Abdominal Pain with Unknown Cause, Female (Child)

Belly (abdominal) pain is common in children. But children often don't complain of pain because they don't have the words to describe what is wrong. They have trouble showing where it hurts. Often they just feel bad or don't want to eat. This can make abdominal pain hard to diagnose in young children. Abdominal symptoms are linked to many problems. Most of the time, the cause of abdominal pain in children is not serious and will go away.

Over the next few days, abdominal pain may come and go or be continuous. It may be hard to decide whether a child has pain or is feeling something else. Abdominal pain may be accompanied by nausea and vomiting, constipation, diarrhea, or fever. Sometimes it can be hard to tell whether children feel nauseated because they just feel bad. A child may constantly touch their stomach or show pain when the stomach is touched.

Abdominal pain may continue even when being treated correctly. Sometimes the cause can become clearer over the next few days and may need further or different treatment. Additional tests or medicines may be needed.

Sometimes viruses or bacteria can cause an infection that causes stomach pain. But not all stomach infections should be treated with antibiotics. Taking antibiotics for reasons other than a bacterial infection can cause problems.

Lab tests and X-rays may be done in the emergency room (ER) to find the cause of pain. However, they are not always needed to diagnose or treat your child.

Your doctor may prescribe medicine for pain and symptoms of infection. Follow the instructions for giving these medicines to your child.

• Comfort your child as needed.
• Try to find positions that ease your child's discomfort. A small pillow placed on the abdomen may help provide pain relief.
• Distraction may also help. Some children are soothed by listening to music or having someone read to them.
• Offer emotional support to your child. Pain can set off some intense, negative emotions, including anger.
• Relaxation methods and behavioral therapy can be helpful if the pain becomes chronic.
• Lying down with a warm washcloth on the stomach may help improve symptoms.
• Have your child sit on the toilet regularly.
• Don't give medicine for abdominal pain or cramps unless instructed by your doctor.

• Don't force your child to eat, especially if they are having pain, vomiting, or diarrhea. Think of what would make you feel better or worse. The same probably goes for your child.
• Water is important to prevent dehydration. Soup, popsicles, or oral rehydration solution may help. Give liquids in small amounts. Don't let your child guzzle it down, which may make them feel worse.
• Don't give your child fatty, greasy, spicy, or fried foods.
• Don't give your child high-fiber foods that are high in residue during the pain episodes.
• Don't give your child dairy products if they have diarrhea.
• Don't let your child eat large amounts of food at one time, even if they are hungry. Wait a few minutes between bites and offer more if tolerated.

Follow up with your child's doctor or as advised. If tests or studies were done, you'll be notified of any new findings that may affect your child's care.

If the pain becomes chronic, your child's doctor may advise behavioral therapies. This might be seeing a therapist, learning relaxation methods, and trying to maintain a child's normal activities.

Keep a record of symptoms, such as vomiting, diarrhea, or fever. This may help the doctor make a diagnosis.

Call 911 if any of these occur:

• Trouble breathing
• Difficulty awakening
• Fainting or loss of awareness
• Rapid heart rate
• Seizure

Contact your child's doctor right away if any of these occur:

• Fever (see Fever and children below)
• Your baby is fussy or cries and can't be soothed
• Continuing symptoms, such as severe abdominal pain, bleeding, painful or bloody urination, nausea and vomiting, constipation, or diarrhea
• Abdominal swelling
• Vaginal discharge or bleeding that is unrelated to menstruation
• Your child can't keep down water or clear liquids. They are at risk for dehydration and need medical help right away.
• Missed periods. Don't be surprised if the doctor does a pregnancy test on any girl above the age of menstruation. This is simply part of the evaluation.
• Severe pain lasting more than 1 hour
• Constant pain lasting more than 2 hours
• Crampy, intermittent pain lasting more than 24 hours
• Pain in the lower right side of the abdomen
• Your child starts acting very sick

Use a digital thermometer to check your child's temperature. Don't use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.
• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The doctor may want to confirm with a rectal temperature.
• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.
• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The doctor may want to confirm with a rectal temperature.
• Mouth (oral). Don't use a thermometer in your child's mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker's directions for correct use. Insert it gently. Label it and make sure it's not used in the mouth. It may pass on germs from the stool. If you don't feel okay using a rectal thermometer, ask the doctor what type to use instead. When you talk with any doctor about your child's fever, tell them which type you used.

Below is when to call the doctor if your child has a fever. Your child's doctor may give you different numbers. Follow their instructions.

When to contact a doctor about your child's fever

For a baby under 3 months old:

• First, ask your child's doctor how you should take the temperature.
• Rectal or forehead: 100.4°F (38°C) or higher
• Armpit: 99°F (37.2°C) or higher
• A fever of ___________as advised by the doctor

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher
• Ear (only for use over age 6 months): 102°F (38.9°C) or higher
• A fever of ___________ as advised by the doctor

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age
• Temperature of 104°F (40°C) or higher in a child of any age
• A fever of ___________ as advised by the doctor