Stomach Ache

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Stomach ache?

Stomach ache can be due to indigestion, stomach virus, ulcers, appendicitis, gallstones, you name it.
Pharmacist

Let's narrow down the cause and determine if your child need urgent care.


Girl holding her stomach

Or if it is something that can be taken care of at the local pharmacy with over-the-counter medications.

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Stomach ache

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How serious is it?

An idea of what your child is dealing with should be determined first.
Pharmacist

Then you can make the best decision on what to do.

Know that:
The severity of the stomach pain does not necessarily correlate to the magnitude of the problem causing the pain.
For instance pain caused by appendicitis is usually dull in the beginning.

 

With this stomach pain, any blood in the stool?

Or is the child vomiting blood?
Pharmacist

No.

 

Seek urgent care or emergency room.
Pharmacist

Here is why:

  • This is serious.
  • Possible bleeding ulcers.

Hospital No blood

 

 

 

 

Stomach ache

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Is the pain confined to the lower right belly area?
Pharmacist

Yes No

 

 

 

 

Stomach ache

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Is it appendicitis?

Yes?
Let's make sure we are not looking at appendicitis.
Pharmacist

 

Ask the child:
Did this stomach pain start around the belly button area?
Pharmacist

 

 

Was this pain minor at first, but it is now becoming sharper and severe?
Pharmacist

 

Yes?
This is how appendicitis usually start.
But don't panic yet.
Pharmacist

Appendicitis usually start with:

  • Pain around the belly button
  • Pain, minor at first, but becomes sharp and severe.

 

Is the child feeling nauseated and or vomiting?
Pharmacist

 

Yes?
There is a feeling of nausea or vomiting with appendicitis.
Pharmacist

Appendicitis usually start with:

  • Pain around the belly button
  • Pain, minor at first, but becomes sharp and severe.
  • Nausea and/or vomiting

 

Does he or she have any appetite for food?
Pharmacist

 

No appetite?
Reduced appetite can be a sign of appendicitis.
Pharmacist

Starting symptoms include:

  • Pain around the belly button
  • Pain, minor at first, but becomes sharp and severe.
  • Nausea and/or vomiting
  • Reduced appetite.

 

Is the child experiencing low grade fever?
Pharmacist

 

Yes?
This can be a symptom of appendicitis.
Pharmacist

Symptoms include:

  • Pain around the belly button
  • Pain, minor at first, but becomes sharp and severe.
  • Nausea and/or vomiting
  • Reduced appetite.
  • Low grade fever

 

Gently press on the right lower belly area and quickly release pressure.

Does the pain increase?
Pharmacist

 

Yes?
This is a sign of inflammation of the appendix.
Pharmacist

Pressing on the right lower belly area increases the pain.

 

Does this pain get worse when your child walk?
Pharmacist

 

Yes?

 

Does the stomach pain get worse when he or she cough?
Pharmacist

 

Yes?
With appendicitis the pain is worse when one cough or walk.
Pharmacist

 


Those were signs and symptoms of appendicitis.
Pharmacist

If you think your child may be looking at appendicitis from the questions so far, start heading to the emergency room.

If you are sure you are NOT looking at appendicitis, let's continue.

Be sure to take a look at the "FYI" before continuing

FYI ER Continue

 

 

 

The appendix is a small pouch attached to the beginning of your large intestine and appendicitis is swelling or inflammation of the appendix caused by infection or fecal matter blockade.

With appendicitis, symptoms would often start with:

  • pain around your belly button.
  • pain may be minor at first, but it becomes more sharp and severe.
  • your appetite will be reduced
  • you may have nausea or vomiting
  • you may have low grade fever.

As the swelling in the appendix increases, in 12 to 24 hours after the start of the illness:

  • Pain tends to move into your right lower abdomen
  • Focuses right above the appendix at a place called McBurney's point.
  • Pain will increase when you gently press on your lower right belly area.

If your appendix ruptures:

  • you may have less pain for a short time and feel better.
  • However, the lining of your abdomen can become infected and swollen from the rupture (peritonitis).
  • Then the pain gets worse and you become very sick.
  • Your pain may be worse when you walk or cough.
  • Sudden movement causes pain.
  • You may prefer to lie still because any movement gives you pain.
  • You might have nausea and vomiting
  • You might be shaking and feverish
  • You might have chills with diarrhea

Well, we don't need to tell you that if you are nodding your head to any of these, that this is a
medical emergency
and you need to get to the hospital now.

