Northwest Health Magazine Spring 2013 IssueNorthwest Health Spring 2013

Kids' Health

My Tummy Hurts!

Many things can cause children to experience abdominal pain.

Go to: Northwest Health Index

When your child skins a knee, it's obvious why it hurts. But figuring out why their tummy hurts can be trickier.

Anxiety, constipation, viral illnesses, urinary tract infections, appendicitis, pneumonia, and more could all be to blame. But the most common cause is stress.

Intestines are responsive to the hormones produced by our brains when we feel intense emotions, says Group Health pediatrician Tashi Gyaltsong, MD. So when children are fearful, anxious, stressed, or nervous, their bellies might hurt. However, not all pain is stress-related and given the many possible causes, it's no wonder abdominal pain is a main reason parents consult a doctor.

Be a Detective

"The best way for a parent to get to the bottom of abdominal pain is to observe their child," says Dr. Gyaltsong. "Parents know their children best and will know when something isn't right," she says. There are ways to sleuth out the likely source of your child's pain.

Monitor bathroom use. A frequent urge to urinate might be a sign of a urinary tract infection. If your child has excessive diarrhea, vomiting, and little urine output, they could have a viral illness. Dehydration then becomes a risk. If your child isn't emptying their bowel, they might be constipated.

Think about what might be on your child's mind. Is there family trouble? Is it possible that your child is being bullied at school? Could your child be stressed about schoolwork or problems with a friend?

Assess your physical environment. Could your child have ingested something harmful or eaten a food new to them? Could they have tripped and gotten hit in the belly?

If your child isn't yet talking, look for nonverbal cues. Not eating, being especially fussy, drawing their legs up while crying, or lying still instead of playing, may indicate abdominal problems.

Home remedies. For constipation, Dr. Gyaltsong suggests setting a designated toilet time, ideally after dinner when there's no rush. Five stress-free minutes, plus increasing fluids and fiber will help immensely. For the worst cases, she recommends a stool softener (like MiraLAX). If you suspect gas pain, try a belly massage.

If your child has a virus, they'll usually get better on their own, but keeping them hydrated is important. Encourage frequent sips of water and bites of liquid-rich foods like soup. Pedialyte can also help.

Know when to see a doctor. "If your child complains but continues playing, that's reassuring. A normal appetite is also a good sign. But if those things aren't true — if pain inhibits activity, if they want to lie down instead of play, if they lose their desire to eat — those signs are concerning," says Dr. Gyaltsong. Also watch for:

  • A drop in urine output
  • Persistent and worsening pain
  • The desire to lie still, which could indicate appendicitis
  • Fever and lots of vomiting and diarrhea
  • Blood in the vomit or stool

Abdominal pain in your child can be troublesome and confusing. If you're worried, always go with your intuition and call your doctor, or contact the Consulting Nurse Service, available around the clock (toll-free at 1-800-297-6877) for advice.

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