Stomachaches and Constipation in Kids

What Causes Stomachaches and Constipation in Children

The digestive tract can be sensitive, especially in kids. These are some of the most frequent causes of abdominal pain and constipation:

Functional constipation – The most common cause of constipation in kids. Triggers include a low‑fiber diet, not drinking enough fluids, lack of physical activity, or “holding it” because passing a stool (poop) hurts or they’re busy playing. Children may withhold stool during toilet training or at school, which allows stool to become larger and harder.
Overeating or indigestion – Large meals, fatty foods, or eating too quickly can cause stomachaches. Indigestion is a broad term for discomfort in the upper abdomen that often improves with smaller meals and a bland diet.
Viruses – Stomach flu and gastroenteritis can cause diarrhea, cramps, and vomiting.
Stress and anxiety – The brain and gut are connected. When kids are worried about school, friendships, or changes at home, it can trigger stomach pain.
Appendicitis – Pain usually starts near the belly button and moves to the lower right abdomen. Pain worsens with movement, coughing, or walking.
Intestinal obstruction or other surgical emergencies – Blockages from swallowed objects or a twisted bowel cause pain, bloating, inability to pass stool or gas, and vomiting. These are rare but need immediate evaluation.
Other possible contributors – Reflux/acid irritation, food allergies or intolerances (e.g., lactose intolerance), urinary tract infections, menstrual cramps or pelvic conditions in teens, and inflammatory bowel disease (IBD) can also cause these symptoms.

Why constipation and stomachaches go hand-in-hand

When stool sits in the colon too long, it becomes hard and causes a stomachache. If a child (toddler age or older) waits to pass stool until every three days or longer, they may strain and have pain.

Constipation can also cause nausea, poor appetite, and bloating. If this is the cause, easing constipation usually relieves the stomachache, too.

Understanding When Abdominal Pain or Constipation Needs Care

Knowing when to manage symptoms at home versus seeking medical help can be tricky. Use the guidelines below to help you decide. Always trust your instincts: If you’re concerned, call your clinician.

Home Care
The following situations usually improve with rest, dietary adjustments and careful monitoring:

Mild tummy aches that come and go, improve after passing gas or a stool, and are not accompanied by fever, vomiting, or blood.
Occasional constipation or infrequent bowel movements (every 2–3 days) when the stool is soft and your child is comfortable.
Abdominal discomfort after overeating or eating unfamiliar foods. Smaller, bland meals can ease indigestion.
Symptoms of a typical viral stomach bug (low‑grade fever, loose stools, or mild vomiting) when your child stays hydrated and is playful.
Infant dyschezia – babies under six months who strain and turn red when pooping, but pass soft stools normally.

Contact the Clinic
Contact your pediatrician within 24–48 hours if:

Your child hasn’t had a bowel movement in more than three days and is uncomfortable or straining.
Stools are large, hard or painful to pass, or you notice streaks of blood on the stool or toilet paper.
Stomach pain lasts longer than 24 hours, recurs frequently, or keeps your child from normal activities.
They also have fever, vomiting, weight loss, poor appetite, a bloated belly, or a change in urination.
Your child is under 3 months old and has any abdominal pain, which usually shows up as poor feeding, irritability, or a change in their bowel patterns.
You suspect dehydration (dry lips, fewer wet diapers or trips to the bathroom, no tears when crying).
Your child has a history of chronic conditions (e.g., inflammatory bowel disease, celiac disease) or is immunocompromised.

Seek Emergency Care
Go to the emergency room or call 911 if your child has any of the following:

Severe or sudden abdominal pain that prevents them from moving or finding a comfortable position, or pain that steadily worsens.
Signs of intestinal obstruction: swollen or distended belly, inability to pass stool or gas, persistent vomiting or bilious (green) vomit.
High fever, bloody stools or vomiting blood; black tarry stools; or skin that turns yellow.
Persistent nausea and vomiting that prevents them from keeping down fluids.
Severe tenderness when the abdomen is touched or swelling of the abdomen.
Sudden lower‑right abdominal pain with fever or vomiting (possible appendicitis).
Painful, swollen scrotum or sudden groin pain (possible testicular torsion).
Trauma to the abdomen or suspected ingestion of a battery, magnet or object.

