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Chronic Abdominal Pain in Children


What is chronic abdominal pain in children?

Children aged 4 to 17 years may have chronic abdominal pain. The pain occurs in your child's abdomen at least 3 times in 3 months.

Abdominal Organs

What are different types of chronic abdominal pain in children?

  • Abdominal migraine is severe abdominal pain with nausea, vomiting, or loss of appetite.
  • Functional abdominal pain is pain that has no known cause. Your child may not want to do his or her daily activities because of the pain.
  • Functional dyspepsia is upper abdominal pain that does not go away when your child has a bowel movement.
  • Irritable bowel syndrome (IBS) is abdominal pain that goes away when your child has a bowel movement. Your child's bowel movements may also look different, or he or she may have more bowel movements than usual.

What causes chronic abdominal pain in children?

  • Inflammation of the esophagus or stomach, or infections such as a parasite infection or a urinary tract infection
  • Menstrual cycle (period) for females
  • Anxiety and stress from problems at school or home
  • Constipation or lactose intolerance
  • A peptic ulcer, Crohn disease, or a urinary tract infection
  • Kidney stones or gallstones

What are the signs and symptoms of chronic abdominal pain?

Signs and symptoms of chronic abdominal pain will come and go. Your child may have them for a day or more, and they may go away but return. Your child may feel pain in all areas of his or her abdomen, and he or she may not want to eat. He or she may not want to do his or her daily activities, such as school or sports. He or she may also have any of the following:

  • Cramping
  • Bloating and gas
  • Constipation or diarrhea
  • Slow growth or growth failure
  • Nausea or vomiting
  • Weight loss without trying

How is the cause of chronic abdominal pain diagnosed?

Your child's healthcare provider will ask about your family history of abdominal pain or problems. Tell him or her if your child takes any medicines, and how well he or she eats and sleeps. Tell him or her if your child has any other health problems or has missed activities because of his or her pain. Tell him or her if your child has been stressed or worried lately. The provider will examine your child, and may have your child rate his or her pain using a pain scale. Your child may also need any of the following:

Pain Scale
  • Blood, urine, or bowel movement tests may be used to check for a disease or infection that may be causing symptoms.
  • Ultrasound, x-ray, CT, or MRI pictures may be used to check for problems such as blocked intestines. Your child may be given contrast liquid to help healthcare providers see the pictures better. Tell the healthcare provider if your child has ever had an allergic reaction to contrast liquid. Do not let your child enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if your child has any metal in or on his or her body.
  • A colonoscopy is used to look at your child's colon. A tube with a light on the end will be put into your child's anus. The tube is then moved up into his or her colon.

  • An endoscopy is used to look at your child's digestive tract. A scope is a long, bendable tube with a light on the end. A camera may be hooked to the scope so the healthcare provider can take pictures. Samples may be taken from your child's digestive tract and sent to a lab for tests.
    Upper Endoscopy (Child)
  • A food elimination test is used before tests to check for celiac disease or irritable bowel syndrome (IBS). For this test, your child will not eat or drink anything that contains lactose. Examples include milk and cheese. This will continue for a few days to see if your child's symptoms improve. More tests are used to find if your child has celiac disease or IBS.
  • A breath test is used to check for problems your child may have with absorbing nutrients from food.
  • A pregnancy test may be done for your daughter if she has started having periods.

How is chronic abdominal pain treated?

Healthcare providers may not find a medical problem that is causing your child's abdominal pain. If no problem is found, they will work to decrease your child's symptoms so he or she can return to his or her normal activities. With treatment, your child's abdominal pain may decrease, happen less often, or go away. Your child may need any of the following:

  • Medicines may be given to decrease stomach acid or treat a bacterial infection. Your child may also be given medicine to decrease diarrhea or to calm his or her stomach and control vomiting. Antidepressants may also be given to help decrease your child's anxiety or help relax his or her upper abdomen. Do not stop giving this medicine to your child unless his or her healthcare provider tells you to.
  • Cognitive behavioral therapy can help your child learn to cope with stress. Your child will learn how to decrease or cope with his or her pain if it happens when he or she is scared or worried.
  • Surgery is rarely needed, but may be done if there is something wrong with your child's abdomen. This could be because an organ in your child's abdomen is out of place, or not working correctly. A blocked intestine is an example of why your child may need surgery.

How can I help manage my child's chronic abdominal pain?

  • Apply heat on your child's abdomen for 20 to 30 minutes every 2 hours for as many days as directed. Heat helps decrease pain and muscle spasms.
  • Make changes to the foods you give to your child, if needed:
    • Give your child more fiber if he or she has constipation. High-fiber foods include fruits, vegetables, whole-grain foods, and legumes.

    • Do not give your child foods that cause gas. , Examples include broccoli, cabbage, cauliflower, and carbonated drinks.
    • Do not give your child foods or drinks that contain sorbitol or fructose if he or she has diarrhea and bloating. Some examples are fruit juices, candy, jelly, and sugar-free gum. Do not give him or her high-fat foods, such as fried foods, cheeseburgers, hot dogs, and desserts.
    • Have your child drink more liquid and eat small meals more often. This may help decrease his or her abdominal pain. Ask your child's healthcare provider how much liquid your child should have and which liquids are best for him or her. The provider may recommend an oral rehydration solution (ORS). An ORS contains electrolytes that will help your child's digestive system.
  • Keep a diary of your child's pain. A diary may help your child's healthcare provider learn what is causing your child's abdominal pain. Include when the pain happens, what your child is doing, how long it lasts, and how he or she says it feels.
  • Encourage your child to keep doing his or her usual activities. Encourage your child to talk about things that worry him or her. Find out if there are stressors at school by talking with your child's teachers. You may be able to help your child learn to cope better.

When should I seek immediate care?

  • Your child's abdominal pain gets worse and spreads to his or her back.
  • Your child's bowel movement has a large amount of blood in it, or looks like black tar.
  • Your child cannot stop vomiting, or vomits blood.
  • Your child has diarrhea for 1 to 2 weeks.
  • Your child has trouble breathing, and his or her skin looks pale.
  • Your child's pain wakes him or her during the night.
  • Your child has trouble swallowing, or pain when he or she swallows.

When should I call my child's doctor?

  • Your child has abdominal pain that wakes him or her up at night.
  • Your child has pain on his or her right side that does not go away.
  • Your child has a fever.
  • Your child has new mouth sores, trouble swallowing, or is losing weight without trying.
  • Your child is not drinking liquids, and he or she is not urinating.
  • You have questions or concerns about your child's condition or care.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's healthcare providers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

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