Episode 57: Tummy Pain in Kids – What’s Really Going On?

Episode 57: Tummy Pain in Kids – What’s Really Going On?

If your little one frequently complains about tummy pain, you’re not alone. As a mum (and Paediatric Dietitian) I know first-hand how gut issues can impact kids. While many parents are told “ Your child will grow out of it,” the truth is, tummy troubles can have many underlying causes, and waiting it out isn’t always the best solution.

In this episode, I break down the four key reasons why kids experience tummy pain and how you can help them feel better – without all the guesswork.

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Links
https://nourishwithkarina.com/feedingbabies
https://nourishwithkarina.com/membership

Highlights:

Introduction (00:00.074)
Understanding Your Child’s Digestive Health Journey (00:29.164)
Understanding Tummy Pain in Children — Causes, Clues & What to Do (02:49.998)
The 4 Root Causes of Tummy Pain in Children — A Practical Guide for Parents (05:06.336)
When Tummy Pain Lingers — Post-Infection IBS and Parasites in Kids (07:27.39)
When Parasites or Anxiety Cause Kids’ Tummy Troubles (09:43.478)
When Emotions, Anxiety & Food Intolerances Cause Kids’ Tummy Troubles (11:59.468)
When Gut Issues Disrupt Life — How Food, Bugs & Early Gut Health Impact Children (14:19.928)
From Food Diaries to Celiac Disease — Diagnosing the Root of Tummy Troubles (16:41.454)
Tummy Troubles in Kids — Celiac, IBD, or IBS? Understanding the Root Causes (19:03.022)
Understanding IBS in Children — Diagnosis, Triggers, and Treatment Options (21:21.848)
Tummy Pain in Kids — When to Seek Help and What Parents Can Do (23:39.8)
Thanks for Listening — How to Support the Show (25:58.56)

Show notes

READ TRANSCRIPT

Show Notes

In this episode, I break down the four key reasons why kids experience tummy pain and how you can help them feel better – without all the guesswork.

What we cover:

Common Causes of Tummy Pain – Infections, food sensitivities, stress, and underlying conditions – how to identify what's really going on.
The Gut-Brain Connection – How emotions play a massive role in digestive health and when to suspect stress-related tummy pain.
Food Intolerances & Sensitivities – Why some children don’t just “grow out of it” and how to spot red flags in their diet.
When to Seek Medical Help – Signs your child’s tummy pain could be something more serious, like coeliac disease or IBS.
Actionable Steps for Parents – Practical tips on managing tummy pain, plus how a food and symptoms diary can be a game-changer.

If your child struggles with gut issues, don’t wait for them to “grow out of it”—let’s get to the root of the problem together.

Show Notes & Links:
Get my favourite kid-friendly gut-friendly recipes: https://nourishwithkarina.com/healthy-recipes-for-kids
Find out how I can help: https://nourishwithkarina.com

If you found this episode helpful, please leave a review or send me a message on Instagram. I’d love to hear from you.

Introduction (00:00.618)
You're listening to the Easy Feed Podcast, episode number 57, tummy pain in kids. Hi there, I'm Karina Savage and with over 20 years experience feeding children, including my own, I've learnt all the secrets that busy mums need to get their children eating better and actually enjoying healthy foods. So a huge welcome to the Easy Feed Podcast.

Understanding Your Child’s Digestive Health Journey (00:29.164)
Welcome back. hope you're really well. Today, I want to talk about a topic that I've had some pretty good experience in over my children's lives from my daughter, was colicky when she was a baby with lots of tummy pain and gut issues. And to my son who to this day still struggles with tummy pain and issues for various reasons. So it's a, it's an area that I am not only well versed in from a clinical

professional scientific perspective, cause I love to keep abreast of all of the latest and greatest in gut issues in kids because that's what I've loved doing for the last 23 years. But certainly as my kids have gotten older, I guess it's a journey, right? Earlier on with my daughter, she had the gut issues and now my son, it's just navigating certain tummy grumbles and gripes and trying to work out what on earth's going on.

