Abdominal pain in teens may occur at some point and is often not a serious problem. The abdominal cavity contains many organs such as the kidney, pancreas, spleen, liver, gallbladder, intestines, appendix, and stomach. Problems with any of these organs can cause abdominal pain leading to gastrointestinal distress. Severe or recurrent pain with other symptoms may require medical care. Some cases of abdominal pain can be a medical emergency, so you may consult the doctor before giving pain medications. It’s important to understand the causes and symptoms of abdominal pain in teenagers for timely intervention. Keep reading to know the causes, accompanying symptoms, diagnosis, and treatment of abdominal pain in teenagers.
Types Of Abdominal Pain In Teenagers (Boys And Girls)
The intensity and location of the abdominal pain indicates the types of abdominal pain (1).
- Generalized pain: The pain is in more than half of the abdominal area. This type of pain may be associated with indigestion, gas, or a viral infection. Sometimes, generalized pain could become severe, thus indicating blockage or other severe problem in the intestines.
- Localized pain: This pain is restricted to one part of the abdomen. It is usually associated with problems in one organ, such as stomach, gallbladder, or appendix.
- Cramping or cramp-like pain: Generally, this pain does not indicate a serious problem. It may be because of bloating or gas and might be followed by diarrhea. Cramp-like pain can be worrisome if it is accompanied by fever, occurs frequently, or lasts more than 24 hours. Women can also experience this type of pain during menstrual periods.
- Colicky pain: This pain usually starts and ends suddenly, occurring in a wave-like pattern. Usually severe in intensity, this type of pain may be associated with kidney stones or gallstones.
Be watchfulAssociated Signs And Symptoms
Abdominal pain often occurs with other symptoms. Based on the underlying cause of the pain, associated signs and symptoms can include the following (2) (3).
- Nausea
- Vomiting
- Headache
- Fever
- Sore throat
- Body ache
- Bloating
- Diarrhea
- Changes in bowel movements
When To See A Doctor?
If your child experiences the following symptoms, seek immediate medical attention (1) (2).
- Change in bowel pattern
- Stomach discomfort lasting for more than a week
- Blood in stool
- Vomiting
- Fever (> 100.4 °F)
- Sore throat
- Headache
- Chest, neck, or shoulder pain
- Prolonged vaginal bleeding
- Weight loss
- Prolonged loss of appetite
- Diarrhea for more than five days
- Bloating for more than two days
- Burning or pain during urination
Home Care Tips To Manage Abdominal Pain
Pediatric abdominal pain can occur due to several reasons and may vary in intensity for each child. If your child experiences abdominal pain with other symptoms, it is advised to visit a healthcare practitioner to identify the cause of abdominal pain. Do not give any over-the-counter medicine to your child without talking to your doctor. However, for mild abdominal pain, you may try the following tips at home to relieve pain (1).
- Sip water: Keep slowly sipping water or other fluids. Warm liquids may help relieve pain.
Image: Shutterstock
- Avoid solid food: Avoid solid food or food that is hard to digest for the first few hours or till you see your doctor.
- Eat specific food items after vomiting: If the teen has been vomiting, then avoid consuming solid food for at least six hours. You may give your child mild food items such as rice, apple juice, or crackers. Do not give your child dairy products.
- Avoid citrus food items during indigestion: If your child is experiencing heartburn or indigestion with pain in the upper part of the abdomen, then avoid citrus, greasy, or fatty foods. You may also avoid tomato products, caffeine, and carbonated drinks.
- Promote relaxation: If stress is the underlying cause, encourage your child to practice techniques like deep breathing or meditation to help reduce stress-related abdominal pain (4).
Quick factCauses Of Abdominal Pain In Teenagers (Boys And Girls)
Abdominal pain can be caused by a variety of conditions. Minor causes can include food poisoning, constipation, acid reflux, food allergies and food intolerance, irritable bowel syndrome, and stomach flu. The severe causes of pain can include the following (1) (3) (5).
- Appendicitis: It is an inflammation of the appendix and occurs quite frequently in adolescents. In this condition, pain usually migrates from the middle section of the abdomen to the right lower part. Other symptoms of appendicits in teens can include nausea, vomiting, abdominal swelling, or low-grade fever (6).
- Gastroenteritis (stomach flu): It is a very common condition and is caused by bacterial or viral infection. Common infection-causing viruses include rotavirus, Norwalk virus, adenovirus, enterovirus while common bacterial agents include Escherichia coli, Salmonella, Shigella, Yersinia, and Campylobacter (5). Other symptoms can include diarrhea, vomiting, fever, or headache.
