Stomach pain in children – causes, symptoms and when to see a doctor

Abdominal pain in children refers to pain or discomfort in the abdominal area and is one of the most common reasons parents seek medical advice. In the vast majority of children, the cause is harmless — typically constipation, a viral infection or functional abdominal pain, where no physical cause can be identified. Only a small proportion of children have an underlying medical condition. On this page, you can learn about the most common causes, when to seek medical advice, and how examination and treatment are carried out.

How Does Abdominal Pain Present in Children?

Abdominal pain in children can present in very different ways depending on the child's age. Younger children often find it difficult to describe exactly where the pain is located and will typically point to the area around the navel, regardless of where the problem actually originates in the abdomen. Very young children may instead pull their legs up towards their body or cry for long periods.

The pain may develop suddenly and be severe, or it may recur over a longer period. Recurrent abdominal pain is typically defined as at least three episodes over two to three months, where the pain affects the child's everyday life — for example, school attendance or leisure activities.

The pain is often located around the navel and occurs without other signs of illness, such as fever or weight loss. Some children also experience nausea, bloating, changes in bowel habits or feeling full quickly after eating.

What Are the Most Common Causes of Abdominal Pain in Children?

Constipation is one of the most common causes of abdominal pain in children, both in acute and recurrent cases. Constipation occurs when stools become hard and difficult to pass and may develop in connection with dietary changes, starting school or periods when the child avoids going to the toilet.

Acute abdominal pain is also frequently caused by a common viral gastrointestinal infection, which may lead to nausea, vomiting, diarrhoea and fever in addition to abdominal pain.

In younger children, abdominal pain may also occur as a result of illness affecting other parts of the body, such as a middle ear infection or urinary tract infection.

When abdominal pain is recurrent, the vast majority of children have what the Danish Paediatric Society refers to as functional abdominal pain.

This means that no physical cause can be identified, even though the pain is very real for the child.

Functional abdominal pain is associated with how the gut and brain communicate through a network of nerves and chemical messengers — known as the gut-brain axis. When this communication becomes particularly sensitive, ordinary sensations from the abdomen may be experienced as uncomfortable or painful.

Stress and worry — both in the child and within the family — can trigger or intensify the pain, but this does not mean that the pain is "only psychological".

Only a small proportion of children with recurrent abdominal pain have an underlying physical disease as the cause.

How Is a Child Examined for Abdominal Pain?

When your child is examined for abdominal pain, the doctor will begin by asking about the nature of the pain: where it is located, how long it has been present, whether it occurs in connection with eating or bowel movements, and whether there are any other symptoms.

The doctor will then examine the abdomen by looking, listening, gently tapping and carefully pressing on different areas.

For most children with typical recurrent abdominal pain and no warning signs, this thorough discussion and examination are sufficient for the doctor to reassure the family and develop a management plan.

In some cases, however, further investigations may be appropriate, such as blood tests or an abdominal ultrasound scan, if the doctor wishes to rule out other causes.

The need for additional investigations is always determined through an individual medical assessment.

How Is Abdominal Pain in Children Treated?

Treatment for abdominal pain in children depends entirely on the underlying cause and is always determined individually by the doctor.

If constipation is the cause, treatment will typically involve a combination of medication to regulate bowel movements, good toilet habits and possibly dietary changes. This type of treatment can take time, and it is not unusual for it to continue over an extended period.

For functional abdominal pain, one of the most important aspects of treatment is often helping the child and family understand what causes the pain and how best to manage it in everyday life.

This involves taking the child's pain seriously without exaggerating or minimising it, while also helping the child continue their normal activities, including attending school.

For some children, a structured approach focusing on sleep, regular meals and stress management can be beneficial.

If psychological or emotional difficulties contribute to the symptoms, it may be appropriate to involve other healthcare professionals in the treatment process.

In cases where abdominal pain is caused by an infection or another specific condition, treatment is directed towards that underlying cause.

When Should You Seek Medical Advice?

Most cases of abdominal pain in children are harmless and do not require urgent medical attention. However, you should contact a doctor if your child experiences abdominal pain together with one or more of the following symptoms:

Blood in the stool, prolonged diarrhoea or vomiting, yellowing of the skin or eyes, weight loss or loss of appetite over an extended period, pain when urinating, or waking at night because of abdominal pain.

The same applies if a previously toilet-trained child suddenly starts wetting themselves, or if the pain becomes more severe or more frequent over time.

If you are unsure, or if the abdominal pain continues to worry you and your family, it is always a good idea to have your child assessed by a doctor — even though, in many cases, no serious underlying condition is found.

Treatment at Charlottenlund Privathospital

At Charlottenlund Privathospital, your child can receive a thorough examination by a specialist in paediatrics.

We begin with a calm discussion with you and your child to gain a complete understanding of the symptoms, followed by a physical examination of the abdomen.

If necessary, we can offer additional investigations to help establish the cause and develop a plan for the next steps.

Book an appointment online.

Sources:

- Danish Paediatric Society: Recurrent Abdominal Pain in Children (RAS) – National Clinical Guideline (2022).