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 (after 6-12 months old). Prior to 6 months the Crying protocols should be used

See More Appropriate Topic If

• Constipation is present and abdominal pain is mild
• Diarrhea is present and abdominal pain is mild
• Pain with Urination is present and abdominal pain is mild
• Vomiting is present and abdominal pain is mild

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 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 > 104°F (40°C)

Call Your Doctor Within 24 Hours (between 9 and 4) 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 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 indigestion, gas pains or overeating. Sometimes a stomachache signals the onset of a vomiting illness from a virus. Watching your child for 2 hours will usually tell you the cause.
2. Rest: Encourage lying down and resting until feeling better.
3. Clear Fluids: Offer clear fluids only (e.g. water, flat soft drinks or 1/2 water 1/2 fruit juice).
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 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, belly cramps may precede each bout of vomiting or diarrhea. With serious causes (such as appendicitis) the pain worsens and becomes constant.
8. Call Your Doctor If
   • Pain is present > 2 hours
   • Your child becomes worse or develops any of the “Call Your Doctor Now” symptoms