🍽️🔥 Indigestion in Children (Functional Dyspepsia / Non-Ulcer Dyspepsia): What It Means and What Helps

✅ “Indigestion” usually means upper belly discomfort: fullness, nausea, burning, bloating, or pain after eating.
When tests don’t show ulcers or another disease, it’s often called functional dyspepsia—real symptoms from a sensitive stomach–brain connection.

1) 🧾 Quick “At-a-glance” box (top of page)

✅ Condition name: Indigestion (Functional Dyspepsia / Non-Ulcer Dyspepsia)
Common names: Upset stomach, “stomach burning,” early fullness, upper abdominal pain after meals

Plain-language summary (2–3 lines):
Functional dyspepsia is ongoing or recurring discomfort in the upper belly (stomach area) without a dangerous cause found. The stomach can be extra sensitive, empty more slowly, or react strongly to stress and certain foods. Most children improve with meal changes, constipation management, stress tools, and sometimes targeted medicine.

Who it affects (typical ages):
More common in school-age children and teens, but can happen at any age.

✅ What parents should do today:

• Use a simple meal plan: smaller meals, avoid trigger foods, no late-night eating.
• Check and treat constipation (very common hidden trigger).
• Track symptoms and red flags.
• Support the gut–brain connection (sleep + stress tools).

⚠️ Red flags that need urgent/ER care:

• Vomiting blood or black “coffee-ground” vomit
• Black tarry stool or significant blood in stool
• Severe worsening abdominal pain, hard/swollen belly
• Persistent vomiting with dehydration
• Unexplained fainting, severe weakness

🟡 When to see the family doctor/clinic:

• Symptoms most days for > 2–4 weeks
• Weight loss, poor growth, poor appetite
• Pain waking child at night repeatedly
• Trouble swallowing, food sticking, or chest pain with swallowing
• Recurrent vomiting
• Family history of celiac disease, inflammatory bowel disease, or ulcer disease

2) 🧠 What it is (plain language)

Indigestion is discomfort in the upper abdomen (stomach area). It can feel like:

• burning
• fullness too quickly
• nausea
• bloating
• ache or pain after meals

Functional dyspepsia means the symptoms are real, but tests do not show a dangerous cause like an ulcer.

Common “mechanisms” (simple):

• the stomach is more sensitive
• the stomach may empty slower
• the nervous system and stress hormones can amplify stomach signals

What part of the body is involved? (small diagram required)

Common myths vs facts

• Myth: “If tests are normal, it’s just in their head.”
  Fact: Functional dyspepsia is a real gut–brain condition.
• Myth: “It must be an ulcer.”
  Fact: Most kids with indigestion do not have ulcers.
• Myth: “Stopping all foods is the best plan.”
  Fact: A balanced, gentle approach works better than overly restrictive diets.

3) 🧩 Why it happens (causes & triggers)

Common causes/triggers

• Large meals, fast eating
• Greasy or spicy foods
• Caffeine (teens), energy drinks
• Stress/anxiety
• Poor sleep
• Constipation (increases abdominal pressure and discomfort)
• Recent stomach virus (temporary sensitivity)
• Reflux/GERD overlap

Less common but important causes (brief)

• Ulcer disease (rare in children; red flags matter)
• H. pylori infection (varies by region; clinician decides when to test)
• Celiac disease
• Gallbladder disease (older kids; right upper belly pain after fatty meals)
• Pancreatitis (more severe pain, vomiting)
• Eosinophilic esophagitis/gastritis (allergy-linked; swallowing issues, feeding problems)

Risk factors

• Family history of functional GI disorders, migraine, anxiety
• High stress environment
• Irregular meals

4) 👀 What parents might notice (symptoms)

Typical symptoms (most common first)

• Upper belly pain or burning (between ribs and belly button)
• Full quickly (“I’m full after a few bites”)
• Nausea (often worse after eating)
• Bloating or burping
• Symptoms worse with stress or big meals
• Sometimes reflux-like symptoms (sour taste)

Symptoms by age group

• Toddlers: harder to describe; may refuse food, clingy, belly holding
• School-age: “tummy hurts after eating,” nausea, early fullness
• Teens: burning/heartburn, nausea, stress-related flare patterns

What’s normal vs what’s not normal

✅ More likely functional dyspepsia:

• normal growth
• symptoms fluctuate
• improves with simple measures and reassurance

⚠️ Needs evaluation:

• weight loss/poor growth
• waking at night with pain
• repeated vomiting
• blood/black stool or blood in vomit
• trouble swallowing

Symptom tracker (what to write down)

• meal timing and size
• specific triggers (spicy, greasy, caffeine)
• timing of pain after meals (minutes vs hours)
• stool pattern (constipation)
• stress and sleep notes
• any vomiting and its color

5) 🏠 Home care and what helps (step-by-step)

✅ What to do in the first 24–48 hours

✅ Do this now (simple starter plan):

1. Smaller meals every 3–4 hours (avoid big portions).
2. Avoid late meals: finish eating 2–3 hours before bed.
3. Reduce trigger foods for 2 weeks (see below).
4. Treat constipation if present.
5. Add a calm “after-meal routine” (walk 10 minutes; no lying down right away).

