Is It Serious?

How to Know When Abdominal Pain Is Something More

By Tiffany D. Kratzer, MD, Director of Pediatric Inflammatory Bowel Disease Center, Director of Pediatric Endoscopy, Wake Forest Baptist Health Brenner Children’s Hospital


Mild abdominal issues are common in children. If your child complains about belly pain, chances are it’s nothing to be concerned about. In some cases, however, abdominal pain can indicate something more serious. Knowing the warning signs can help you determine whether your child needs medical attention or simple at-home care.

Red Flags

When it comes to abdominal pain and related issues, the following are symptoms you should be concerned about:

  • Intense abdominal pain that lasts longer than two weeks
  • Diarrhea that lasts longer than two weeks
  • Vomiting that lasts longer than two weeks
  • Loss of appetite
  • Weight loss
  • Blood in the stool
  • Blood in vomit
  • Abdominal pain with accompanying joint pain
  • Food getting stuck in the throat

Serious abdominal symptoms like these can be due to any number of causes. These may include celiac disease, an inflammatory bowel disease such as Crohn’s disease or ulcerative colitis. Other causes may be chronic reflux, allergic esophagitis or something rarer. That’s why it’s important to take your child to his or her pediatrician to have serious symptoms evaluated. Then, if necessary, your pediatrician can refer you to a pediatric gastroenterologist.

Fortunately, most abdominal symptoms in children don’t have serious causes. In toddlers, the most common sources of abdominal pain are constipation and hunger. Reflux is common in younger children as well.

Constipation and reflux often occur in older children and teens, too. Some kids in this age group can develop irritable bowel syndrome (IBS). This is a non-life-threatening chronic abdominal pain disorder due to nerve ending sensitivity.

Treating Abdominal Issues at Home

For constipation, increase your child’s fluid intake, particularly water. Limit lactose (cheese and milk) and increase fiber (fruits and vegetables). It’s also important to remind younger children to sit on the toilet regularly and remain on the toilet long enough to have a full bowel movement.

Fluid intake is also essential for treating diarrhea. Probiotics are a naturally healthy way to address both constipation and diarrhea. They can even be given to babies in liquid form.

To treat minor reflux symptoms at home, make sure your child avoids foods that are high in acid (citrus fruits, tomato-based products) and fatty or greasy foods. Also eliminate caffeine intake, including chocolate products. Keep infants in an upright position and avoid having older children lie down for 30 minutes after a meal. Eating earlier in the evening can help as well.

If consistent at-home care isn’t properly managing your child’s symptoms, talk to your pediatrician. He or she can recommend additional treatment or referral options.

Have you had to alter your child’s diet to address abdominal symptoms? If so, share your food tips in the comments below. To make an appointment with a Brenner Children’s Hospital pediatric specialist call 336-716-WAKE.


*Sponsored by Brenner Children’s Hospital