But I can certainly relate to parents who have children with gut issues because it's not always easy. And even someone who is specialized, qualified, spends so much time in this area. I even struggle sometimes to work out what's going on with my son. And so I find that a lot of parents get told by doctors and not to throw doctors under the bus here because they're phenomenal human beings and they do so much for all of us all the time.

But I feel like in this area, it's just so hard to work out what's going on. They say, they'll grow out of it. That your toddler will grow out of their tummy pain and their diarrhea and their bloating. Your baby will grow out of their colicky symptoms and gas and sleepless nights. And when I work with parents and we fix their children, it's amazing. And they're like, my gosh, I wish that we'd met sooner. I wish I hadn't spent two years trying to work out the cause or.

just waiting it out because I was told to wait it out because eventually they'll get better. And I think that people get told that because they don't know what else to do or professionals don't know what else to tell them. They'll grow out of it because it's a really hard, tricky journey to navigate unless you really know what you're talking about. So I want to shed some light on some various factors.

Understanding Tummy Pain in Children — Causes, Clues & What to Do (02:49.998)
that can contribute to tummy pain in children. And certainly if you ever suspect that your child's got a food related tummy pain intolerance, then reach out to me because I can 100 % help you navigate that path. Whether it's a baby who you're worried about, they're having allergies or intolerances or whether your toddler's got diarrhea, whether your toddler's got constipation.

You name it, I love nothing more than diving into a complex case of guys in children and fixing it because it's so rewarding and I love the tricky complex cases. So if you've got a tricky complex case and you can't seem to find your way forward with your little one, some of them have really bad rashes on their butt because they're just got, it's ripping them basically as they, they're doing a poo. I'm sorry. We are going to talk a bit about poo but.

Sometimes kids constipated too, and that has a whole other effect on appetite, general wellbeing, bloating, discomfort, willingness to go to the toilet. So gut issues are a real issue in, for so many kids, 33 % of visits to a pediatric gastroenterologist have constipation. Constipation is massive.

I only posted a comment on, not comment, an Instagram reel on managing constipation. was over the holiday period and it was like one of my most popular reels to date. And it just highlights the number of parents that are concerned or want to know more about it because it is huge. There's so many people out there, constipated adults and kids included. And constipation is a whole nother conversation and I've got a podcast episode on this.

And we can talk more about constipation later in another podcast episode. But for today, I would like to try to help you navigate why your child may have gut pain or tummy pain, I should say. Because tummy pain can be incredibly multifactorial and incredibly difficult to try to navigate and understand, especially with little children, especially if they're not talking fluently yet. It's a guessing game.

The 4 Root Causes of Tummy Pain in Children — A Practical Guide for Parents (05:06.336)
And it can be really tricky to navigate. my mind, there's four key areas that could cause tummy pain in children. And it's really important to try to understand the underlying cause of the tummy pain so that you can start to address it. Because I tell you, I've seen many, many children over my years that are referred to me by pediatric gastroenterologists. And these children are literally missing terms and terms of school.

because of their tummy pain and their issues, whether it's diarrhea or extreme cramping, they're just missing so much of school, so much learning, connecting with their friends. can be really socially isolating and it can affect children's learning because their attendance at school drops. So it's really important to understand what the contributing underlying factors are for the tummy pain so that we can fix it so that kids can go on living a normal, healthy life.

and happy and connected so that they're actually able to see their friends. So the first contributing factor is sickness and infection. So if a child gets sick, and I've certainly experienced this with my children over the years, if they get sick, one of the first things I'll say to me is, my tummy hurts, you my tummy's sore. And so children will often represent pain, I should say verbalized tummy pain when they're feeling unwell.

