What’s causing your little one’s tummy trouble?
January 17, 2018
What’s causing your little one’s tummy trouble?

    “My tummy hurts!” When this phrase is accompanied by a brief bout of vomiting or diarrhea, it’s likely a stomach bug that will run its course. Other causes of abdominal discomfort in kids aren’t quite as obvious.

    “The abdomen contains the stomach, intestines and several organs,” said Flora Szabo, MD, pediatric gastroenterologist. “When you consider this, along with the complex nature of the human body and how the various systems impact each other, it can be difficult for parents to navigate the sources and proper treatment of children’s abdominal pain.”

    Dr. Szabo helps to demystify some of the common causes of tummy troubles in children and when it’s time to seek the help of a pediatrician or specialist.

    Child With Stomach Pain


    Constipation is one of the most common culprits of abdominal pain in children, causing feelings of cramping, bloating and loss of appetite. Though it is common, constipation is often overlooked especially in older children who are more independent. If your child has gone two or more days without a bowel movement, it hurts to go to the bathroom or stool is hard, constipation is likely causing the discomfort.

    Increase fiber and fluid and limit the intake of foods that are known to cause constipation, such as milk, cheese, bananas, breads and pastas. Pear or prune juice may help to encourage a bowel movement and ease constipation. If dietary changes don’t help, talk to the pediatrician about whether or not an over-the-counter stool softener is appropriate given your child’s age, symptoms and medical history.


    Gas is another frequent cause of cramping and bloating. A number of factors can lead to excessive gas. Oftentimes it is related to a specific food, particularly sugar, that a child’s intestines have a difficult time breaking down. Excessive gas can also be the result of swallowing too much air, such as when chewing gum or eating too quickly.

    While vegetables, such as beans and broccoli, are known for causing gas, they have many nutritional benefits. Try to space out the veggies that trigger gas and mix in other, less offensive options in between. It is a good idea to limit soda and juice, as the carbonation and sugar can lead to bloating and gas. If gas is related to constipation, drinking more water may help.

    There are antacids available that can help with children’s gas pain. Make sure to read the label and check with your pediatrician to ensure safety.

    Gastroesophageal reflux

    Gastroesophageal reflux, or heartburn, is characterized by burning in the upper chest and middle abdomen, pain when swallowing, a taste of acid in the throat or excessive burping. Most people experience heartburn at some point in their lives, but when it is an ongoing issue it can cause problems with growth, vomiting and damage to the stomach and esophageal lining.

    Eating smaller, more frequent meals and limiting acidic, spicy and high-fat foods can lessen irritation to the stomach. It’s also helpful to avoid carbonated beverages, which can be harsh on the already delicate tissues in the esophagus and stomach.

    The pediatrician may recommend antacids or other medications to reduce acid and relieve pain.


    Ulcers in children are relatively rare and are primarily caused by a bacteria called Helicobacter pylori. The bacteria weakens the coating in the stomach and upper small intestine and allows acid to irritate the sensitive tissues, resulting in a painful wound, or ulcer. Certain medications, such as aspirin and ibuprofen, can also irritate this lining and result in an ulcer. Although ulcers don’t always have symptoms, they often cause sharp, burning and constant pain between the breastbone and belly button, particularly when the stomach is empty. The child may also experience nausea and vomiting.

    If you suspect that your child has an ulcer, it is important to talk with your pediatrician. The doctor will most likely conduct an endoscopy or blood test to diagnose and determine the source of the ulcer. Depending upon the type and severity of the ulcer, antibiotics may be prescribed to eliminate the bacteria, along with medication to reduce stomach acid and limit further damage to the stomach lining.


    Appendicitis is a very serious medical condition that requires prompt attention. If the appendix, a small organ attached to the colon, ruptures and bursts it can release bacteria into the abdomen and bloodstream.

    The challenge is that when children experience appendicitis, they often don’t have the symptoms common in adults. If your child complains of unusual abdominal pain, particularly around the belly button and lower right side and it is accompanied by fever, vomiting or diarrhea, seek medical attention.


    It’s been a common theme related to a variety of conditions, but different foods impact people’s bodies differently. Take note of specific foods that tend to cause gas, reflux and other abdominal pain for your child and replace them with healthy alternatives that are easier to digest. Help your child to maintain a diet high in fiber to keep bowel movements regular, and drink plenty of water.

    Abdominal pain can be a sign of many other conditions, and is sometimes related to situations in other areas of the body, such as a urinary tract infection, ear infection, strep throat, stress or anxiety. Other times, ongoing pain is related to a chronic condition, such as celiac disease, irritable bowel syndrome or underactive thyroid, which needs attention.

    Stomach aches are not always a cause for alarm, but there are times when it is the body’s signal of something serious. It’s important to monitor the situation closely and trust your parental intuition. If vomiting or diarrhea lasts more than 2-3 days, or includes blood, seek the advice of your pediatrician immediately. Also consult your doctor in the event of intense pain, blood in the urine, inability to eat or pain specifically in the lower right portion of the abdomen. The pediatrician may conduct additional testing, or refer your child to a pediatric gastroenterologist for further evaluation and treatment.

    Meet our gastroenterology and nutrition team, or call (804) 828-CHOR (2467) for more information.

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