When ‘my tummy hurts’ isn’t just an excuse

Paul Tran, M.D.

Submitted photo

You know your child better than anyone. If they’re acting differently or you have a gut feeling something is wrong — call your doctor. We’d much rather see a child for a minor issue than miss something serious.”

As parents, how do we know when our child’s belly pains are something that will go away on its own versus something more serious? It’s a question every parent, including myself, has faced.

As a pediatrician, I’ve treated countless children with abdominal complaints, and I’m here to tell parents and educators something important: we need to take these symptoms seriously. A stomachache can signal a genuine medical issue — one that, if left untreated, can impact a child’s physical health, academic performance and emotional well-being.

Sometimes it’s nothing serious

Mild belly aches are common in children and usually nothing to worry about. They often come and go without preventing your child from playing or doing their usual activities. They may show up around mealtimes or during moments of stress or excitement.

However, you should be concerned if the pain is severe enough that your child doesn’t want to do their favorite activity, if the discomfort lasts for several hours without improvement or is accompanied by other symptoms like vomiting or fever.

What you can do from home

For mild symptoms, comfort is key. Encourage your child to rest in a comfortable position, offer small sips of clear fluids such as water or ginger ale and try a warm compress on the belly. Hold off on solid foods until they’re feeling better.

Always trust your instincts. If something feels off, don’t hesitate to seek medical care.

The truth about constipation

One of the biggest issues I see as a gastroenterologist is constipation. Many kids feel shy talking about bathroom stuff, but I tell them, “Hey, this is my job. I chose to talk about this all day! The situation may be pretty ‘crappy,’ but we can fix it. Let’s get to the ‘bottom’ of this problem so it stops being a ‘pain in the behind.’”

Constipation is typically defined as having fewer than three bowel movements a week or passing very large, painful stools. The number of bowel movements may vary from child to child, so what’s most important is a noticeable change from your child’s normal pattern.

Constipation is one of the most common causes of belly pain that seems to come and go. It can often be prevented with diet and lifestyle changes. Staying active is a great way to keep things moving.

Chronic tummy troubles

Some children may have ongoing stomach issues that aren’t emergencies but still disrupt daily life. These can include conditions like chronic constipation, inflammatory bowel disease, Celiac disease or even stomach ulcers.

For ongoing concerns, talk to your pediatrician. These include cases where your child has belly pain several times a week for more than a few weeks, consistently needs to stay home from school or activities, isn’t eating well or has unusual changes in bowel habits. Your pediatrician can help identify triggers and develop a plan to manage symptoms and pain.

Visit urgent care after hours for symptoms like persistent vomiting or moderate pain that keeps coming back but is not an emergency.

Signs it might be an emergency

There are key warning signs that should bring you straight to the emergency room. These include continuous vomiting, a fever with abdominal pain and blood in vomit. While bloody stools can be very alarming, they are generally less of an emergency and can usually be evaluated by your pediatrician.

You should also seek emergency care if your child has a belly that’s hard, swollen or extremely tender, is unusually drowsy or weak or is inconsolably upset.

Appendicitis is the most common emergency surgery for children. While older kids may report classic symptoms like severe, sudden abdominal pain that starts near the belly button and moves to the lower right side, younger children often complain of more vague symptoms.

In younger kids, parents should watch for sudden, severe pain that worsens with time, trouble walking, guarding their belly, fever or vomiting.

A key sign of appendicitis is that there’s usually no distraction from the pain; children won’t be interested in playing or participating in their favorite activities.

You know your child better than anyone. If they’re acting differently or you have a gut feeling something is wrong — call your doctor. We’d much rather see a child for a minor issue than miss something serious.

And remember, pediatric-focused care makes a real difference. Children aren’t just small adults; they have unique medical needs. Whenever possible, seek care from providers who specialize in pediatrics.

Editor’s note: Paul Tran, M.D. is a pediatric gastroenterologist at Phoenix Children’s Arrowhead, Avondale and Thomas campuses. He lives in Paradise Valley. Please submit comments at yourvalley.net/letters or email them to AzOpinions@iniusa.org. We are committed to publishing a wide variety of reader opinions, as long as they meet our Civility Guidelines.