likely
one of the highest fevers the child has ever had.
With a moderate fever: - The child feels warm or hot.
- You are
sure the child has a fever.
With a mild fever: - The child may feel a little warm.
- You
think the child might have a fever, but you're not sure.
A baby that is extremely sick: - May be limp and floppy like a rag
doll.
- May not respond at all to being held, touched, or talked
to.
- May be hard to wake up.
A baby that is sick (but not extremely
sick): - May be sleepier than usual.
- May not eat
or drink as much as usual.
Pain in children under 3 years It can be hard to tell how much pain a baby or toddler is in. - Severe pain (8 to 10): The
pain is so bad that the baby cannot sleep, cannot get comfortable, and cries
constantly no matter what you do. The baby may kick, make fists, or
grimace.
- Moderate pain (5 to 7): The baby is
very fussy, clings to you a lot, and may have trouble sleeping but responds
when you try to comfort him or her.
- Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds
when you try to comfort him or her.
Pain in children 3 years and older - Severe pain (8 to 10): The pain
is so bad that the child can't stand it for more than a few hours, can't sleep,
and can't do anything else except focus on the pain. No one can tolerate severe
pain for more than a few hours.
- Moderate pain (5 to 7): The pain is bad enough to disrupt the child's normal activities and
sleep, but the child can tolerate it for hours or days.
- Mild pain (1 to 4): The child notices and may complain of the pain,
but it is not bad enough to disrupt his or her sleep or activities.
Shock is a life-threatening condition that may occur quickly
after a sudden illness or injury. Symptoms of shock in a child may include: - Passing out (losing consciousness).
- Being very sleepy or hard
to wake up.
- Not responding when being touched or talked to.
- Breathing much faster than usual.
- Acting confused.
The child may not know where he or she is.
Blood in the stool can come from
anywhere in the digestive tract, such as the stomach or intestines. Depending
on where the blood is coming from and how fast it is moving, it may be bright
red, reddish brown, or black like tar. A little bit of bright red
blood on the stool or on the toilet paper is often caused by mild irritation of
the rectum. For example, this can happen if you have to strain hard to pass a
stool or if you have a hemorrhoid. Certain medicines and foods can affect the color of stool. Diarrhea
medicines (such as Pepto-Bismol) and iron tablets can make the stool black.
Eating lots of beets may turn the stool red. Eating foods with black or dark
blue food coloring can turn the stool black. If you take aspirin or some other medicine (called a blood thinner) that prevents blood clots, it can cause some blood in your stools. If you take a blood thinner and have ongoing blood in your stools, call your doctor to discuss your symptoms. Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in children are: - Diseases such as diabetes, cystic fibrosis, sickle
cell disease, and congenital heart disease.
- Steroid medicines,
which are used to treat a variety of conditions.
- Medicines taken
after organ transplant.
- Chemotherapy and radiation therapy for
cancer.
- Not having a spleen.
Temperature varies a little depending on how you measure it.
For children up to 11 years old, here are the ranges for high, moderate, and
mild according to how you took the temperature. Oral (by mouth), ear, or rectal temperature - High:
104°F (40°C) and
higher
- Moderate:
100.4°F (38°C) to
103.9°F (39.9°C)
- Mild:
100.3°F (37.9°C) and
lower
A forehead (temporal) scanner is usually 0.5°F (0.3°C) to 1°F (0.6°C) lower than an oral temperature. Armpit (axillary) temperature - High: 103°F (39.5°C) and higher
- Moderate:
99.4°F (37.4°C) to
102.9°F (39.4°C)
- Mild: 99.3°F (37.3°C) and lower
Note: For children under 5 years old, rectal temperatures are
the most accurate. It is easy for your diabetes to become out of control when
you are sick. Because of an illness: - Your blood sugar may be too high or too
low.
- You may not be able take your diabetes medicine (if you are
vomiting or having trouble keeping food or fluids down).
- You may
not know how to adjust the timing or dose of your diabetes
medicine.
- You may not be eating enough or drinking enough
fluids.
An illness plan for people with diabetes usually covers things like: - How often to test blood sugar and what the target
range is.
- Whether and how to adjust the dose and timing of insulin
or other diabetes medicines.
- What to do if you have trouble keeping
food or fluids down.
- When to call your doctor.
The plan is designed to help keep your diabetes in control even
though you are sick. When you have diabetes, even a minor illness can cause
problems. Many prescription and nonprescription medicines can cause
belly pain or cramping. A few examples are: - Aspirin, ibuprofen (such as Advil or Motrin), and
naproxen (such as
Aleve).
- Antibiotics.
- Antidiarrheals.
