Dealing with confusing stomach complaints
“My tummy hurts!” What child hasn’t uttered these words with a moan, cry or a sniffle? And what parent hasn’t grappled with weighing the significance of the complaint: Does it signify a serious medical condition, a more benign condition like too much candy, or is it, perhaps, a cry for attention? Abdominal pain, or bellyache, is a common childhood complaint, with everything from flu to school avoidance bringing on the lament of a painful tummy. Most “simple” stomachaches are located in the center of the abdomen and experienced as a dull or crampy pain. The pain may come and go and may last a few minutes to an hour or two. The child usually can more around, despite his or her discomfort, and feels well during the interval between episodes of pain.
This type of stomachache is often caused by nervous tension or physical stress and frequently follows eating or drinking. It may be associated with constipation and gas and may be relieved by a bowel movement. Typically, a child with a stomachache caused by stress, whether it is simply a test at school or more serious concern elsewhere, may be difficult to manage. In most cases, once the stress is eliminated, the pain usually leaves as abruptly as it arrived, with perhaps only a vague lingering ache. The “cure” is usually a combination of reassurance, understanding, support, which goes a long way in helping to alleviate a child’s stress. It is important for a parent to remember that the pain in most simple stomachaches is not contrived, it is very real. It may be seen more often in families with histories of “sensitive stomachs” or “nervous colons,” even in children as young as 3. Over-the- counter analgesics containing ibuprofen (Advil or Motrin) or acetaminophen (Tylenol) are best avoided. Antacids, clear liquids, or a warm bath may help ease the distress.
There are a few other causes of abdominal pain, however, that may be more serious and require medical evaluation. Strep throat, pneumonia, urinary infection, ulcer disease, and the early stages of appendicitis can all look like simple stomachaches.
In developing appendicitis, the child may complain only of a vague stomachache at first, but then the pain will more to the lower right quadrant of the abdomen, becoming sharper, more sever, and constant. The pain is often accompanied by fever and sometimes vomiting as well. Usually, an appendicitis attack takes many hours before it develops into an emergency, but it is unpredictable.
Intestinal infections, both viral and especially bacterial, can cause not only excessive stomach pain, but vomiting, diarrhea, and possible fever. Bacterial infections come from food or water that has become contaminated due to mishandling. If symptoms of infection occur, the child should be seen by a physician immediately for possible medical treatment.
A good rule of thumb is that if your child’s complaints of stomach pain are not assuaged by the usual comforts, especially in the presence of vomiting, diarrhea, or fever, seek medical advice as soon as possible.
By Dr. David Horwitz
A clinical assistant professor of pediatrics at New York University School of Medicine.
(All medical information is for informational purposes only. Please consult a physician if you have any questions or concerns.)