Site logo icon

Abdominal Pain in Kids: What’s Normal and When to Worry

We frequently see this scenario: a child with abdominal pain that is so bad it makes them cry. It’s been going on for several days, they’ve thrown up, and now they won’t eat their favorite foods. All they want to do is lay on the couch. Eventually, the parents become worried about appendicitis.

Abdominal pain is a tricky, but a super common complaint for kids. “Dr. Google” will tell a concerned parent it’s anything from constipation to appendicitis. Our goal is to offer a reliable, and more comforting perspective on belly pain in kids.

The Most Common Causes


1. Constipation.

This child often complains of intermittent abdominal pain for days. The pain tends to be sharp and crampy, and may even make kids cry out in pain. In our experience, these kids tend to complain more about their pain in the afternoon or evening.

Constipation in kids doesn’t mean “no poo for 5 days.” It tends to be incomplete emptying of the bowel because there are more fun things to do than spend time on the toilet. As a result, the stool backs up. The intestines pull out even more water making poo harder, and then the muscles squeeze and squeeze to try and get the extra poo out.

Interestingly enough, constipated kids sometimes have urine symptoms, like peeing frequently or even having accidents. It’s kind of like being pregnant: the belly is so full of poo, that it pushes on the bladder, just like a baby would; there’s less space, which means more accidents and more frequent trips to the potty.

2. Gas.

This pain looks a lot like constipation pain: sharp and stabbing, intermittent, and without other illness symptoms like fever or vomiting. The biggest difference is there is no stool when we look on a belly x-ray, or an enema doesn’t make much progress. Just like constipation, though, these kids are in a lot of pain, which can be really stressful for families.


1. Gastroenteritis (stomach virus)

This one is a little easier to see. These kids get abdominal pain suddenly and usually have friends or family with a stomach virus already. Kids may have fever, nausea, and vomiting with the pain, and then the diarrhea starts. It hits quickly, though, generally within 24 hours after exposure. This type of abdominal pain typically gets better about 2 days after the vomiting stops, but some kids still have pain for several days as their “insides” recover from the mass evacuation.

2. Bladder Infection

Abdominal pain due to a bladder infection is usually accompanied by some other symptoms: fever, nausea/vomiting, pain when peeing, accidents, and foul-smelling urine. Younger kids tend to have nausea/vomiting, and decreased appetite, whereas the older kids are better at reporting symptoms like painful peeing.

3. Pneumonia

Pneumonia abdominal pain comes with other symptoms, too. These kids look sick: fever, cough, decreased appetite, and fast breathing. Their bellies hurt because the pain from the lung infection is “referred” or felt in the nerve endings in the abdomen.

4. Strep Throat

Abdominal pain is one of the strep throat triad of symptoms. If your child has a sore throat, headache, and belly pain, having them tested for strep may be a good idea and can be done at KidMed Urgent Care with our on-site lab services.

The Most Worrisome Causes

**Disclaimer: Yes, these are scary, and yes, they need fixing right away. BUT, they are NOT the most common reasons kids complain of belly pain. If you’re the type of person who gets peace of mind from having more information, then read on. If this does not describe you, then skip this part!

1. Appendicitis

This is probably the number one reason parents are worried when they bring their child with abdominal pain. The most common symptoms of appendicitis are pain that starts out around the belly button and then localizes to the right lower belly, and abdominal “guarding.” That just means the kids do everything they can to protect their belly to keep it from moving. The bottom line, though, is to get your child checked if your parent’s radar goes off and you’re worried about appendicitis; you know your babies better than anyone else.

2. Intussusception

This is when the intestines “telescope” in on themselves, and cut off circulation. It hurts A LOT, and usually comes and goes. These kids have severe pain, inconsolable crying, and may pull their legs up; then it stops just as suddenly as it started. Some kids may also be throwing up bile and have bloody or “currant jelly” poo. It typically happens between 6 months and 6 years old, but it really peaks around 1.5 – 2.5 years old.

What Do You Do if Your Child Has Abdominal Pain?

  • Consider what else is going on: When was the last time they pooped? What have they been eating? (i.e., could this be gas from too much dairy?) Are there other illness symptoms with it? (fever, vomiting/diarrhea, painful peeing, etc).
  • Give it some time to see if the pain changes.
  • And finally, when in doubt, have them checked out. Remember, YOU are the expert on your child. So trust your instincts.

The pediatric urgent care professionals at KidMed Urgent Care are here to help.

Read More