And so that's a pretty generalized symptom, but often they will say their tummy hurts when they're feeling unwell. So any common virus, common colds, even gastro bugs, absolutely will cause tummy pain. But any kind of virus that your child picks up, often they will talk about that causing them tummy pain because they just don't feel well. Now, sometimes children will have...

lingering tummy pain once they've recovered. So two weeks later, they still have tummy pain. And that's when we start talking about the post-infectious irritable bowel type syndrome or condition where you have a virus and your immune system is affected, you're run down. let's remember that 75 % of our immune system is in our gastrointestinal tract. So your immune system's taken the battering.

When Tummy Pain Lingers — Post-Infection IBS and Parasites in Kids (07:27.39)
It's tried to produce all these soldiers fight the virus and kill the virus so that you can eventually get better. Your immune system's taken the battering and so your gut's taken the battering. And that's why you can have this sort of post-infectious lingering tummy pain, IBS type symptom because your gut has taken the battering. Your immune system's been hammered by this virus or this bacteria. So it's very common to have a lingering.

tummy pain after being sick, but if it goes on for too long, then definitely reach out to your doctor or myself because it's important that we address any ongoing tummy pain. And if you find that their tummy pain continues on for a couple of weeks, then that's probably that post-infectious irritable bowel. And hopefully that does settle down. And often it does.

But sometimes it hangs around for way longer than you would like. If your child is really acutely unwell with high temperatures, not sleeping, they definitely go and see the doctor. Aside from viruses causing tummy pain, infections such as H. pylori, well it's actually Helicobacter pylori, that can also cause a lot of tummy pain and gut issues in people, children and adults. So.

H. pylori infection can be quite uncomfortable and can be a contributing factor to tummy pain. Otherwise you've got parasite infection, parasitic infection, most common parasitic infections in kids. So threadworm, all different types of worms. There's threadworm, there's pinworm, there's brownworm, there's hawkworm, there's tapeworm and they're less common. But worms is definitely a common cause of tummy pain and

It can cause changes to their poo. They get an itchy bottom. So worms are definitely something to consider if your child has tummy pain. And then if you're worried about them having a different parasite, like you've treated them for worms, they're still getting tummy pain. Then you can get a stool sample where you have to get it scooped their poop basically, and send it off to the lab where they will test for parasites. And look.

When Parasites or Anxiety Cause Kids’ Tummy Troubles (09:43.478)
Yes, there's H. pylori, which can be tested for an stool sample, but then there's also other parasites such as deintamoeba fragilis, which is a parasite. And look, they don't necessarily treat it if they find it because most infected people don't have any symptoms. Sometimes they do. That's where you have to have a chat to your doctor about what to do if you do find a parasite. But often if that particular parasite is found, that they will do nothing.

But if other parasite is found and it's more problematic, then yes, it may be treated with medication. And, and of course, if you suspect worms and treat them with worm, worm tablets that you can get the chemist. So they are other causes of tummy pain in children aside from your common cold or virus, so to speak. So the second factor that can be a big contributing factor to tummy pain.

and gut issues in children is anxiety and emotional stress. Now more and more, we are learning about the tightly intricate phenomenal relationship. It's a really connected via the enteric nervous system. It's the gut brain access. It is like a connection. It's a neural motor highway from the gut to the brain with all these neurotransmitters going from the gut to the brain, communicating all the time sitting here listening to this podcast now.

Your gut is talking to your brain. Okay. And if your gut is not happy and healthy, then that can absolutely affect your brain. But vice versa, if you are stressed and anxious, that will communicate back to your gut. And certainly we've all experienced that situation where we're nervous or super anxious before an exam. I used to get it before big tennis games. They used to play tennis competitively and they used to have to run to the toilet because I was nervous. And so that's very normal.

when you're anxious or stressed that you need to have a bowel action, it might be looser. It's just that emotional hormonal response. And again, it's the brain and the gut talking to each other. So children may be stressed about starting school. They may be stressed about going to school, friendship fires.

