'Ouch!': Should I be worried if my child has pain in his tummy?

Find out why it's hurting.
Find out why it's hurting.

Your child has pain in their side or in their general gut area.

But why? Where did it come from? And should you be worried?

It can start as a sudden stabbing pain out of nowhere, or build up from a small low level ache.

It can be acute – meaning it lasts for only a short time, or chronic - lingering for days or weeks. 

We can all make a fairly cut and dried diagnoses on the cause of pain when it is an injury like stubbing a toe or twisting an ankle, but when it comes to internal pain it is a bit more worrying. 

“Pain in the side or in the abdomen is a common complaint, and it’s a common reason for people to visit their doctor or the emergency room,” explains Dr Jacques Badenhorst, a gastroenterologist fNetcare Christian Barnard Hospital in Cape Town.

Dr Badenhorst gives some guidance on a few things that may be causing that pain:

Gas and constipation

“Gas or constipation is usually the biggest false alarm when it comes to abdominal and side pain.

Each can cause fairly severe pain, but they usually aren’t harmful.

Normally, gas and constipation pains can be identified by their inconsistency - the pain will usually come and go, and it will change depending on how you’re sitting or standing.

Gas and constipation pain should also subside within an hour or shortly after a bowel movement.”

Irritable bowel syndrome

Irritable bowel syndrome, or IBS, is a common condition that affects the large intestine and causes cramps. 

According to Dr Badenhorst, IBS can range from mild to severe, and factors like food intolerance, stress and hormones can trigger it, causing symptoms such as cramps, pain, bloating, diarrhea and constipation.

“A doctor can diagnose IBS and prescribe medication if necessary.”

Kidney or gallbladder stones

Kidney stones in children are far less common than in adults but they occur for the same reasons.

Minerals form crystal deposits in the kidneys which grow into stones, most of which are about the size of a grain of sand.

Although Gallstones used to be considered rare in children, there has been a rise in the diagnosis of gallstones and some studies suggest that almost 2% of children may have gallstones.

“Kidney stones may be passed naturally, but in more severe cases, they may require surgery. Talk to your doctor if your child experiences severe, radiating pain that lasts for more than a day.” 

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“Diverticulosis is when pockets form in the walls of the digestive tract when the inner layer of your intestine pushes through weak spots in the outer lining.

This pressure makes them bulge out, creating little pouches.

Most often it happens in the colon, the lower part of your large intestine.”

“Symptoms include belly pain or cramping, bloating, constipation or diarrhea.”

Inflammatory Bowel Disease

Dr Badenhorst explains that inflammatory bowel disease (IBD) is an umbrella term used to describe disorders that involve chronic inflammation of your digestive tract. 

Most people diagnosed with IBD are 10 to 40 years old. However, some children younger than 5 years old get IBD.

IBD tends to run in families and about 1 in 5 people with either Crohn's disease or ulcerative colitis has a close relative with some form of IBD.

Types of IBD include:

•Ulcerative colitis. This condition causes long-lasting inflammation and sores (ulcers) in the innermost lining of your large intestine (colon) and rectum.

•Crohn's disease. This type of IBD is characterized by inflammation of the lining of your digestive tract, which often spreads deep into affected tissues.

“Both ulcerative colitis and Crohn's disease usually involve severe diarrhea, abdominal pain, fatigue and weight loss.”


One of the most serious reasons for abdominal pain is appendicitis. 

“Appendicitis, or an infection of the appendix, can be a life-threatening condition.

Appendicitis is considered a medical emergency, and surgery is required to remove the appendix.

If your child has pain (especially on your right side), fever, vomiting and loss of appetite, get emergency medical attention.”


“Pancreatitis is a disease in which the pancreas becomes inflamed.

There are two types of Pancreatitis – acute, where the pain is sudden and lasts a short time, and chronic, which has long-lasting symptoms.”

“Symptoms include fever, higher heart rate, nausea and vomiting, a swollen and tender belly, and pain in the upper part of the belly that goes into your back,” says Dr Badenhorst.

“Eating may make it worse, especially foods high in fat.”

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According to Dr Badenhorst, chronic pancreatitis is rare in children. 

"Trauma to the pancreas and hereditary pancreatitis are two known causes of childhood pancreatitis and children with cystic fibrosis — a progressive, disabling, and incurable lung disease — may also have pancreatitis.  But more often the cause is not known."

“The first thing to do if your child has pain in their abdominal area is to keep track of the pain, and see what makes it worse.

For example, does it hurt more when they stand up or sit down? When they breathe in or breathe out?  Is it a constant pain or does it come and go? 

If the pain is severe or interrupting your childs ability to function properly then it is best to seek medical attention.”

“However, don’t delay getting medical help if they have severe pain, fever, swelling and tenderness, blood in the stools, yellowing of the skin or ongoing nausea and vomiting – then you need to see a doctor immediately,” concludes Dr Badenhorst.

Compiled for Parent24 by Anneline Hlangani.

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