 

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Stomach ache

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Is it gallstones?

Is the stomach pain in the right upper or middle upper belly area?
Pharmacist

No

 

Yes?
let's rule out a gallstone situation.
Pharmacist

 

Ask the child:
Is the pain dull and constant?
Pharmacist

 

Yes?

 

Is it sharp and cramping?
Pharmacist

 

Yes?
Symptom of a gallstone.
But don't panic yet.
Pharmacist

Symptoms include:

  • Dull, constant pain in the right upper or middle upper abdomen
  • Sharp, cramping pain in the right upper or middle upper abdomen

 

Is this pain spreading or did it spread to the back?
Pharmacist

 

Yes?

 

Did it spread to below the right shoulder blade?
Pharmacist

 

Yes?
This is a sign and symptom of gallstones.
Pharmacist

Symptoms include:

  • Dull, constant pain in the right upper or middle upper abdomen
  • Sharp, cramping pain in the right upper or middle upper abdomen
  • Pain that may spread to the backor below the right shoulder blade

 

Is the child passing clay-colored stools?
Pharmacist

 

Yes?
With gallstones, one may pass clay-colored stools.
Pharmacist

Symptoms include:

  • Dull, constant pain in the right upper or middle upper abdomen
  • Sharp, cramping pain in the right upper or middle upper abdomen
  • Pain that may spread to the back or below the right shoulder blade.
  • Clay colored stools

 

Is the skin or eyes yellowing?
(jaundice)
Pharmacist

 

Yes?
With gallstones, the skin or whites of the eyes may be yellowing.
Pharmacist

 

Any fever with this stomach pain?
Pharmacist

 

Yes?

 

What about nausea or vomiting?
Pharmacist

 

Yes?

 


Those were signs and symptoms of gallstones.
Pharmacist

If you nodded your head to the discussions so far, you should start heading to the nearest emergency room with the child.

If that is not the case, we can continue. Be sure to see the "FYI" for good information.

FYI ER Continue

 

 

 

Gallstones may be as small as a grain of sand or as large as a golf ball. They form inside the gallbladder

These stones are often found during a routine x-ray, abdominal surgery, or other medical procedure. But, if a large stone blocks either the cystic or common bile duct (called choledocholithiasis), you may have a cramping pain in the middle to right upper abdomen.

The pain goes away if the stone passes into the first part of the small intestine (the duodenum). Else, you will need surgery as soon as possible if not right away.

If you have these symptoms, you should seek urgent or emergency care if the pain is very severe:

  • Constant, sharp, cramping or dull pain in the right upper or middle upper abdomen
  • This pain may spread to the back or below the right shoulder blade
  • Yellowing of skin and whites of the eyes (jaundice)
  • Clay-colored stools
  • This type of pain with nausea and vomiting
  • This type of pain with fever

 

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Stomach ache

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Kidney stones?

Ask the child:
Did this pain start on the belly area or side of the back? ...

And moved down to the groin or bladder area?
Pharmacist

No

 

Yes?
Hmmm. Let's rule out possible kidney stones.
Pharmacist

 

Is this a severe pain that started suddenly?

It may also go away suddenly, only to return later.
Pharmacist

 

Yes?
Sign of the pain of kidney stones.
Pharmacist

 

Have you or the child noticed any blood in the urine?
Pharmacist

 

Yes?

 

What about an abnormal urine color?

Or cloudy urine with strong odor?
Pharmacist

 

Yes?
This is a sign and symptom of kidney stones.
Pharmacist

Symptoms include:

  • Severe pain that started suddenly
  • Pain that comes in waves (colicky)
  • Pain that moved down to the groin or bladder area
  • Bloody urine
  • Cloudy urine with strong odor.

