ABDOMINAL PAIN

Symptom Definition

• Pain or discomfort located between the bottom of the rib cage and the groin crease.
• The older child complains of a stomachache.
• The younger child should at least point to or hold the abdomen

See More Appropriate Topic (instead of this one) If

• CONSTIPATION present and abdominal pain is mild
• DIARRHEA present and abdominal pain is mild
• URINATION, PAIN WITH present and abdominal pain is mild
• VOMITING present and abdominal pain is mild
• Crying and not sure what's causing it, see CRYING

WHEN TO CALL YOUR DOCTOR FOR ABDOMINAL PAIN

Call 911 Now (your child may need an ambulance) If:

• Not moving or too weak to stand

Call Your Doctor Now (night or day) If

• Your child looks or acts very sick
• You suspect poisoning with a plant, medicine, or chemical
• Unable to walk or walks bent over holding the abdomen
• Pain mainly low on the right side
• Pain or swelling in the scrotum or testicle
• Severe pain anywhere
• Pain (or crying) present > 2 hours
• Blood in the bowel movements or vomiting blood
• Vomiting bile (yellow or green)
• Recent injury to the abdomen
• Age under 2 years
• Fever > 105°F (40.6°C)

Call Your Doctor Within 24 Hours (between 9am and 4pm) If

• You think your child needs to be seen

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns
• Abdominal pains are a recurrent ongoing problem

Parent Care at Home If

• Mild abdominal pain and you don't think your child needs to be seen

HOME CARE ADVICE FOR MILD ABDOMINAL PAIN

1. Reassurance: A mild stomachache can be caused by something as simple as gas pains or overeating. Sometimes a stomachache signals the onset of a vomiting or diarrhea illness from a virus (gastroenteritis). Watching your child for 2 hours will usually tell you the cause.
2. Rest: Encourage lying down and rest until feeling better.
3. Clear Fluids: Offer clear fluids only (e.g., water, flat soft drinks or 1/2 strength fruit juice). For mild pain, offer a regular diet.
4. Prepare for Vomiting: Keep a vomiting pan handy. Younger children often refer to nausea as a "stomachache."
5. Pass a BM: Encourage sitting on the toilet and trying to pass a bowel movement (BM). This may relieve pain if it is due to constipation or impending diarrhea.
6. Avoid Medicines: Any drug could irritate the stomach lining and make the pain worse. Do not give any medicines for stomach cramps.
7. Expected Course: With harmless causes, the pain is usually better or resolved in 2 hours. With gastroenteritis (stomach flu), belly cramps may precede each bout of vomiting or diarrhea and last several days. With serious causes (such as appendicitis), the pain worsens and becomes constant.
8. Call Your Doctor If:
   • Pain present > 2 hours
   • Mild pain present > 48 hours
   • Your child becomes worse or develops any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Pediatric HouseCalls Online. Copyright © 2000-2005 Barton Schmitt, M.D. FAAP

Reviewed 8/2005

Revised 8/2005

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