- Constipation: Constipation occurs when there is difficulty in bowel movements due to hard stool or bowel movements are less frequent (less than three per week). Pain due to constipation is usually on the left side of the abdomen (5). Other symptoms can include pain and straining in the rectum area during bowel movements, bloating, or rectal bleeding (7).
- Urinary tract infection: This condition is very common among teenagers, especially in girls. Apart from abdominal pain, symptoms can include side pain or back pain, fever and chills, pain or burning during urination, foul-smelling urine, cloudy urine, or presence of blood in the urine (8).
- Stress: Emotional distress such as anxiety and stress, or psychological issues such as depression in school-aged children can also cause recurring abdominal pain. This pain, also known as functional abdominal pain, has no other identifiable cause. In addition, no other symptoms such as nausea, vomiting, fever, weakness, or diarrhea are observed in those teenagers (9). Dr. David D. Clarke, MD, president of the Psychophysiologic Disorders Association and a board-certified consultant gastroenterologist from Portland, Oregon, says, “Stress is the most common cause of abdominal pain in teenagers. The diagnostic testing of functional (stress-related) abdominal pain does not reveal any organ disease or structural abnormality. Clues that the abdominal pain is stress-related include pain that moves from place to place in the abdomen, is relatively brief (seconds to a few minutes), is relieved after a bowel movement, or is triggered by a light touch over the abdomen. It is important to look for sources of stress in the teenager’s life, such as stressful life issues, a history of trauma, and undiagnosed depression or anxiety.”
Image: Shutterstock
- Food reactions (intolerance): Certain food items when consumed can cause reactions. One such condition is lactose intolerance. Consumption of dairy products in lactose intolerant teenagers may cause abdominal pain, bloating, gas, or diarrhea.
- Gastroesophageal reflux disease (GERD): It occurs when the contents of the stomach come back (acid reflux) and irritate the food pipe (esophagus). A systematic review by multiple research and health institutions on GERD symptoms in children showed significant variation in prevalence between studies (0%-38% of the study population). On average, GERD symptoms were present in more than 10% of children weekly and in 25% of children monthly. Teenagers with GERD can experience heartburn, bad breath, wearing down of teeth, vomiting, pain in the chest or upper abdomen, or pain during swallowing (10).
- Kidney stones: Kidney stones are hard solid mass of minerals and elements that lodge in the kidneys. Usually, these stones pass through urination, but might sometimes remain in the kidneys thus causing discomfort. The pain due to kidney stones starts suddenly in the back or the sides and is severe and persistent. Other symptoms may include nausea and vomiting (11).
- Trauma or injury: Any blunt trauma or injury in the abdominal area can not only cause pain but also perforations, and hematoma (bleeding) in internal organs (5).
- Gallbladder disease: In this condition, the bile ductiTube carrying bile produced by the liver to the gallbladder and then to the small intestine is blocked, often due to the presence of gallstones. The pain is usually experienced in the upper right part of the abdomen and after meals while other symptoms include fever and jaundice. The increasing obesity among teenagers has increased the risk of gallstone formation (12).
- Inflammatory bowel disease (IBD): This disease is also known as ulcerative colitis or Crohn’s disease. This condition mostly peaks in the age group of 15 to 35 years. The inflammation in the gastrointestinal tract (gastritis) can cause abdominal pain, weight loss, or diarrhea. Teenagers with ulcerative colitis can also experience blood-laden diarrhea (13).
- Irritable bowel syndrome: It is a chronic disorder that affects the large intestine or colon. The symptoms include chronic abdominal pain, bloating, diarrhea, loss of appetite, or change in bowel movements (14).
- Peptic ulcers: It is an open sore wound that appears in the stomach or upper part of the small intestine. An infection by Heliobacter Pylori bacteria has been identified as the most common cause of these ulcers. The symptoms can include burning stomach pain, loss of appetite, frequent burping, or vomiting (15).
- Pancreatitis: It is a disease caused by the swelling and inflammation of the pancreas. The condition is rare in children. One of the main symptoms of pancreatitis is pain in the upper left or middle part of the abdomen. Other symptoms include clay-colored stools, indigestion, bloating, and hiccups.
- Abdominal migraine: This disorder is usually diagnosed in children between three to ten years of age. Its symptoms include moderate to severe stomach pain accompanied by nausea, vomiting, headache, anorexia, and pallor. It causes recurring and chronic pain in children.
- Functional gastrointestinal disorders (FGID): They are a set of chronic abdominal disorders characterized by similar symptoms such as abdominal pain, dysphagia, dyspepsia or indigestion, bloating, constipation, or diarrhea.