“Gentle stomach” meal plan (2-week trial)

Try reducing:

• greasy/fried foods
• very spicy foods
• chocolate and peppermint (some kids)
• tomato/citrus if burning is worse
• caffeine and energy drinks (teens)
• carbonated drinks

Try adding:

• small protein with each meal (eggs, yogurt, chicken, beans)
• simple carbs (rice, oats, potatoes)
• fruits/veg in moderate portions
• water and milk (if tolerated)

Constipation connection (high yield)

If your child has:

• hard stools,
• belly pain relieved by stooling,
• stool withholding, …then constipation treatment is often the missing piece.

Stress and gut tools (kid-friendly)

• belly breathing (2 minutes)
• guided imagery
• predictable sleep routine
• “worry time” earlier in evening (school-age)

6) ⛔ What NOT to do (common mistakes)

• Don’t skip meals all day and then eat a huge dinner (worsens symptoms).
• Don’t rely on frequent antacids daily without clinician guidance.
• Don’t start highly restrictive diets without support.
• Don’t label the child as “picky” or “dramatic”—symptoms are real.

OTC medication cautions

• Avoid routine NSAIDs (ibuprofen) on an empty stomach if they worsen pain.
• Don’t use multiple OTC products at once.

7) 🚦 When to worry: triage guidance

🔴 Call 911 / Emergency now

• Vomiting blood with weakness/fainting
• Severe pain with collapse or confusion

Example: “My child vomited blood and is faint.”

🟠 Same-day urgent visit

• Repeated vomiting with dehydration
• Black tarry stool or significant blood in stool
• Severe worsening pain, hard swollen belly
• Persistent vomiting unable to keep fluids down

Example: “Severe stomach pain + cannot stop vomiting.”

🟡 Book a routine appointment

• Symptoms most days for > 2–4 weeks
• Weight loss, poor appetite
• Pain waking child at night
• Trouble swallowing or food sticking
• Family history of celiac/IBD/ulcer disease

Example: “Upper belly pain after meals for a month.”

🟢 Watch at home

• Mild to moderate symptoms, normal growth, improving with meal plan and stool management

8) 🩺 How doctors diagnose it (what to expect)

What the clinician will ask

• Pain location (upper belly vs lower)
• Timing with meals
• Vomiting details and red flags
• Stool pattern and constipation
• Diet, caffeine, stressors
• Medication use (NSAIDs)
• Growth and appetite

Physical exam basics

• Growth chart review
• Abdominal exam
• Signs of anemia or dehydration
• Throat/chest if reflux symptoms

Possible tests (and why)

Depends on red flags:

• Bloodwork (anemia, inflammation, liver/pancreas markers if indicated)
• Celiac screening
• Stool tests if diarrhea/blood
• H. pylori testing if clinically appropriate
• Ultrasound if gallbladder concern
• Endoscopy if red flags, bleeding, poor growth, or severe persistent symptoms

What tests are usually not needed

• Extensive imaging for mild symptoms improving with lifestyle measures
• Routine H. pylori testing without specific indications

What results might mean

• Normal evaluation → functional dyspepsia plan
• Abnormal labs or red flags → targeted treatment and specialist referral

9) 🧰 Treatment options

First-line treatment

• Meal structure (smaller, earlier dinners)
• Trigger reduction trial
• Constipation management
• Sleep and stress tools

If not improving (next steps)

• Consider a short trial of acid suppression if heartburn/epigastric burning is prominent (clinician-guided)
• Consider therapy tools (CBT) if stress is a major driver
• Consider pediatric GI referral if persistent or red flags

Severe cases (hospital care)

• Severe dehydration from vomiting
• GI bleeding
• Severe pain needing urgent workup

Medication/treatment details (parent-friendly)

Lifestyle/meal plan

• What it does: reduces stomach overload and irritation
• How to do: smaller meals, avoid late meals, identify triggers
• Side effects: none

Acid suppression (PPI or H2 blocker) — clinician-directed

• What it does: reduces acid-related irritation (especially burning symptoms)
• How to give: as prescribed; usually time-limited trial with reassessment
• Common side effects: diarrhea/constipation, headache
• Serious side effects (rare): infection risk, nutrient concerns with prolonged use
• When to stop/seek help: rash/allergy, worsening symptoms
• Interactions: clinician reviews other meds

Prokinetic or nausea medications

• Used only in select cases; clinician-guided

10) ⏳ Expected course & prognosis

• Many children improve within 2–4 weeks with consistent meal and routine changes.
• Some children have flare-ups during stress or illness.

What “getting better” looks like

• fewer symptoms after meals
• less nausea
• better appetite
• improved sleep and daily functioning

What “getting worse” looks like

• increasing pain severity
• persistent vomiting
• weight loss or fatigue
• bleeding signs

Return to school/daycare/sports

Yes. Encourage regular meals and hydration.