 

What about nausea and / or vomiting

With this pain?
Pharmacist

 

Yes?
May experience nausea and vomiting with kidney stones.
Pharmacist

Symptoms include:

  • Severe pain that started suddenly
  • Pain that comes in waves (colicky)
  • Pain that moved down to the groin or bladder area
  • Bloody urine
  • Cloudy urine with strong odor
  • Nausea and vomiting

 

Any frequent urge to urinate?
Pharmacist

 

Yes?
Sign of kidney stones. Especially if it follows severe stomach pain.
Pharmacist

Symptoms include:

  • Severe pain that started suddenly
  • Pain that comes in waves (colicky)
  • Pain that moved down to the groin or bladder area
  • Bloody urine
  • Cloudy urine with strong odor
  • Nausea and vomiting
  • Frequent urge to urinate

 

Is the child experiencing fever and chills?
Pharmacist

 

Yes?
Passing kidney stones can aslo cause this.
Pharmacist

Symptoms include:

  • Severe pain that started suddenly
  • Pain that comes in waves (colicky)
  • Pain that moved down to the groin or bladder area
  • Bloody urine
  • Cloudy urine with strong odor
  • Nausea and vomiting
  • Frequent urge to urinate
  • Fever and chills

 


Those were signs and symptoms of kidney stones pain.
Pharmacist

If you've nodded your head to any of these symptoms, we suggest you take the child to the nearest hospital.

Would you like to do that now or continue if you don't think it is a kidney stone situation?

Be sure to take a look at "FYI" for a brief summary of what to expect with kidney stones.

FYI ER Continue

 

 

 

Kidney stone's stomach pain include:

Severe pain that:

  • started suddenly and may go away suddenly
  • comes in waves (colicky)
  • is felt in the belly area or side of the back
  • may move to groin area (groin pain) or testicles (testicle pain)

Also severe pain with

  • blood in urine
  • abnormal urine color
  • nausea and vomiting
  • chills or fever

 

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Stomach ache

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Is this pain mainly when you apply pressure to certain parts of the belly?
Pharmacist

 

Seek urgent care or emergency room.
Pharmacist

Here is why:

  • Doctors call this point tenderness. It means your child has tenderness in a certain area.
  • May be looking at peritonitis (inflammation of the tissue that lines the abdominal cavity)
  • May be looking at appendicitis or twisted Fallopian tube.
  • May be looking at certain types of hernia.

If you touch parts of the belly and your child feel pain in that part or the area feels tender, we consider this a medical emergency.

Nearest ER

 

Would your child describe the stomach pain as being cramp-like?
Pharmacist

 

Yes?
This is more likely due to gas and bloating.
Pharmacist

If it is followed by diarrhea, then it is due to gas or bloating. Your child may be suffering from lactose intolerance or food allergies.

If it lasts more than 24 hours or there is fever, then he or she will need to seek urgent care.

Urgent Care

 

Does the child feel the stomach ache all over the belly?

Or in more than half of the belly?
Pharmacist

 

Yes?
Possible stomach virus, indigestion, or gas.
Pharmacist

If it gets more severe, the intestines might be blocked.

 

Is this pain dull and coming in waves?

And the child is vomiting?
Pharmacist

 

Yes?
Possible intestinal obstruction.
Pharmacist

 

Is this stomach ache sharp and constant?

Worse when he or she move?
Pharmacist

 

Seek urgent care or emergency room.
Pharmacist

Here is why:

  • May be looking at peritonitis.
  • If your child feel relief when lying still and severe pain when he or she move or try to get up. Call 911.

Nearest ER

 

Did the pain start suddenly, like turning on the light switch?
Pharmacist

 

Seek urgent care or emergency room.
Pharmacist

Here is why:

  • Possible causes include kidney stones, perforated ulcer.
  • Something may have ruptured in the stomach.

Nearest ER

 

Does this pain travel to any other areas of the body?
Pharmacist

 

Seek urgent care or emergency room.
Pharmacist

Here is why:

If it travels to:

  • Right collar bone:
    May suggest gallbladder pain.

  • Left shoulder area:
    May suggest a ruptured spleen or even pancreatitis.

  • Private parts:
    May suggest Kidney stones.

  • The back:
    Must seek emergency help.

Nearest ER

 

Alright.
There are other causes of stomach pain.
Pharmacist

Some will require emergency care, others urgent care while others are due to minor stomach discomfort.

Bottom line:
If your child is writhing around with severe pain trying to find the best comfortable position, you should start heading to the emergency room or seek urgent care.

Especially if it started suddenly and you know he or she didn't eat anything bad or does not have gas problems.

If you are convinced the stomach pain is not life threatening or does not require urgent care, let's see what a pharmacist recommend your child take to relieve the pain that is available over-the-counter.

Nearest ER Pharmacist