Ask Dr. Cavallo
How do I know when my child’s stomach ache is serious? When should I call the doctor?
Stomach aches are common and often no more serious than a short-lived intestinal virus. But they can also signal problems that require immediate medical attention.
Pain that comes and goes is more likely to be a stomach bug. Regular claims of stomach pain at bedtime or when it’s time to go to school – but not on weekends or vacations – might be simple avoidance tactics.
However, pain that’s continuous or gets worse may signal something more serious, such as appendicitis or intestinal blockage. When a child has pain that doesn’t go away or increases, or has severe pain accompanied by fever, vomiting, skipping meals or apparent dehydration, call you doctor.
Many Causes of Stomach Aches
Getting at the cause of stomach pain takes detective work. A family history of kidney stones, gallstones, irritable bowel syndrome, Crohn’s disease or ulcerative colitis suggests stomach pain is more likely to be from one of these conditions.
Acid reflux disease, or heartburn, is surprisingly common, particularly among premature infants. They may spit up frequently or become fussy and arch their backs after feedings. Older children may have this and not mention symptoms such as wet burps or burning in the chest.
Constipation is a frequent source of pain among school age children, who may not realize it’s not normal to skip many days of bowel movements or to have painful movements.
Chronic stomach pain can be a sign of celiac disease, a disorder linked to a negative reaction to wheat gluten. It affects about one in 133 people. The odds increase to one in 22 for children whose parent or sibling has it.
Some stomach pain is harder to explain. A condition called chronic abdominal pain of childhood affects 13 percent of middle-school and 17 percent of highschool students, and it accounts for 2 to 4 percent of pediatric office visits. Many children outgrow it, but some develop irritable bowel syndrome as adults.
Food allergies may be also be a culprit. They’re generally accompanied by rash, bloating or vomiting after a child eats certain foods.
If you’re ever in doubt about the cause of your child’s stomach pain, check with your doctor.
Charles Cavallo, MD, is a pediatrician with Pediatric Associates, PSC, in Northern Kentucky.
