Abdominal Pain

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Abdominal pain is a common problem in children. Every child has instances where they have a “tummy ache” usually around the belly button. Most of the time the causes of pain don’t last very long and may be caused by constipation, gas, indigestion, or even the stomach flu. Ninety-five percent (95%) of abdominal pain isn’t from a serious medical condition and the child will get better on his/her own.

Acute abdominal pain felt in other areas may be something more serious. If the pain is located down the right side of the abdomen, it may be related to appendicitis and you should take your child to the Emergency Room immediately.

A careful medical history is important when a doctor is trying to determine the cause of the child’s pain. The doctor needs to know how often the pain occurs, what makes the pain better or worse, does it happen at mealtime or at school? Is there also diarrhea or constipation with the pain? A child’s feelings also need to be considered. When a child is worried, frustrated or unhappy (stressed), they may have stomach cramping or ache.

When abdominal pain happens over and over, it is called recurrent abdominal pain. There may be several different causes and it is important for your child to see the doctor:

  • Food allergies (including Celiac Disease)
  • Drinking too much fruit juice
  • Enzyme deficiencies (such as lactose intolerance)
  • Toxic substances
  • GERD
  • IBD
  • Gallbladder Disease
  • H. Pylori
  • Constipation
  • Stress
  • A stomach virus
  • Trouble urinating that may be caused by an infection


Your doctor may be able to detect the cause of the abdominal pain based on questions you answer (such as types of food eaten, contact with people with same symptoms, antibiotics use etc.). However, your doctor will usually take blood, stool, and/or urine samples for testing. Depending on the location of the child’s symptoms (whether the upper or lower stomach hurts), your doctor may order further testing.

If your doctor suspects that the child may have GERD he/she may want to conduct an Upper Endoscopy, and/or a pH Probe Study.

If your doctor suspects a bacteria in the child’s digestive tract, a H. Pylori Breath Test or Bacterial Overgrowth Breath Test may be conducted. Your doctor may also suspect that the child is lactose intolerant and needs a Lactose Intolerance Breath Test.

If the child’s pain has been in the lower abdomen, your doctor may want to conduct other tests in order to diagnose the problem. Some of these tests include Colonoscopy, Capsule Endoscopy, CT Scan, Ultrasound, HIDA Scan, Upper GI Series with SMBT.


Treatment varies depending on the cause of the recurrent abdominal pain and may consist of medication, changes in diet, techniques for coping with stress, or surgery in severe cases. Dietary changes are very helpful with chronic abdominal pain. Consider meeting with one of our dieticians for a nutritional consult. Call (865) 546-3998 to schedule an appointment.

A psychologist can help both the child and the family cope with a child’s pain, and can help the child get back to normal activities. Please also consider having your child meet with our psychologist, Regina Hummel, Ph.D. to discuss issues that may be related to the abdominal pain, such as stress etc. Call (865) 546-3998 to schedule an appointment.

DO NOT give your child any medication for abdominal pain without checking with your doctor first.

When to contact the Doctor

  • Bloody stools, severe diarrhea
  • Recurrent vomiting
  • Refusing to eat or drink anything for a long period of time
  • Pain when urinating, urinating a lot, or feeling it is urgent
  • High fever
  • Behavior changes
  • Pale, sweating, or sleepy or not wanting to do anything
  • Your child’s pain is severe and has lasted for more than 1 hour
  • Your child’s pain is constant and has lasted more than 2 hours
  • Your child’s pain comes and goes and lasts more than 24 hours (1 day)
  • You have questions or concerns.