Stomachache Have a tummy complaint? Here's a few questions to ask the patient.

August 23, 1998|By Rasmi Simhan | Rasmi Simhan,CONTRIBUTING WRITER

Your child might jabber away about everything from sports to school, but when it comes to a stomachache, sometimes all you get is: "My tummy hurts." Is it appendicitis, or simply not wanting to go to school? When it's time to play detective, keep these questions in mind:

Where does it hurt?

Most minor stomachaches occur close to the belly button, says pediatrician Azam Baig of Annapolis-based South River Pediatrics.

Causes include "dietary indiscretions" such as overeating "a ton of ice cream," says Dr. Robert Ancona at Cross Keys Pediatrics in Baltimore.

This intermittent pain rarely lasts longer than two hours, and can be helped with antacids such as Tums, Pepto-Bismol or Children's Mylanta, the doctors say. If the child needs more than one or two doses, see a doctor. Avoid over-the-counter analgesics containing ibuprofen (Advil or Motrin) or acetaminophen (Tylenol).

Intense pain to either side spells trouble. Pain in the lower-right abdomen may indicate appendicitis, which is accompanied by nausea, vomiting and fever. More common in males than females, appendicitis usually begins with "crampy, colicky-like mid-abdominal pain and loss of appetite," according to Intelihealth, an online publication of Johns Hopkins University.

Pain above the stomach may indicate hyperacidity or peptic ulcers, which also require medical attention.

What did you eat?

Foods rich in fats or refined sugars may trigger constipation, according to the Nemours Foundation Center for Children's Health Media in Wilmington, Del. (

Laxatives may worsen the problem, so ask your child to drink more water, eat high-fiber foods and exercise more.

If symptoms include cramps, gas and bloating after consuming dairy products, talk to a pediatrician about lactose intolerance.

The stomachache may have a nonmedical cause: an empty stomach or poor breakfast. Ask the child to choose between a trip to the bathroom or something to eat.

Are you worried about something?

Stomachaches caused by stressful situations, such as school tests or domestic problems, generally dissipate once the stress is eliminated, says Dr. David Horowitz, clinical assistant professor of pediatrics at New York University School of Medicine.

Are there other symptoms?

In general, signs that the child requires immediate attention: a distended, rigid or bruised abdomen; bleeding; bloody vomit or bloody bowel movements.

Cramps and diarrhea could be gastroenteritis, or inflammation of the stomach and intestine. Widespread in the winter among school-age children, this infectious virus is the second most common illness in the United States, according to Intelihealth.

How intense is the pain?

Can your child do his or her daily tasks or is he or she doubled over in pain?

As Horowitz put it, "A good rule of thumb is that if your child's complaints of stomach pain are not assuaged by the usual comforts, especially in the presence of vomiting, diarrhea or fever, seek medical advice as soon as possible."

Pub date: 8/23/98

Baltimore Sun Articles
Please note the green-lined linked article text has been applied commercially without any involvement from our newsroom editors, reporters or any other editorial staff.