When a child complains of a stomachache every new term or school morning, it can be hard to tell whether they’re truly in pain or just reluctant to go. The AAP’s HealthyChildren.org lists constipation and urinary tract infections among common causes of abdominal pain, alongside emotional upset, and notes that school-age children can have recurring pain with no other obvious explanation.
Why It Happens
According to HealthyChildren.org, common reasons for a child’s stomachache include constipation, urinary tract infections, and emotional upset. Constipation is a frequent cause of lower abdominal pain in older children, urinary tract infections are more common in 1- to 5-year-olds, especially girls, and strep throat can also come with belly pain in children over 2. The AAP also describes functional abdominal pain disorders, where no clear cause is found and the gut and brain signal each other in an extra-sensitive way. The pain is real to the child, not made up. Many adults know the experience of a stressful day showing up in the stomach.
How It Looks at Different Ages
The AAP notes that school-age children may have repeated stomachaches without another explanation, and it suggests checking whether something at home, at school, or with friends is troubling them. Pain that rises around a new term, a new class, or friendship changes, and eases on weekends or school breaks, may point toward emotional tension. That pattern alone isn’t conclusive, so physical causes such as constipation are worth checking at the same time.
What Helps at Home
Start by keeping a pain log for about two weeks: when the pain comes (morning, before school, after meals), where it hurts, how long it lasts, and how it relates to eating and bowel movements. This can help a lot at a visit. If a child has trouble putting feelings into words, HealthyChildren.org suggests play-based tools such as drawing or pretend play. Acknowledge the pain first (“That sounds really uncomfortable”), then ask gently whether anything about school feels worrying.
A calm, unhurried morning, regular meals and bathroom times, and enough fluids and fiber may help. Repeated absences can feed school anxiety, so sharing the situation with the teacher and agreeing on how to use the school nurse can be useful. Cognitive behavioral therapy is also described as helpful for stress-related gut symptoms.
Common Parent Misunderstandings
Dismissing it as “faking” can make a child feel unheard and stop sharing, while focusing too intensely on the pain can make a child watch their body more closely. Likewise, an emotional trigger doesn’t rule out a physical cause. The goal is to acknowledge the pain while helping the child keep to daily routines where possible.
When to Consider Talking with a Pediatrician
It’s worth seeing a pediatrician if the stomachaches keep returning for more than two weeks, if there’s weight loss, vomiting, blood in the stool, or fever, or if pain is causing repeated missed school. Pain low on the right side, constant pain lasting more than 2 hours, or a child who looks very sick or limp may need prompt medical care, including an emergency room visit. This information isn’t a diagnostic tool and doesn’t replace advice from a medical professional.