Stomach ache in children: when to watch and when to see a doctor

Evgeniya Loik — GP, pediatrician, gastroenterologist, nutritionist

The common, harmless causes

Children get stomach aches often, and most of the time the cause is benign: overeating or unfamiliar food, constipation, trapped gas, or anxiety — "my tummy hurts before school" is a real and well-described phenomenon, not an excuse. Pain like this is usually short-lived, comes without fever, and the child behaves normally between episodes.

When to seek care urgently

Do not wait if abdominal pain comes with any of the following:

• severe pain, pain that is getting worse, or pain that wakes the child at night;
• fever, repeated vomiting (especially green or bile-stained), or forceful projectile vomiting in an infant;
• blood in the stool, or black stools;
• a rigid abdomen, or a child who will not let you touch it;
• pain that has shifted to the lower right side of the abdomen;
• marked lethargy, refusing to drink, or signs of dehydration.

When to book a routine appointment

If there are no red flags but the pain keeps coming back — weekly or more often over a month — that is worth a planned visit to a pediatrician or pediatric gastroenterologist. Recurrent abdominal pain is rarely "just how they are": it usually has a specific, findable cause, from constipation and food intolerance to functional abdominal pain.

How the assessment works

It starts with a conversation and an examination — an experienced doctor narrows the list of possible causes at that stage alone. Anything further is ordered only if the findings call for it: lab tests, an abdominal ultrasound. We do not run a "full work-up just in case" — that is what evidence-based practice means in day-to-day paediatrics.

At GMS children are seen by pediatricians consulting in English and Russian, including a pediatrician-gastroenterologist; that consultation is AED 750, with ultrasound in the same clinic on the same visit and lab tests taken there too. If your child is too unwell to travel, a doctor can come to you.

Guidelines referenced

• American Academy of Pediatrics (HealthyChildren.org). Abdominal Pain in Children
• NASPGHAN — North American Society for Pediatric Gastroenterology, Hepatology and Nutrition

FAQ

What usually causes stomach ache in children?

Most of the time the cause is benign: overeating or unfamiliar food, constipation, trapped gas, or anxiety — “my tummy hurts before school” is a real and well-described phenomenon. Pain like this is usually short-lived, comes without fever, and the child behaves normally between episodes.

When should we seek care urgently?

With severe pain, pain that is getting worse or wakes the child at night; fever, repeated vomiting, especially green or bile-stained, or forceful projectile vomiting in an infant; blood in the stool or black stools; a rigid abdomen or a child who will not let you touch it.

The pain keeps coming back but is not acute — what then?

If there are no red flags but the pain returns weekly or more often over a month, that is worth a planned visit to a pediatrician or pediatric gastroenterologist. Recurrent abdominal pain usually has a specific, findable cause, from constipation and food intolerance to functional abdominal pain.

Which tests are ordered?

It starts with a conversation and an examination — an experienced doctor narrows the list of possible causes at that stage alone. Anything further is ordered only if the findings call for it: lab tests, an abdominal ultrasound. We do not run a “full work-up just in case”.

This article is for information only and does not replace a consultation. If you have symptoms, see a doctor.

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