Abdominal pain is one of the most common reasons children visit a clinic or emergency department. The good news: most cases are not dangerous. The key is knowing what to watch for and how to respond calmly.

1) Go to urgent care NOW if any red flags

Seek urgent assessment if abdominal pain comes with:

  • Child looks very unwell, very sleepy, or hard to wake
  • Severe pain that is worsening or constant
  • Green (bilious) vomiting, blood in vomit, or persistent vomiting
  • Black stool or large amounts of blood in stool
  • Swollen/hard belly, severe tenderness, or pain with walking/jumping
  • Fever + worsening belly pain
  • Testicular pain/swelling (can present as belly pain)
  • Under 3 months old with significant irritability/pain
  • Dehydration signs (very low urine, dry mouth, lethargy)

2) The most common cause: constipation (often missed)

Constipation can cause:

  • Pain around the belly button or lower belly
  • Pain before stooling, better after stooling
  • Hard/large stools, painful stooling
  • Soiling/“skid marks” (overflow)
  • “Daily stool” but still hard or incomplete (daily does not rule it out)

If constipation is likely and no red flags:

  • Increase water
  • Toileting routine after meals (5–10 minutes; feet supported)
  • Increase fiber gradually
  • Discuss stool softening therapy with your clinician (often needed for weeks–months)

3) Other common causes by age

Toddlers (1–4 years)

  • Constipation, viral illness, gas/bloating
  • UTI (sometimes vomiting/fever without urinary symptoms)
  • Less common but important: intussusception (episodes of severe pain), appendicitis

School age (5–12 years)

  • Constipation
  • Functional abdominal pain (gut sensitivity / stress, often around belly button)
  • Reflux/indigestion
  • Celiac screening considered if symptoms persist or growth concerns

Teens

  • Constipation, reflux/gastritis, IBS
  • Period-related pain
  • Important: IBD if blood in stool, weight loss, chronic diarrhea

4) When to book a clinic visit (not emergency)

  • Pain persists > 1–2 weeks
  • Recurrent pain affecting school/sleep
  • Poor appetite, weight loss, persistent nausea
  • Ongoing constipation symptoms
  • Blood in stool (especially mixed in stool)

5) What helps parents most

  • Keep a brief diary: pain timing, stool pattern, triggers
  • Treat constipation early if suspected
  • Reassure your child and keep routines normal when safe
  • Seek evaluation if recurrent or disruptive

Free Printable for Parents

Get our pediatrician-approved Constipation Action Plan (PDF) by email.