Age

Infants (0–12 months) – Newborns may strain or grunt during bowel movements because they are learning to coordinate muscles. Constipation in babies can result from formula changes or introduction of solids. Gas, colic, and reflux are also common causes of abdominal discomfort. Rare but serious causes of abdominal pain include necrotizing enterocolitis (problems with the intestinal tissue), volvulus (twisted intestine) and pyloric stenosis (stomach muscle blocks the intestine). Any infant under 3 months with stomach pain and irritability, vomiting, blood in stool, or reduced feeding should be seen urgently.
Toddlers (1–5 years) – Constipation from a limited diet, a high-milk diet, potty‑training struggles, or refusing to use public toilets is common. Intussusception (telescoping bowel) and ingestion of objects (batteries or magnets) are age‑specific emergencies. Teach your child to tell you when they feel the urge to poop and respond promptly.
School‑age children (6–11 years) – Appendicitis becomes more likely in this older age group. Chronic stomachaches can be caused by constipation, irritable bowel syndrome or anxiety. Keep track of pain patterns and triggers.
Teens (12–18 years) – In addition to constipation, consider period cramps, ovarian cysts, pelvic inflammatory disease, and sexually transmitted infections. Girls with severe or worsening pelvic pain need prompt evaluation. Stress, eating disorders, and pregnancy can also present as stomach pain.

Duration and Pattern

Sudden, severe pain demands quicker evaluation than mild, intermittent discomfort.
If possible, note where the pain is and what makes it better or worse. Pain that wakes your child from sleep or worsens with movement is concerning,
Keep a bowel movement and pain diary. Does your child always complain before school or at bedtime? Patterns can reveal constipation or stress triggers.

Other Symptoms

Seek a quicker assessment if they also have fever, vomiting, rash, jaundice, weight loss, poor growth, or urinary symptoms.

Bloating or gas with no other symptoms often suggests indigestion or constipation. Encourage water and gentle movement.

Diet, Hydration and Lifestyle

Children who drink lots of milk and eat few fruits or vegetables are prone to constipation. Encourage a balanced diet with fiber and limit dairy to three servings per day.
Poor hydration dries stools and slows them down. Encourage your child to drink water throughout the day, and limit sugary drinks and soda.
Kids engrossed in play may ignore the urge to poop. Remind your child to listen to their body’s signals. Encourage bathroom breaks and have them sit on the toilet for five minutes after meals as a habit.

Medical History and Medications

Children with chronic conditions like celiac disease, hypothyroidism, or inflammatory bowel disease may need more frequent monitoring.
Certain medications (e.g., iron supplements) can cause constipation. Speak with your clinician about ways to improve these side effects.

At-home Care That Helps Most Children

When your child is in pain, you want to relieve tummy aches and constipation quickly. These strategies are backed by pediatric guidelines and can help your child feel better:

Hydrate, hydrate, hydrate – Offer water throughout the day. Adequate fluids keep stool soft and prevent dehydration.
Fiber‑rich foods – Add fruits (pears, peaches, plums, apricots, prunes), vegetables, beans, and whole grains. Offer these foods several times a day. Limit constipating foods like white bread, rice, potatoes, and unripe bananas.
Juice in moderation – For children over one year old, small glasses of prune, apple, pear, or grape juice may soften stools.
Limit milk and dairy – Too much dairy can harden stools. Keep milk products to three servings daily.
Encourage regular toilet sits – Have potty‑trained children sit on the toilet for five minutes after meals. The body’s natural reflex is to poop after eating. Provide a foot stool so their knees are above their hips.
Use proper positioning for infants – Help babies release stool by gently holding their knees to the chest and pumping the legs.
Encourage physical activity – Movement stimulates the intestines. For older children, daily play and exercise help keep things moving.
Stool softeners or fiber supplements (under supervision) – If dietary changes don’t help after a few days, your clinician may suggest laxatives or soluble fiber powders. Discuss dosing with your clinician before starting any medication.
Positive reinforcement – Sticker charts and praise encourage kids to sit on the toilet and let stools out. Avoid punishments or forcing sits; power struggles often worsen withholding.
Rest and comfort measures – Gentle belly massage and a quiet rest can soothe cramps.

Parents often assume constipation means their child isn’t pooping every day. In reality, normal bowel patterns range from three times per day to once every two days. For infants, there’s an even wider range of what’s “normal."

Going longer between pooping doesn’t always mean constipation if stools are soft and passed easily, especially in breast‑fed infants who may poop every 4–7 days.

Focus on stool consistency (soft and easy to pass) and your child’s comfort rather than strict schedules. Children can be constipated even if they have daily bowel movements if they are withholding and passing small, hard nuggets.

Most childhood constipation is functional, meaning there is no underlying anatomical or medical cause. It often develops when kids avoid pooping because of pain or inconvenience. Helping them develop predictable toilet habits and making stools soft break this cycle. Stool withholding can last months, so be patient and use positive reinforcement.