Stomach pain in children: Toddler tummy aches

Although tummy aches are a common complaint in children – the reason for five to 10 per cent of all visits to a doctor or emergency facility – they seldom turn out to be a cause for serious concern.

Most of the time, tummy pains are caused by a viral infection and disappear in a couple of days. A study from the University of Indiana showed that only one or two out of a hundred children had problems serious enough to require specific treatment or surgery.

Look for the signs

There are some signs, however, that you should bring to your healthcare provider's attention to help work things out. Oddly enough, severity of pain is not necessarily the most important issue. Gas trapped in a loop of bowel may cause sudden, inconsolable screaming in a child who writhes on the floor but has no fever, does not vomit and recovers by relaxing in a warm bath. Worrisome signs that may be more serious problems:

• A pattern of increasing pain over several hours that makes the child reluctant to stand up straight, let you touch his tummy or move;

• Abdominal pain associated with high fever;

• Vomiting, especially of brown, green or yellow material, or blood;

• A distended abdomen: one that is tense and swollen, protruding more than normal for your toddler;

• Pain with urination;

• Blood or pus in urine or dark brown urine, and

• Blood, darkened stools that look like currant jelly, or pus in the stool.

If your child has any of the symptoms above you should bring them to your healthcare provider's attention immediately.

Recurring abdominal pain

If recurring tummy aches wake the child at night and are associated with weight loss, this can signal a chronic inflammation or infection in the bowel.

Recurring complaints that come up only in stressful situations (such as going to a new school or day-care or leaving on a trip) and are accompanied by no other symptoms are a way of expressing tension. The child and the situation need investigation, not the tummy.

Pain plus rash

Abdominal pain accompanied by a rash on the buttocks and/or legs that resembles bruising can be caused by a condition called Henoch-Schonlein Purpura. You may never have heard of it, but it is surprisingly common. Nobody knows for sure what causes this condition, but it seems to be related to a bacterial or viral infection. Inflammation of the small blood vessels can lead to bleeding in the skin as well as the bowel and kidneys. While it's not life threatening, your paediatrician will want to watch your child carefully over the course of a few days.

Food sensitivity

Food sensitivity, especially lactose intolerance, can cause cramping and wind. There is frequently (but not always) a family history of problems digesting milk. If you suspect this is the problem, eliminate milk and milk products (or whichever food you think is responsible) for a week. If the symptoms disappear, reintroduce it. If symptoms return when milk is introduced, talk to your healthcare provider about adjusting your child's diet to eliminate milk while providing enough calcium.

Unusual causes of tummy aches

Tonsillitis

It may surprise you to learn that tonsillitis can sometimes occur not with throat pain, but with a fever and tummy pain. Sometimes a child thought to have appendicitis has actually been diagnosed with tonsillitis instead.

Urine infections and pneumonia

Can sometimes cause abdominal pain as well. Paediatricians check urine samples and chest X-rays if they're not convinced that a tummy ache is in the tummy. Be alert to other complaints that come from other areas even if the main concern is the tummy.

Trust your instincts

If you think your child is really ill, let your healthcare provider know, even if there is nothing specific that you can put your finger on.