- Hepatitis: Hepatitis A, B, and C are the most common types of viral hepatitis. This disease is caused due to inflammation of the liver. The symptoms of this disease are fever, abdominal pain, fatigue, nausea, vomiting, dark-colored urine, jaundice, and joint pain.
- Substance abuse: The repeated use of certain drugs such as opioids or hallucinogens could cause abdominal pain along with other symptoms such as rectal bleeding, nausea, acid reflux, constipation and vomiting.
- Autoimmune disorders: Several autoimmune disorders including collagen vascular diseases, Lupus, and Wegener granulomatosis can cause abdominal pain. Other symptoms of these disorders include oral ulcers, dysphagia, GERD, diarrhea, constipation, fecal incontinence, and gastrointestinal bleeding.
The graph below shows the global prevalence of irritable bowel syndrome (IBS) in children and adolescents. The pooled prevalence of IBS was reported to be highest in Asia (16.2%). It was found to be 4.8% and 4.2% in the USA and Europe, respectively.
Global prevalence of irritable bowel syndrome in children and adolescents
Source: Paediatric functional abdominal pain disorders; Nature reviews disease primersGirls versus boys data were available for some countries, whereas, for India, Korea, and Mexico, only overall prevalence data was reported (denoted by gray bars)
Lower abdominal pain in teenage boys
Apart from the above causes, teenage boys can experience abdominal pain due to the following condition (5).
- Testicular torsion: It occurs most frequently in teenage boys as an emergency condition that requires immediate medical attention. Testicular torsion occurs due to the twisting of the spermatic cordiBunch of nerves, blood and lymph vessels, and ducts that runs from the abdomen to the testicle and connects the testicle to the scrotum. , thus blocking the supply of blood to the testicle. The symptoms may include severe pain in the scrotum, abdominal pain, enlarged testicles, and swollen, red and tender scrotum (16).
Lower abdominal pain in teenage girls
A few causes of abdominal pain are specific to teenage girls (1) (5).
- Dysmenorrhea (Cramps and pelvic pain with menstruation): This condition is associated with painful cramps during menstruation and is the most common problem in girls among all age groups. Characteristic symptoms may include pain in the lower abdomen, pelvic pain, pain that radiates to the lower back and thighs, nausea, vomiting, and headache. This pain usually lasts for eight to 72 hours and occurs with the start of the menstrual flow (17).
- Mittelschmerz (Ovulation pain): Hormonal changes occurring during menstruation may cause ovulation pain. This pain occurs in the lower abdomen around mid-menstrual cycle (between seven and 24 days) and is associated with an increase in luteinizing hormoneiHormone that stimulates ovulation in women and causes testicles to make testosterone. (LH) levels. It is usually felt in the lower right part of the abdomen and the intensity may vary from mild to severe (18).
Did you know?Mittelschmerz (ovulation pain) usually goes away within three to twelve hours and does not require any treatment (18).
Image: Shutterstock
- Endometriosis: Endometriosis is one of the more serious gynecological issues a teenage girl might face. The symptoms of endometriosis often start during adolescence. The condition is defined as the presence of endometrial tissue outside of the uterus. It can present symptoms such as back pain, flank pain, nausea, headache, fatigue, and urine urgency (19).
- Ovarian torsion: This condition occurs mostly due to ovarian cysts or ovarian tumors and can cause acute abdominal pain. The pain usually occurs on one side and right-sided pain is more common than left-sided pain. Other symptoms can include nausea, vomiting, fever, and presence of palpable mass (20).
- Ectopic pregnancy: Ectopic pregnancy occurs outside of the uterus (usually inside fallopian tubesiPair of tubes that carry eggs from ovaries to the uterus in women. ) and can be life-threatening. In sexually active teenagers, ectopic pregnancy can present symptoms such as severe sharp lower abdominal pain, cramping on the affected side of the pelvis, abnormal uterine bleeding, and amenorrhea (absence of menstruation) (17).
- Pelvic inflammatory disease (PID): This condition refers to the infection and inflammation of the upper genital tract, including the uterus and fallopian tubes. In adolescents, multiple sexual partners and increased incidence of sexually transmitted diseases (STDs) increase the risk of PID (21). The symptoms include lower abdominal pain, abnormal findings in pelvic examination (uterine tenderness/cervical motion tenderness), abnormal vaginal or cervical discharge (16).
- Threatened abortion: According to the World Health Organization, threatened abortion is defined as a pregnancy-related bloody vaginal discharge or frank bleeding during first half of the pregnancy without the dilation of the cervix. Symptoms can include lower abdominal pain and vaginal bleeding (22).
