When your Child’s Belly Pain Requires a Trip to the ER

As a parent, it's natural to worry when your child complains of stomach pain. While many instances of tummy troubles are harmless and resolve on their own, there are times when that discomfort could signal a more serious underlying issue. In this article, Shore Pediatric Care Center Medical Director Dr. Hatem Elhagaly explains the signs and symptoms that indicate it's time to head to the ER for your child's stomach pain.

“There are many less urgent and treatable conditions that cause belly pain, such as functional abdominal pain, stomach viruses, constipation and food intolerances. These can usually be managed by your child’s pediatrician or even with at-home treatments. However, if your child experiences any of the symptoms below, it’s important to seek medical care,” says Dr. Elhagaly.  “There are many conditions that we can treat close to home, right here at Shore Medical Center’s separate pediatric ER and inpatient unit, but if it requires more advanced care, we will transfer your child to a specialized children’s hospital.”

  1. Sudden or Intense and Persistent Pain: If your child's stomach pain is sudden, unusually severe and continues for more than one hour, it could be a sign of a serious problem. “Sharp, unrelenting pain that doesn't improve with over-the-counter remedies or time are signs you should come to the ER,” says Dr. Elhagaly. “Appendicitis, intestinal obstruction or other abdominal emergencies could be causing this level of pain and require medical intervention.”
  2. Fever, Vomiting, Diarrhea, etc.: Pay attention to any additional symptoms your child may be experiencing alongside the stomach pain. Symptoms like high fever, persistent vomiting, bloody diarrhea, or sudden weight loss should raise a red flag. “These symptoms could indicate an infection, inflammatory condition, or other serious issues that require prompt medical evaluation and treatment. But even excessive vomiting or diarrhea from a stomach virus can lead to dehydration, which also requires a trip to the ER. Dehydration from stomach viruses is actually one of the most common conditions we treat.” The signs of dehydration include: fewer than six wet diapers a day, more than twelve hours without urinating, decreased saliva or crying without tears. Dr. Elhagaly added, “Pay attention to the color of the vomit. If it is dark green and bilious, it could mean an intestinal blockage. You should also be concerned if the vomit is bloody.”
  3. Abdominal Distention and Tenderness: A visibly swollen or distended abdomen, especially if it's accompanied by tenderness or pain when touched, could be a sign of a blockage or other urgent problem within the digestive system. “This blockage could have various causes. For example, intussusception, where a segment of the intestines telescopes into another segment, or volvulus, where the intestines twist. Intestinal blockages always require immediate emergency medical attention – if left untreated, it can lead to major complications or even death.”
  4. Change in Behavior: “If your child's stomach pain is causing significant changes in behavior, such as extreme lethargy, reluctance to move, or an inability to engage in regular activities due to pain, it's time to seek medical attention,” says Dr. Elhagaly. “You know your child best, and if they are not acting themselves, bring them in.”
  5. Previous Medical Conditions: Children with pre-existing medical conditions, such as diabetes, inflammatory bowel disease, sickle cell disease, malignancy, or a history of abdominal surgeries may be at a higher risk of experiencing complications related to stomach pain. If your child falls into this category and experiences severe or persistent stomach pain, seeking emergency treatment and informing the care team of your child’s medical history is essential.
  6. Trauma or Injury: If your child has experienced a recent injury to the abdomen, such as a fall or impact, or even an injury to the testicles, and is now complaining of stomach pain, it's crucial to get them assessed by a medical professional. Trauma can cause internal injuries that may not be immediately apparent but require prompt attention.
  7. Pain Localized to a Certain Area: If your child has pain in their lower right side, that could be appendicitis and requires a trip to the ER. If it is in the upper right side, it could be gallbladder problems, such as cholecystitis or liver conditions. Pain in the upper region could indicate reflux or pancreatitis, and pain in the middle that also includes a bulge could be a strangulated umbilical hernia.  

Dr. Elhagaly says that parents should pay special attention to infants, especially those under 12 weeks of age, and bring them to see a doctor promptly if they have persistent undiagnosed abdominal pain, are crying for more than three hours, or are crying ‘hysterically’. It’s also concerning if the baby’s abdomen is distended or tender to touch.

In situations where you're unsure whether your child's stomach pain requires a trip to the ER, it's always better to err on the side of caution. Pediatricians and medical professionals recommend trusting your parental instincts. If you have any concerns about the severity or potential causes of your child's stomach pain, don't hesitate to contact your child's doctor or a medical helpline for guidance.

Specialized Pediatric Emergency Care at Shore
Dr. Elhagaly is proud to lead the Pediatric Care Center at Shore Medical Center, the only hospital in the region to offer a separate pediatric ER and inpatient unit. 

“At Shore, pediatric specialists and neonatologists are available around the clock to care for your child. We have taken special effort to make the hospital experience less frightening and painful for children by implementing ‘ouchless’ and sensory-friendly programs,” says Dr. Elhagaly. “With special devices designed to make needle sticks, sutures, and IVs less painful, we are minimizing medical trauma in children. With our sensory-friendly program, our staff have been trained by professionals from the Atlantic County Special Services School on how to best support children on the autism spectrum. We have a full menu of sensory toys, weighted blankets and headphones, along with communication devices that children are already familiar with from school so they can communicate with us during their care. We want all children and their families to feel safe and comfortable coming to the ER. Your child’s health and well-being are of utmost importance, and timely intervention can make a big difference in their health and recovery.”

Shore’s Pediatric Care Center is located at Shore Medical Center and accessible through the main ER entrance at 100 Medical Center Way, Somers Point, NJ, 08244. To learn more about Shore Medical Center’s Pediatric Care Center, click here or call 609-653-5300.