Abdominal Pain in Children: Common Causes and Appendicitis Warning Signs
“My tummy hurts” is one of childhood's most common complaints, and most of the time the cause is minor: constipation, gas, a stomach bug, or even anxiety about school. But abdominal pain is also how appendicitis announces itself — so every parent should know what separates an ordinary tummy ache from an emergency.
What are the most common causes of stomach pain in kids?
- Constipation — the single most common cause of recurrent belly pain in children. Hard, infrequent stools and pain that comes and goes point this way.
- Gas — crampy pain that moves around and eases after passing gas or a bowel movement.
- Stomach virus — crampy pain with vomiting or diarrhea.
- Anxiety or stress — real pain, often on school mornings, that fades once the stressful moment passes.
- Urinary tract infection — lower belly pain with burning during urination or new bedwetting.
What are the warning signs of appendicitis?
Appendicitis is the emergency we worry about most with belly pain. Watch for this pattern:
- Pain that starts near the belly button and moves to the lower right side
- Pain that gets worse with movement — walking, jumping, coughing, or riding in the car over bumps
- Loss of appetite, then nausea or vomiting
- Fever developing after the pain starts
- A child who wants to lie still and guards their belly when touched
Seek emergency care for belly pain if:
- Severe, worsening, or constant pain — especially pain localizing to the lower right side
- A rigid, hard, or very tender belly, or pain when you press and let go
- Green (bilious) vomit or vomit that looks like stool
- Bloody or black stools
- Belly pain with testicular pain or swelling in boys (possible testicular torsion — a time-critical emergency)
- Intermittent episodes of severe pain with drawing up the legs and “currant jelly” (bloody, mucus-like) stool in a baby or toddler — possible intussusception
- Belly pain with lethargy, pale/clammy skin, or signs of dehydration
What can I do at home for mild stomach pain?
- Offer small sips of water; avoid sugary drinks
- A warm compress or warm bath can ease crampy pain
- Encourage a bowel movement if constipation is likely — and address constipation generally with fluids, fiber, and activity
- Avoid pain medicine at first if you are considering an ER visit — it can mask symptoms doctors need to evaluate. Ask first if unsure.
- Watch and note: where is the pain, is it constant or crampy, what makes it better or worse, and is there fever, vomiting, or diarrhea?
When should I call the pediatrician?
- Belly pain lasting more than a few hours without improvement
- Recurrent stomachaches (keep a simple diary of timing, foods, and bowel habits)
- Pain with fever, vomiting, diarrhea, or painful urination
- Weight loss or poor growth alongside belly pain
Related reading: vomiting & diarrhea, urgent care or ER? (blog).
Sources
This guide was reviewed against guidance from:
Frequently asked questions
What does appendicitis feel like in a child?
Typically pain starts vaguely around the belly button, then localizes to the lower right side and worsens with movement, jumping, or coughing. Loss of appetite, nausea, vomiting, and fever usually follow. It needs emergency evaluation.
Should I give pain medicine for stomach pain?
For mild, clearly minor pain it is fine. But if the pain is significant and you might go to the ER, hold off — pain medicine can mask findings the doctor needs. When in doubt, call first.
Can constipation really cause severe pain?
Yes — constipation is the most common cause of recurrent abdominal pain in children and can be surprisingly painful. But new, severe, or worsening pain should still be evaluated rather than assumed to be constipation.
What is intussusception?
A condition where part of the intestine telescopes into itself, usually in babies and toddlers. It causes intermittent episodes of severe pain, drawing up the legs, vomiting, and bloody mucus-like (‘currant jelly’) stool — an emergency.
Reviewed by Ali Ozcan, MD, MBA
Board-certified pediatric emergency medicine physician and creator of ER4Kids. This guide reflects the same trusted, evidence-based guidance Dr. Ozcan provides to families in the emergency department.
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