Five little words no parent wants to hear

“I have a belly ache.”

Whether it’s night or day, those five little words can cause big concern for parents. What can you do to treat and comfort your child?

“Stomach pain is one of the most common complaints in children, and it can be caused by a variety of reasons,” said Roshann L. Hooshmand, MD, a pediatrician at Cape Cod Pediatrics in Forestdale.

Gastroenteritis

If the stomach pain is combined with nausea, vomiting or diarrhea, viral gastroenteritis is often the cause. Onset can be sudden; symptoms usually subside in 24 to 48 hours, but the child needs plenty of care during that time. 

“When they’re able to tolerate fluids, we typically recommend oral rehydration with an electrolyte replacement and then slowly resume their diet,” she said. “Kids who have persistent vomiting or pain or persistent diarrhea with blood or mucus need to be medically evaluated.”

Constipation

Constipation is one of the most common medical reasons for belly pain that Dr. Hooshmand sees in kids, she said.

“In a child who occasionally complains of stomach pain, but is going to school, growing normally and not being awakened by belly pain at night, constipation is often the cause.”

Dr. Hooshmand said there are two types of constipation – the kind where kids don’t go regularly and the kind where they’re not fully evacuating their bowels. Treatments include stool softeners and working on their habits.

“Children live busy lives, just as adults do, and they don’t always have the opportunities to eat well. They need to eat a diet that’s balanced and filled with fruits, veggies and enough fluid. They need to listen to the cues of their body that tell them when they need to go to the bathroom.

“Make sure the child takes time in the day to go to the bathroom, whether it’s before they go to school or after they come home from school or after they have supper at night. When the children are young, we encourage parents to take their kids to the bathroom, either before or after a meal.”

Emotional Reasons

Emotional issues can sometimes translate to stomachaches.

“When they get stressed, children tend to feel things physically, and the stomach is definitely a place where they can feel things,” she said. “As part of our evaluation, we always ask about stressors.

“Sometimes when kids have stomach issues, we can’t find anything through a physical exam, but there has been a big change, like a divorce in the family or the loss of a loved one. Oftentimes by working on the coping strategies, we can gain some improvement.”

Acid Reflux

Just like adults, children sometimes suffer from acid reflux.

“When kids get stressed, oftentimes they have more acid production in their stomach and they have some gastritis symptoms,” she said. “But nowadays there are a lot of good options for over-the-counter antacids. Kids can use Tums or Mylanta, and that should alleviate it in the short term. If you have a child who’s having ongoing antacid needs, that needs further evaluation.”

When to See a Doctor

If stomach pain is waking a child at night, keeping them from going to school or is associated with a loss of appetite or weight loss, further evaluation is needed. That could include imaging studies and laboratory tests.

“We see a lot of belly pain in the office, and it’s interesting to evaluate the kids, but I think a lot of it is educating the parents,” she said. “They can help their children understand their bodies and what they’re feeling, and understand the associations between stomach pain and eating, stress and going to the bathroom.”