There are numerous causes of abdominal pain and common causes vary with the age of the child.

Common causes listed below include:

• Abdominal cramps, usually comes and goes, often associated with diarrhea and may be caused by a virus, bacteria or parasite
• Constipation
• Appendicitis - rarely seen in children under 4 years. Typically, the child has constant, severe pain that often starts in the umbilical area and then may change to the classic, right lower area of the abdomen
• Medications, especially some antibiotics
• Urinary tract infections
• Often with strep throat
• Menstrual cramps
• Severe coughing or pneumonia
• Psychological
• Trauma
• Intussusception, which is a telescoping of the bowel with in itself causing obstruction, vomiting, severe pain and red, "currant-jelly" type stools
• Bowel obstructions
• Food poisoning - usually associated with eating spoiled foods (see diarrhea section for more information)
• Ulcers
• Pyloric stenosis - infants under 3 months presenting with projectile vomiting, caused by a spasm and thickening of the muscle where food exits the stomach
• Colic in babies is a term used for crying babies that are usually unconsolable for periods of a couple hours and may be caused by gassiness. This may be due to a formula intolerance or allergy to a formula. In breast-fed babies, food or drink that the mother is consuming may cause colic.  Gassy foods like beans, broccoli, onions, cabbage or spicy foods may cause the baby to be gassy.  Also caffeinated drinks, chocolate or red wine may create an irritable baby.
• "Spitting up" or gastroesophageal reflux in babies can sometimes cause a fussy baby with abdominal pains. A baby who spits up alot may develop "heartburn" or what is known as esophagitis.  Signs of this include a baby who cries alot with feeding or arches with feeds.  They may have a decreased appetite. 

If your child is acting sick, the child may need immediate evaluation.. The doctor should be contacted immediately if a

• A baby is constantly crying, alternating with restless sleep; pale or mottled, blotchy skin or has other signs of acting sick
• An older child is doubled over with pain or crying with pain for more than a half to one hour or worsening pain in a two hour period
• Moderate or severe dehydration
• Unable to walk or walks bent over
• Blood in stool
• Possibility of poisoning with chemicals, plants or other toxic substances
• Recent injury to the abdomen
• Marked tenderness in any location or mild tenderness in the right lower quadrant when touched
• Urinary tract infection symptoms (frequent urination, pain with urination, blood in the urine, foul smell to the urine or urgency to urinate)
• Other concerning signs listed under vomiting or diarrhea

• Recurrent abdominal pain - pain that comes and goes
• Abdominal pain associated with constipation
• Associated symptoms that may need evaluation like sore throat, earache, persistent cough

If pain is severe and worsening over a two hour period, the child will need to be evaluated immediately. A warm washcloth or hot water bottle over the abdomen may be soothing. Do not try to give solids, but try clear fluids first.

See other appropriate sections for associated symptoms like vomiting, diarrhea, earache, cough, sore throat

Psychological distress. Occasionally, with psychological distress, a child may complain of abdominal pain. You may suspect this if your child has no other physical symptoms and

• is unusually clingy, or having unusual aggressive or withdrawn behavior
• there has been some traumatic event, like a move, change at school, change in the home situation, marital discord, illness or death in the family, scary TV or movie show, disruption in friendships, or suspicion of sexual molestation
• rarely does this awaken a child at night

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