Diagnosis Of Abdominal Pain
The diagnosis may require a series of laboratory tests and examinations. Your healthcare practitioner may consider the following factors including age, history of pain, any trauma, associated symptoms, family history, and gynecological history (5).
Diagnosis may also require physical examination including abdominal examination, and rectal and pelvic examination. Other laboratory investigations may include the following (1).
- Blood, stool, and urine tests to check for infectious agents (bacteria, virus, or parasite)
- Ultrasound of the abdomen
- Abdominal X-ray
- CT scan
- Colonoscopy or sigmoidoscopy (tube through the rectum into the colon to look into intestines and colon)
- ECG (electrocardiogram)
- Upper endoscopy (tube through the mouth into the esophagus, stomach and upper small intestine to detect any problems)
- Upper gastrointestinal (GI) and small bowel series (set of X-ray to check for any ulcers, abnormalities, inflammation, blockages, or abdominal tumors)
Treatment Of Abdominal Pain In Teens
Treatment of abdominal pain depends on the underlying condition or disease. The following treatment methods are used to treat the causes of pain.
- Doctors can recommend antibiotics to your child in case of infections.
- Inflammatory diseases are often treated or managed with anti-inflammatory agents or immunosuppressorsiMedication used to keep the body’s immune system in check. . Pain relievers or analgesicsiMedicine used to relieve pain can also be given to relieve severe pain.
- Teenagers with constipation may be recommended stool softeners or laxatives. For conditions associated with acid-reflux in teens, doctors may prescribe antacids or H2 blockersiMedicine that reduces the amount of acid produced by glands in the lining of the stomach .
Image: Shutterstock
- Teenagers experiencing functional abdominal pain due to emotional distress may be advised counseling or psychological therapy.
- In addition, doctors may also suggest changes in the child’s nutrition and diet to relieve symptoms related to food reactions or intolerance and bowel movements.
- In other cases such as appendicitis, ovarian or testicular torsion, abdominal trauma, or intestinal blockages, surgery works as the best option.
Quick tipRisks Factors For Abdominal Pain In Teens
The following factors might increase the risk of abdominal pain.
- Age: Some conditions such as appendicitis, gastroenteritis, or testicular torsion that cause abdominal pain are more prevalent in teenagers and older children.
- Family history: Owing to previous medical history in families, your child may be more prone to gynecological conditions (endometriosis or dysmenorrhea), inflammatory diseases, and food reactions.
How To Prevent Abdominal Pain?
Abdominal pain might not always be preventable. However, you can encourage your child to follow these precautions to minimize the risks of certain conditions that lead to stomachache (1).
- Stay hydrated, and drink plenty of water in a day.
- Eat small and frequent meals.
- Perform regular physical activity and do age-appropriate exercises regularly.
- Avoid consumption of food items that can cause indigestion or gas.
- Consume high-fiber and well-balanced diet. Include fruits, vegetables, and whole grains in all meals.
Frequently Asked Questions
1. Can puberty cause abdominal pain?
Yes. The emotional distress that a teen faces during puberty can manifest itself in the form of abdominal pain (26).
2. How long will my abdominal pain last?
Abdominal pain usually lasts for about 24 to 48 hours (27).
3. What are the possible risks associated with over-the-counter pain relievers in teens with abdominal pain?
Over-the-counter pain relievers may be effective when treating a particular problem, but they can have some serious side effects if they are consumed in high doses over a long period. Most side effects target the stomach and can cause problems such as a mild stomach ache or, in severe cases, gastritis, ulcers, and gastrointestinal bleeding. To avoid these side effects, consult your healthcare provider before self-medicating with over-the-counter pain relievers (28).
4. Can exercise or physical activity cause abdominal pain in teens?
Strenuous exercise or physical activity can cause abdominal pain in teens. This type of pain is called exercise-related transient pain (ETAP). This can also be referred to as a ‘stitch’ and is a localized pain most commonly felt in the lateral aspects of the mid-abdomen, although it may occur in any region of the abdomen. This ETAP tends to be a sharp pain when severe and feels like cramping, aching, or pulling when less intense (29).
Abdominal pain in teens may happen for various reasons, ranging from something as mild as constipation to something as serious as testicular torsion or threatened abortion. The symptoms and severity of the pain differ based on the underlying cause. The doctor may ask for a detailed medical history, do a physical examination, and advise other investigations if necessary. The doctor may suggest lifestyle modifications, medications, psychotherapy, or more complex interventions such as surgery to manage abdominal pain in your teen. If your teen complains of abdominal pain, do not hesitate to consult your doctor.
