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What do kids' tummy aches mean? Look for these signs, pediatricians say

Stomach pain in kids can have many causes — and some can be serious.
/ Source: TODAY

Stomach pain is one of the most common complaints among kids. But parents may be missing some causes of frequent tummy pain or treating those stomach aches incorrectly, a new poll suggests.

“Tummy pain is one of the things we see very often in primary care pediatrics,” Dr. Susan Woolford, pediatrician and co-director of the C.S. Mott Children’s Hospital National Poll on Children’s Health, tells  

The poll, released last month, included responses from a nationally representative sample of 1,061 parents of children ages 3 to 10. The results indicate that as many as one in six parents (17%) say their child has stomach aches at least once a month. But 42% of parents polled hadn’t discussed the issue with their child’s doctor.

It's not necessarily surprising that parents aren't talking to their pediatrician about every single stomach ache, Dr. Christina Johns, a Maryland-based pediatric emergency physician and spokesperson for the American Academy of Pediatrics, tells

But because frequent stomach pain can be a sign of underlying issues, including gastrointestinal problems and anxiety, she encourages parents to bring that to their doctor's attention.

"In my practice, I'd rather see somebody a million times and say, 'Hey, I think we're OK today,' rather than miss something concerning," says Johns, who was not involved with the new poll.

Common causes of stomach pain in kids:

In the new poll, parents reported a high level of confidence in identifying some of the common reasons for stomach pain in kids.

The experts tell that the most common causes of tummy aches in kids can include:

Rarely, stomach pain can signal a more severe issue. Of those more serious conditions, appendicitis is the most common, Woolford says.

Frequent tummy aches can be a sign of anxiety

Sometimes, chronic stomach aches in kids can be an early sign of underlying mental or emotional issues. And 27% of parents in the new poll attributed their child's tummy pain to anxiety, worry, avoiding school or trying to get attention.

While this finding may not be surprising amid the ongoing youth mental health crisis, Johns says, "It really sounds a big alarm bell that, as people and health care professionals, we've got to stay connected better for the care of the whole child."

One big concern is that this kind of pain may be easier to miss, experts say.

"Once it becomes really intense pain, then I think parents would seek care in those circumstances," Woolford says. But when children's stomach pain is chronic, meaning "it's concerning, but not as dramatic, but it happens but recurrently, sometimes that's hard for people (to recognize)," she adds.

If early symptoms of anxiety go unaddressed, they can develop into more serious avoidance behaviors, withdrawal from social activities, changes in eating and sleeping patterns and slipping grades, Johns says.

Another issue is that a third of parents in the survey reported using over-the-counter products to ease their child's stomach pain, which isn't appropriate for anxiety-related tummy aches. And some medications, especially those containing bismuth or salicylates (found in aspirin, for instance), can be harmful to young children, the experts warn.

"The temporary relief of pain medication is not helping to solve that particular question," Woolford says.

When to see a doctor:

Woolford and John say parents should pay attention to these signs, which can indicate a more serious cause of stomach pain:

  • The location of the pain. If the pain is in the lower right area of the abdomen, that could suggest appendicitis, for example, Woolford says.
  • Other symptoms associated with the pain. For instance, if the pain is associated with fever, vomiting, a hard or swollen belly or blood in the stool, Woolford says those are signs that the tummy pain could have a more severe cause.
  • Whether or not the child is able to participate in normal activities, like eating and playing. If the pain is so severe that it prevents those activities or wakes the child up during the night, that indicates a more serious issue.
  • The nature of the pain. Pain can be dull or sharp, for example, or it may be sudden, intermittent or chronic. Clues like these can help figure out what might be going on.

Properly addressing kids' stomach pains isn't just about treating it at the moment, Woolford says. "Because some of the more common causes are constipation and indigestion, we can (also) think about some preventive measures to avoid abdominal pain," she says.

That might include dietary changes, such as drinking more water, avoiding some highly processed foods or eating more fiber.

And if parents suspect their child's stomach pain might be due to anxiety or worry, "they shouldn't dismiss it," Woolford says.

A lack of access to quality mental health care for kids can make it challenging for parents to get the kind of help their children need, though, Johns says. But bringing it up to their pediatrician is a good first step, the experts agree.

"There are lots of kids with anxiety, worry, OCD and other (mental health issues) coming out of the pandemic," Johns says. "That's very, very real right now."