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Abdominal Pain

Children often experience a stomach-ache. It can be caused by illness (stomach flu or a bacterial, viral, or parasitic infection), constipation, or anxiety, even hunger. Most of the time, stomach-aches can be resolved with a bland diet, rest, and fluids.

But there are times when sudden or chronic abdominal pain is a marker of something more serious, especially when accompanied by weight loss, persistent vomiting or if there is blood in the stool, all of which should be a sign to call your child’s doctor.

Your child should see a doctor if abdominal pain

  • Lasts longer than 24-hours
  • Is in the lower, right side of the abdomen
  • Is accompanied by vomiting or diarrhea
  • Is caused by an injury
  • Results in a swollen stomach that is hard to the touch
  • Occurs along with bleeding in the stool

Pay attention to where your child is having pain. If it’s low and on the right side of the abdomen, it could be appendicitis. If you notice green vomit, there could be an intestinal blockage that must be treated quickly. Blood in the stool also could be a symptom of infection or inflammatory bowel disease.

Peptic Ulcer Disease

When acid in the digestive tract creates open sores on the inner surface of the stomach or small intestine, they can cause abdominal pain. These sores, called peptic ulcers, cause symptoms such as heartburn or indigestion, bloating, dark or bloody stools, chest pain or nausea in addition to stomach pain. Children also may not tolerate spicy or fatty foods very well.

Peptic ulcers can form inside the stomach or duodenum (the upper tract of the small intestines). One of the most frequent causes of peptic ulcers is the presence of Helicobacter pylori (H. Pylori), a type of bacteria responsible for many stomach infections and inflammation. Another cause could be the frequent use — or over-use — of aspirin, ibuprofen, and naproxen products. In rare cases, it could be a marker for stomach cancer.

Pediatric gastroenterologists at SSM Health Cardinal Glennon Children’s Hospital should be consulted if you have recurrent or chronic abdominal pain. To check for ulcers, they may order tests (endoscopy or Upper GI test) that enable them to see directly inside your digestive tract. Lab tests also will be ordered to check for the presence of bacteria.

Treatment will depend upon what caused the ulcers. Antibiotics can kill infections and other over-the-counter or prescription medications can reduce stomach acid.

Functional Abdominal Pain

About 10-15 percent of all school-age children experience a condition known as functional abdominal pain (also called intractable abdominal pain), where children experience persistent stomach aches for months at a time. It is called functional because the pain occurs even though there is no blockage, inflammation (irritation), cancer, or infection.

Symptoms include diarrhea or constipation (or both), indigestion, bloating, and vomiting along with mild, moderate, or severe episodes of recurrent abdominal pain.

SLUCare pediatric gastroenterologists at SSM Health Cardinal Glennon specialize in evaluating abdominal pain in children and identifying potential causes. For some children diagnosed with functional abdominal pain, treatment can be a matter of changing your child’s diet or working to reduce their stress level.

We have a multidisciplinary team of doctors, nurses, dieticians, and social workers who work with families to identify the cause and then treat functional abdominal pain. Diagnosis usually involves a medical exam and screening tests if needed, such as blood, urine, and stool tests. Imaging tests, including X-rays, ultrasound, or computed tomography (CT) scans also may be ordered.

Our team will work closely with you and your child to create an individualized treatment plan that may include:

  • Diet modifications
  • Medications
  • Cognitive behavioral therapy
  • Pain control
  • Physical therapy
  • Patient education
  • Percutaneous electrical nerve field stimulator (PENFS) system
Two main conditions that fall under functional abdominal pain are:


A chronic condition that can cause abdominal pain and which is often accompanied by a bloated feeling and bouts of chronic diarrhea, constipation, or both. It is one of the most common gastrointestinal disorders in the United States, affecting both children and adults.

IBS can be diagnosed with history and a medical exam as well as additional screening labs such a blood work.

IBS Symptoms

  • Persistent abdominal pain
  • Bloating
  • Gassiness (excess flatulence)
  • Chronic bouts of constipation and/or diarrhea

Dyspepsia is a pain that radiates from the upper middle part of your abdomen. Symptoms, which include pain and bloating, sometimes mimic that of an ulcer because it can cause a burning sensation in the stomach.

Dyspepsia is typically diagnosed with history taking and a medical exam, along with screening labs such as blood test. An endoscopy, which is a procedure during which a flexible scope is sent down your child’s throat to see inside the esophagus and stomach as well as part of the intestines, also may be ordered. Your child’s doctor also may ask for a test to check for Helicobacter pylori (H. pylori), which is a known bacteria that causes stomach pain.

Once diagnosed, treatment may involve simple, over-the-counter medications or prescription drugs.

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