Infographic: Surgical Consultation For Acute Abdominal Pain
Surgical consultation is often indicated in acute abdominal pain in children to determine problems that require prompt treatment through surgery. It can help prevent severe causes, such as appendicitis, from complicating and causing other issues. Go through the infographic to know indications for surgical consultation in children with acute abdominal pain. Illustration: Momjunction Design Team
Empower yourself with expert advice on managing abdominal pain in children and adolescents. Alleviate your child’s discomfort with tips and insights shared in this helpful video.
Key Pointers
- Abdominal pain can be categorized into generalized, localized, cramp-like, or colicky type indicating the underlying issue.
- Causes of abdominal pain range from minor issues such as food poisoning or constipation to severe issues such as appendicitis or kidney stones.
- Teenage boys may experience abdominal pain due to testicular torsion, while girls may experience dysmenorrhea.
- Symptoms such as vomiting, bleeding, fever, or changes in bowel movement along with the pain warrant medical attention.
- Home care measures to manage abdominal pain include drinking water and avoiding greasy, spicy, or hard-to-digest foods.
Illustration: Causes Of Abdominal Pain In Teens And Tips To Manage It
Image: Dall·E/MomJunction Design Team
References
1. Abdominal Pain: U.S. National Library of Medicine
2. Stomachaches in Children & Teens, American Academy of Pediatrics
3. Abdominal Pain Causes: HealthLink BC
4. Stress-related Stomach Pain: When to see a doctor; The University of Chicago Medical Center
5. Leung, A. K., & Sigalet, D. L. Acute abdominal pain in children: American Family Physician
6. Appendicitis in Teens: American Academy of Pediatrics
7. Symptoms & Causes of Constipation in Children; National Institutes of Health
8. Moreno, M. A. Urinary Tract Infections in Children and Adolescents; JAMA pediatrics
9. Shapiro, M. A. and Nguyen M. L., Psychosocial stress and abdominal pain in adolescents; Mental Health in Family Medicine
10. An Adult Disease That More Teens Are Getting; MemorialCare
11. Kidney Stones in Children and Teens; American Academy of Pediatrics
12. Kidney stones; Michigan Medicine
13. Bishop J., Lemberg D. A., and Day A., Managing inflammatory bowel disease in adolescent patients; Adolescent health, Medicine and Therapeutics
14. Irritable Bowel Syndrome (IBS) in Children: Stanford Children’s Health
15. Symptoms & Causes of Peptic Ulcers (Stomach Ulcers); National Institutes of Health
16. Testicle Pain & Testicular Torsion; American Academy of Pediatrics
17. Osayande A. S. and Mehulic S., Diagnosis and initial management of dysmenorrhea: American Family Physician
18. Brott N.R. and Le J.K., Mittelschmerz; StatPearls Publishing LLC.
19. Dun E. C. et al., Endometriosis in adolescents; Journal of the Society of Laparoendoscopic Surgeons
20. Taheri M. R., Dubinsky T. J. and Kolokythas O., Ovarian Torsion in a Teenage Girl with Genitourinary Anomaly; Radiology Case Reports
21. Paradise J. E. and Grant L., Pelvic inflammatory disease in adolescents: Pediatrics in Review
22. Moury M. and Rupp J.T., Threatened abortion; StatPearls Publishing LLC.
23. Philip Bufler et al.,Recurrent Abdominal Pain in Childhood;Deutsches Arzteblatt international
24. Dennis Anheyer et al.,Herbal Medicines for Gastrointestinal Disorders in Children and Adolescents: A Systematic Review;Pediatrics; AAP Publications
25. Abdominal pain in children;Better Health Channel; Department of Health, State Government of Victoria, Australia
26. What causes GI issues in teens – and how to get them to talk about it; UT Southwestern Medical Center
27. Using medication: The safe use of over-the-counter painkillers;National Library of Medicine.
28. Abdominal pain;Mount Sinai
29. Darren Morton and Robin Callister; (2015); Exercise-Related Transient Abdominal Pain (ETAP);NCBI.
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Read full bio of Dr. Elna Gibson
Dr. David D. Clarke is president of the Psychophysiologic Disorders Association and Clinical Assistant Professor of Gastroenterology Emeritus at Oregon Health & Science University in Portland, Oregon. Board-certified in Gastroenterology and Internal Medicine, he practiced from 1984-2009. Moreover, he has authored books including ‘They Can’t Find Anything Wrong!’ and ‘Psychophysiologic Disorders’. Dr. Clarke lectures across North America and in Europe and has appeared on over 100 television and radio broadcasts.
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