Abdominal Pain with Unknown Cause, Female (Child)

Belly (abdominal) pain is common in children. But children often don't complain of pain because they don't have the words to describe what is wrong. They have trouble showing where it hurts. Often they just feel bad or don't want to eat. This can make abdominal pain hard to diagnose in young children. Abdominal symptoms also are linked with many problems. Most of the time, the cause of abdominal pain in children is not serious and will go away.

Over the next few days, abdominal pain may come and go or be continuous. It may be hard to decide whether a child has pain or is feeling something else. Abdominal pain may be accompanied by nausea and vomiting, constipation, diarrhea, or fever. Sometimes it can be hard to tell whether children feel nauseated because they just feel bad. A child may constantly touch their stomach or show pain when the stomach is touched.

Abdominal pain may continue even when being treated correctly. Sometimes the cause can become clearer over the next few days and may require further or different treatment. Additional tests or medicines may be needed.

Sometimes viruses or bacteria can cause an infection that causes stomach pain. But not all stomach infections should be treated with antibiotics. Taking antibiotics for reasons other than a bacterial infection can cause problems.

Lab tests and X-rays may be done in the emergency room (ER) to find the cause of pain. But they are not always needed to diagnose or treat your child.

Home care

Your healthcare provider may prescribe medicine for pain and symptoms of infection. Follow the instructions for giving these medicines to your child.

General care

  • Comfort your child as needed.

  • Try to find positions that ease your child’s discomfort. A small pillow placed on the abdomen may help provide pain relief.

  • Distraction may also help. Some children are soothed by listening to music or having someone read to them.

  • Offer emotional support to your child. Pain can trigger some intense, negative emotions, including anger.

  • Relaxation techniques and behavioral therapy can be helpful if the pain becomes chronic.

  • Lying down with a warm wash cloth on the stomach may help improve symptoms.

  • Have your child sit on the toilet regularly.

  • Don't give medicine for abdominal pain or cramps unless instructed by your healthcare provider.

Diet

  • Don't force your child to eat, especially if they are having pain, vomiting, or diarrhea. Think of what would make you feel better or worse. The same probably goes for your child.

  • Water is important to prevent dehydration. Soup, popsicles, or oral rehydration solution may help. Give liquids in small amounts. Don't let your child guzzle it down,which may make them feel worse.

  • Don't give your child fatty, greasy, spicy, or fried foods.

  • Don't give your child high-fiber foods that are high in residue during the pain episodes.

  • Don't give your child dairy products if they have diarrhea.

  • Don't let your child eat large amounts of food at one time, even if they are hungry. Wait a few minutes between bites and offer more if tolerated.

Follow-up care

Follow up with your child's healthcare provider or as advised. If tests or studies were done, you'll be notified of any new findings that may affect your child’s care.

If the pain becomes chronic, your child's provider may advise behavioral therapies. This might be seeing a therapist, learning relaxation techniques, and trying to maintain a child's normal activities.

Special notes to parents

Keep a record of symptoms, such as vomiting, diarrhea, or fever. This may help the provider make a diagnosis.

Call 911

Call 911 if any of these occur:

  • Trouble breathing

  • Difficulty awakening

  • Fainting or loss of awareness

  • Rapid heart rate

  • Seizure

When to seek medical advice

Call your child's healthcare provider right away if any of these occur:

  • Fever (see Fever and children below)

  • Your baby is fussy or cries and can't be soothed

  • Continuing symptoms, such as severe abdominal pain, bleeding, painful or bloody urination, nausea and vomiting, constipation, or diarrhea

  • Abdominal swelling

  • Vaginal discharge or bleeding that is unrelated to menstruation

  • Your child can't keep down water or clear liquids. They are at risk for dehydration and need medical help right away.

  • Missed periods. Don't be surprised if the provider does a pregnancy test on any girl above the age of menstruation. This is simply part of the evaluation.

  • Severe pain lasting more than 1 hour

  • Constant pain lasting more than 2 hours

  • Crampy, intermittent pain lasting more than 24 hours

  • Pain in the lower right side of the abdomen

  • Your child starts acting very sick

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until he or she is at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell him or her which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° (38°C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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