11) ⚠️ Complications (brief but clear)

Common complications

• Food avoidance
• Anxiety around eating
• Missed school if symptoms are frequent

Rare serious complications

• If an ulcer or other disease is present (red flags) → bleeding/anemia (needs evaluation)

12) 🛡️ Prevention and reducing future episodes

• Regular meals (don’t skip breakfast)
• Avoid late-night eating
• Limit caffeine (teens)
• Keep stools soft and regular
• Stress management tools and sleep routine

13) 🌟 Special situations

Infants

Indigestion/functional dyspepsia is usually not the infant diagnosis—consider reflux, milk protein allergy, feeding issues.

Teens

• Watch energy drinks and late-night meals
• Stress and sleep deprivation are common triggers

Kids with chronic conditions

• NSAID use can worsen stomach irritation—discuss alternatives when possible

Neurodevelopmental differences/autism

• Avoid overly restrictive diets; maintain safe foods and use gradual changes
• Consider feeding therapy support if food refusal develops

Travel considerations

• New foods + irregular meals can worsen symptoms
• Keep regular meal times and hydration

School/daycare notes

• Allow water bottle access
• Encourage small snacks rather than long gaps without food
• Provide a plan for nausea/upper belly pain episodes

14) 📅 Follow-up plan

• Try home plan for 2–4 weeks.
• Follow up sooner if:
  • red flags appear
  • weight loss/poor appetite
  • nighttime waking pain
• Bring:
  • 1–2 week food diary
  • stool pattern log
  • symptom timing notes
  • medication list (especially NSAIDs)

15) ❓ Parent FAQs

“Is it contagious?”

No.

“Can my child eat ___?”

Usually yes, but start with:

• smaller meals
• avoid greasy/spicy/caffeine triggers
• avoid late-night eating If dairy worsens symptoms, discuss lactose intolerance vs allergy with your clinician.

“Can they bathe/swim/exercise?”

Yes. Exercise is fine; avoid heavy meals right before intense activity.

“Will they outgrow it?”

Many children improve as the gut–brain sensitivity settles, especially with healthy routines. Some may have flare-ups under stress.

“When can we stop treatment?”

When symptoms are stable for a few weeks, keep the healthy routine baseline. If medication was used, stop only with clinician guidance after reassessment.

16) 🧾 Printable tools (high-value add-ons)

🧾 Printable: One-Page Action Plan (Indigestion / Functional Dyspepsia)

Today’s plan:

• Smaller meals every 3–4 hours
• Dinner finished 2–3 hours before bed
• Reduce triggers for 2 weeks (greasy/spicy/caffeine/carbonation)
• Walk 10 minutes after meals
• Treat constipation if present
• Use calm breathing if nausea/pain flares

Call clinic if: symptoms > 2–4 weeks, poor appetite, weight loss, pain wakes child at night.

Urgent care if: vomiting blood/black vomit, black stools, severe pain with hard belly, dehydration.

🧾 Printable: Medication Schedule Box

(If prescribed.)

• Medication: __________________ Time: ______
• Notes / side effects: __________________________

🧾 Printable: Symptom Diary / Tracker

Date: ______

• Pain location: upper belly / chest / other
• Pain severity (0–10): ____
• Trigger foods: _______________________________
• Timing after meals: __________________________
• Nausea/vomiting: ____________________________
• Stool pattern (constipation?): ________________
• Sleep/stress notes: __________________________

🧾 Printable: “Red Flags” Fridge Sheet

⚠️ Urgent: vomiting blood/black vomit, black tarry stool, severe worsening pain or hard swollen belly, persistent vomiting with dehydration, weight loss/poor growth.

🧾 Printable: School/Daycare Instructions Page

• Allow water bottle and bathroom breaks
• Encourage regular snacks (avoid long gaps without food)
• Notify parent if severe pain, repeated vomiting, or child appears very unwell

17) 📚 Credible sources + last updated date

Trusted references (examples):

• Children’s hospital resources on functional abdominal pain and dyspepsia
• National pediatric society resources on recurrent abdominal pain and red flags
• Pediatric GI society information on functional GI disorders

Last reviewed/updated on: 2025-12-30
Local guidance may differ based on your region and your child’s medical history.

🧡 Safety disclaimer

This guide supports—not replaces—medical care. If you are worried about your child, trust your instincts and seek urgent medical assessment.

This guide was fully developed & reviewed by Dr. Mohammad Hussein, MD, FRCPC ROYAL COLLEGE–CERTIFIED PEDIATRICIAN & PEDIATRIC GASTROENTEROLOGIST Board-certified pediatrician and pediatric gastroenterologist (Royal College of Physicians and Surgeons of Canada) with expertise in inflammatory bowel disease, eosinophilic gastrointestinal disorders, motility and functional testing, and complex nutrition across diverse international practice settings.

To book an online assessment Email Dr. Hussein’s Assistant Elizabeth Gray at: Elizabeth.Gray@pedsgimind.ca
In the email subject, please write: New Assessment Appointment with Dr. Hussein

Important: This appointment is completely online as Dr. Hussein is currently working overseas. This service is not covered by OHIP