- Laxatives.
- Iron
supplements.
Seek Care TodayBased on your answers, you may need care soon. The
problem probably will not get better without medical care. - Call your doctor today to discuss the symptoms
and arrange for care.
- If you cannot reach your doctor or you don't
have one, seek care today.
- If it is evening, watch the symptoms and
seek care in the morning.
- If the symptoms get worse, seek care
sooner.
Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care. - Call your doctor now to discuss the symptoms and
arrange for care.
- If you cannot reach your doctor or you don't have
one, seek care in the next hour.
- You do not need to call an
ambulance unless:
- You cannot travel safely either by driving
yourself or by having someone else drive you.
- You are in an area
where heavy traffic or other problems may slow you down.
Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Make an Appointment Based on your answers, the problem may not improve without medical
care. - Make an appointment to see your doctor in the
next 1 to 2 weeks.
- If appropriate, try home treatment while you
are waiting for the appointment.
- If symptoms get worse or you have
any concerns, call your doctor. You may need care sooner.
Swallowed or Inhaled Objects Postoperative Problems Abdominal Pain, Age 12 and Older Home TreatmentMost of the time, a child's
abdominal pain will get better with home treatment and the child will not need a visit to
a doctor. Home treatment for abdominal pain often depends on other
symptoms that are present with the pain, such as diarrhea, nausea, or vomiting. See the Related Information section of this topic for information on some of these other symptoms. Try the
following, one at a time in the order listed, if your child has mild abdominal
pain without other symptoms: - Have your child rest when he or she has mild
stomachaches. Most symptoms will get better or go away in 30
minutes.
- Have your child sip clear fluids, such as water, broth,
tea, or fruit juice diluted with water.
- Have your child try to
pass a stool.
If the measures above do not work, you may also try
these: - Serve your child several small meals instead of 2
or 3 large ones.
- Serve mild foods, such as rice, dry toast or
crackers, gelatin, or applesauce. Do not give your child spicy foods, other
fruits, or drinks that have caffeine or carbonation until 48 hours after all
symptoms have gone away. These foods may make your child's stomachache
worse.
- Do not give your child any medicines without talking to the
doctor first. Medicines may mask the pain or make it worse.
Symptoms to watch for during home treatmentCall your doctor if any of the following occur during home treatment: - Pain increases or localizes to one section of
the abdomen.
- Other symptoms develop, such as diarrhea, nausea, vomiting,
or fever.
- The belly feels hard or looks very
swollen.
- Symptoms become more severe or frequent.
PreventionAbdominal pain in children can often be
prevented. - Abdominal pain in children is often caused by
irregular bowel habits. Become familiar with your child's normal bowel
patterns. Also, be aware of the size and consistency of your child's stools.
This will help to determine whether constipation is a problem. For information
on preventing constipation and establishing toilet training, see the topic
Constipation, Age 11 and Younger.
- Try to
make sure your child has regular eating habits. Overeating is a common cause of
abdominal discomfort. Have your child eat slowly and stop when he or she feels
full. For more information, see the topic
Healthy Eating for Children.
- Swallowing
air (aerophagia) can cause abdominal pain and a swollen abdomen. Your child may
also have a lot of belching or flatus. Limit chewing gum and carbonated
beverages to help prevent this. Many children swallow air when they are anxious
or frightened.
Preparing For Your AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment. You can help your
doctor diagnose and treat your child's condition by being prepared to answer
the following questions: - Has your child had an injury to the
abdomen?
- How long has your child had the pain?
- What was
your child doing when the pain started?
- Has your child had similar
episodes of abdominal pain before? What were these episodes like? How were they
treated?
- Is the pain constant, or does it come and
go?
- Is the pain localized to one area or generalized over the whole
belly?
- How severe is the pain? What has your child's activity level
been?
- Can your child describe the pain? Is the pain cramping, a
steady ache, or sharp and burning?
- What makes the pain better? What
makes the pain worse?
- Does your child have other symptoms, such as
nausea, urinary problems, constipation, or diarrhea?
- Is your child
vomiting? If so, describe how much, how often, and how long.
- Does
your child have a fever?
- Has your child recently traveled outside
of his or her native country?
- Has your child drunk any untreated
well, stream, or lake water?
- Does your child have any
health risks?
ReferencesOther Works Consulted- Campo JV, et al. (2004). Recurrent abdominal pain, anxiety, and depression in primary care. Pediatrics, 113(40): 817-823.
CreditsByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine Kathleen Romito, MD - Family Medicine Specialist Medical ReviewerAdam Husney, MD - Family Medicine Current as of:
May 3, 2017 Last modified on: 8 September 2017
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