Information for parents
Abdominal Pain in Children
“My child keeps complaining of tummy pain. Should I be worried?” It is one of the most common questions parents ask. Recurring abdominal pain affects many school-aged children, and in most cases it is not caused by serious disease.
That said, pain that is persistent, severe, or comes with other symptoms such as weight loss, bleeding or ongoing diarrhoea deserves a proper assessment.
Common causes of tummy pain
Short-lived tummy pain often comes with viral illnesses or gastroenteritis. When pain keeps coming back over weeks or months, doctors consider a range of causes. Some of the more common ones are below.
Constipation
Constipation is one of the most frequent causes of recurring pain, and it is easily missed because many children still poo daily. Pain is often crampy and may ease after a big bowel motion.
Gastrointestinal infections
Viral gastroenteritis usually settles within days. Some infections, including certain parasites, can cause longer-lasting symptoms, and some children have a period of gut sensitivity after an infection.
Coeliac disease
An immune reaction to gluten that can cause tummy pain, bloating, diarrhoea or constipation, tiredness and poor growth. It is diagnosed with a blood test and often a gastroscopy.
Inflammatory bowel disease (IBD)
Crohn’s disease and ulcerative colitis are less common but important causes, particularly when pain comes with diarrhoea, blood in the poo, weight loss or poor growth.
Reflux and dyspepsia
Pain or burning in the upper tummy, early fullness, nausea or discomfort after eating can be caused by reflux, gastritis or functional dyspepsia.
Disorders of gut-brain interaction
Functional abdominal pain, irritable bowel syndrome (IBS) and functional dyspepsia are very common in children. The pain is real and comes from increased sensitivity in how the gut and brain communicate, rather than from damage or inflammation.
How growth, stool pattern, appetite and other symptoms guide assessment
A careful history and examination are the most important parts of the assessment. Doctors will ask where the pain is, when it happens, what makes it better or worse, and how it affects school, sport and sleep. They will look closely at your child’s growth chart, bowel habits, appetite and energy, and any family history of gut conditions.
A child who is growing well, has normal bowel habits and no warning signs is much less likely to have an inflammatory or structural problem. Weight loss, blood, ongoing diarrhoea or poor growth point towards a need for testing.
Why scans and blood tests can sometimes be normal despite genuine pain
Many causes of recurring tummy pain do not show up on tests, because they involve how the gut moves and how pain signals are processed rather than visible damage. A normal result is useful — it helps rule out conditions that need specific treatment — but it does not mean your child is making up the pain.
When testing is useful
When tests are needed, they are chosen to answer a specific question. Common first-line tests include a blood count, inflammatory markers, coeliac screening, and a stool test such as faecal calprotectin, which helps detect bowel inflammation. Ultrasound or other imaging is used when a particular problem is suspected. Repeating tests that were already normal rarely adds useful information.
When endoscopy is considered
A gastroscopy and/or colonoscopy may be recommended when there are signs of inflammation, bleeding, suspected coeliac disease or IBD, swallowing problems, or persistent symptoms where biopsies would help guide treatment. In children, these procedures are performed under anaesthetic care.
When should I be concerned?
Not every tummy ache needs a specialist. See your GP promptly, and ask about referral, if your child’s abdominal pain comes with any of these:
- Weight loss, poor growth or delayed puberty
- Blood in the poo or black, tarry stools
- Persistent diarrhoea
- Persistent or bile-stained (green) vomiting
- Pain or diarrhoea that regularly wakes your child from sleep
- Unexplained fever, mouth ulcers, joint pain or skin rashes
- Difficulty or pain with swallowing
- Pain that is consistently in one spot away from the belly button, or that is steadily getting worse
- A family history of IBD or coeliac disease
Seek urgent care for severe or worsening pain, a rigid or very tender tummy, green vomit, or a child who seems very unwell.
When should my child see a paediatric gastroenterologist?
Recurring pain with normal tests is often a disorder of gut-brain interaction, and constipation is one of the most common causes of tummy pain.
Most children with tummy pain can be assessed and managed by their GP or paediatrician. A paediatric gastroenterologist can help when red flags are present, when pain is persistent and affecting daily life, when test results are abnormal, or when a gastroscopy or colonoscopy may be needed.
A specialist review can also be reassuring for families of children with long-standing pain and normal tests, and help put a clear plan in place to get back to school, sport and normal routines.
Straight answers
Questions parents often ask
My child complains of tummy pain most days but seems otherwise well. Should I worry?
Recurring pain in a child who is growing well and has no warning signs is usually not due to serious disease. It is still worth seeing your GP to look at the pattern and check for common causes such as constipation.
Could my child’s tummy pain be caused by stress or anxiety?
Stress can make gut symptoms worse, as it does in adults, but that does not mean the pain is imagined. The gut and brain are closely connected, and treatment often addresses both.
Does my child need a scan?
Most children do not. Imaging is used when a specific problem is suspected based on the history, examination or other test results.
Could it be a food intolerance?
Sometimes certain foods trigger symptoms, but broad elimination diets are rarely helpful and can affect nutrition. Any dietary changes are best guided by a doctor or dietitian.
What is faecal calprotectin?
It is a stool test that measures a protein released when the bowel is inflamed. It helps doctors decide whether conditions like IBD need to be investigated further.
Related children’s gut-health resources
Constipation in Children
Withholding, painful poos, soiling and why treatment often takes months rather than days.
Disorders of Gut-Brain Interaction
Functional abdominal pain, IBS and dyspepsia — why the pain is real even when tests are normal.
Coeliac Disease in Children
Testing, when a gastroscopy is needed, and why not to stop gluten too early.
Inflammatory Bowel Disease in Children
Crohn’s disease and ulcerative colitis — symptoms, diagnosis and modern treatment.
If your child has persistent gastrointestinal symptoms or your GP has recommended specialist assessment, you can find information about appointments with Dr Rohan Malik here.