Stomach Pain in Kids and Teens: Causes and Relief

If you have kids, you’ve probably heard them say, “My stomach hurts.” Maybe it’s after a big meal, before school or in the middle of the night. As a parent, it's not always easy to know what’s causing the pain or when to be concerned. 

Stomach pain, also called abdominal pain, is common in kids and teens, and most stomachaches aren’t serious. Causes include constipation, stomach viruses, something your child ate or even stress. 

But some stomachaches deserve a closer look, especially when the pain doesn’t go away or your child seems unusually uncomfortable. 

“It’s always better to err on the side of caution,” says Sangita Bhasin, MD, a pediatrician at Scripps Coastal Medical Center Encinitas. “If you’re concerned about your child’s stomach pain, call the doctor, especially if the pain keeps coming back, gets worse or your child just doesn’t seem like themselves.”

Gas and indigestion 

Gas can cause bloating and stomach cramps. Common triggers include carbonated drinks, beans, certain vegetables and eating too quickly. Avoiding carbonated drinks, eating slowly and limiting foods that trigger symptoms may help reduce discomfort.

Constipation 

Constipation is a common cause of stomach pain in kids. Signs include hard or painful stools, fewer bowel movements and bloating. Younger children may not realize they’re constipated, so ask when they last had a bowel movement and whether it hurt. 

In younger children stool withholding can also contribute to constipation.

Overeating or eating too quickly 

Eating too much or too quickly can cause bloating and discomfort. Greasy foods and too much candy may also upset the stomach. Encourage your child to eat slowly and stop when full. 

Lactose intolerance 

Some kids have trouble digesting lactose, a sugar found in milk and dairy products. This happens when their bodies don’t make enough of an enzyme called lactase. Symptoms may include stomach cramps, bloating, gas or diarrhea after consuming dairy. 

Milk allergy 

A milk allergy is different from lactose intolerance. It occurs when the immune system reacts to proteins in milk. 

Symptoms can include stomach pain, vomiting, diarrhea or hives. A severe allergic reaction can cause breathing problems and require emergency care. 

Stress and anxiety 

Does your child get stomachaches before school or a big test? Stress and anxiety can cause real physical symptoms, including stomach pain, nausea and diarrhea. Kids may not always recognize or know how to explain what they're feeling. 

“Stomach aches that appear to have no apparent cause may be due to stress, especially if the pain is recurrent. But all the child knows is that their stomach hurts,” says Dr. Bhasin. “When this happens, gently ask the child if they’re worried about something and want to talk about it. There could be problems at school or with friends.” 

If your child keeps getting stomachaches, talk with their pediatrician to check for other possible causes. 

Stomach virus 

A stomach virus, such as norovirus, can cause cramps, nausea, vomiting, diarrhea and sometimes fever. These infections spread easily in schools, child care settings and households. 

Most children recover at home, but vomiting and diarrhea can cause dehydration, especially in younger children. 

Recurring stomachaches can have several causes, including constipation, food intolerance and stress. However, some conditions require medical evaluation, especially when pain is persistent or accompanied by other symptoms.

Here are some conditions to watch for:

Appendicitis 

Appendicitis requires emergency treatment. Pain may start near the belly button and move to the lower right side. Other symptoms include fever, vomiting or loss of appetite. Signs may differ in younger children. 

Inflammatory bowel disease 

Inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis, causes ongoing inflammation in the digestive tract. 

Symptoms may include recurring stomach pain, diarrhea, blood in the stool, fatigue and unexplained weight loss. 

Other possible causes 

Urinary tract infections, acid reflux and menstrual cramps can also cause stomach pain in kids and teens. 

Sudden, severe pain in the lower belly or testicles requires emergency medical care. 

Most mild stomachaches improve on their own. But constant, worsening or severe pain may signal a problem that needs medical attention.

Seek emergency medical care if your child has: 

• Severe, constant pain that makes it hard to move or walk 
• Worsening pain in the lower right belly, which may be appendicitis 
• Green or bloody vomit, or blood in the stool 
• A swollen, very painful belly 
• Severe dehydration with unusual sleepiness or weakness 
• Sudden, severe lower abdominal or testicular pain 
• Trouble breathing, fainting or difficulty waking up 

Call your pediatrician promptly if your child has: 

• Constant stomach pain that doesn’t let up for more than two hours
• Pain that worsens or interferes with daily activities 
• Repeated vomiting or trouble keeping fluids down 
• Signs of dehydration, such as less urination, dry mouth or fewer tears 
• Stomach pain with fever, especially if your child seems ill 
• Pain or burning when urinating 
• Recurring stomachaches, ongoing diarrhea or unexplained weight loss 

Call your pediatrician promptly if your child is younger than 2 and has unexplained stomach pain. Babies younger than 3 months with a fever of 100.4 degrees or higher need immediate medical evaluation. 

If your child seems seriously ill, don't wait for the pain to go away. 

For a mild stomachache without warning signs, rest, fluids and other simple home remedies may help your child feel better. 

Here are some things you can try: 

• Encourage rest. Let your child relax in a comfortable position. 
• Offer fluids. Give small, frequent sips of water. If your child has vomiting or diarrhea, an oral rehydration solution can help replace lost fluids and salts. Continue breast milk or formula for infants. 
• Try gentle warmth. Place a warm, not hot, compress on your child’s belly to ease cramps. 
• Offer small meals. Let your child eat familiar foods when hungry. Don’t force them to eat. 
• Encourage bathroom breaks. Sitting on the toilet may help if constipation is causing discomfort. 
• Check before giving medications. Ask your pediatrician before using laxatives or other stomach remedies. Ibuprofen can irritate the stomach. 

These tips are for mild stomach pain without warning signs. If your child’s pain gets worse or doesn’t improve, contact your pediatrician.