When Emotions, Anxiety & Food Intolerances Cause Kids’ Tummy Troubles (11:59.468)
Changes to family dynamics. Sometimes you see kids present with lots of tummy pain when sadly their families are separating, their parents are going through a divorce. So children will present with tummy pain when they are emotionally unsettled and that can absolutely be a common symptom there. Also toileting anxiety, so not wanting to go to the toilet at school, perhaps because there's not

proper doors on there, perhaps they feel vulnerable, you can still see the legs, you still see the head, it depends on what the toilet's like at the daycare centre or the school, but definitely toileting anxiety can be another contributing factor to gut problems and also constipation in children. Signs that the anxiety is one of the root causes of the tummy pain is when it settles down.

in school holidays or when you're away on holiday and your child is more relaxed and happy. That's a very good way to assess whether or not your child is actually getting tummy pain from anxiety. Does it settle down in the school holidays or does it settle down when you're away, when they're removed from that anxious environment and they're happier? Because if it does go away, then that's a very clear indicator that the tummy pain is more stress anxiety related.

Next factor, which is where I've devoted a lot of my career is food intolerances and sensitivities causing tummy pain. And this is where I often get parents say to me, oh, Karina, I wish we'd met sooner. I have been told for years and years not to worry. Your child will grow out of it. It's just a stage. But the thing is they don't always grow out of it. And yes, children's absorption of nutrients and

Tolerance for certain proteins and foods can improve over time, but not always. And if we can do something to help them, why wouldn't we do it? Why would you put them through months and years of discomfort and sleepless nights or not wanting to go to school in case they get diarrhea or all of those contributing sort of social ripple effects because of these gut issues. Like I've met adults that...

When Gut Issues Disrupt Life — How Food, Bugs & Early Gut Health Impact Children (14:19.928)
quit their job because it involved a two hour car ride and they weren't confident that they weren't going to poop their pants because they had urgent loose bowel actions and they couldn't control it. so that two hours in the car was just so stressful because they were worried they were going to poop themselves. They quit their job. It's phenomenal the impact that guys can have on people, adults and children. And often we don't realize that.

unless we're affected firsthand, ourself. So with the food, definitely there's many different types of food that can cause gut issues in children. We have protein, so proteins, food proteins tend to cause allergic type reactions. And then carbohydrates in food tend to cause irritable bowel type symptoms of bloating and mucusy poos and

gas, wind, loose bowel action, sometimes constipation. The food proteins can also cause, especially in babies, mucusy, poos, blood in the poo. So foods can definitely trigger a whole host of gut issues. And this is where I love helping families get to the bottom of what's actually causing the problem for their child, because then we fix it. The child lives their best life.

The parents aren't worried anymore. No one's got tummy pain anymore and everyone just gets on with it. It's wonderful. But it's about trying to understand what is actually going on. And the way to do that is a very logical kind of calculated approach, looking at gut history right the way back to when they were born, how they were born, what milk feeds they had, the antibiotic exposure, all of that first 1000 days, the early development of the gut microbiome plays a direct role.

in what's going on with the three-year-old's gut or the six-year-old gut or the 12-year-old's gut and their tummy pain right now. So it's really important to look at the big picture. I also look at what they're currently eating, what their current symptoms are, and then we formulate a plan based on my assessment of what I think could be contributing to their current gut problems. And with my son, I've pretty much worked it out. I think he's just got rid of a gut bug at the moment, which is throwing everything out of whack.

From Food Diaries to Celiac Disease — Diagnosing the Root of Tummy Troubles (16:41.454)
And a stool sample can be really helpful there in that context to help diagnose whether there's something else at play here. But it's really important to understand and diagnose proper food intolerances so that you can then manage it effectively. And you know how to keep their symptoms at bay so that they can live their best life and they're not running off to the toilet or not wanting to go to school in case they poop their pants. So it's really important that you understand.

What is the cause of the gut usage so we can fix it? And when people book in to see me, I will always ask them to keep a food and symptoms diary so that I can get a good history from them. And then I can form my assessment and then guide them as to what I think are the main contributing factors for their child's tummy pain. When we talk about a management plan, sometimes this involves probiotics, sometimes it doesn't. It really depends on.

the individual situation and also what has happened in that first 1000 days with the development of their gut microbiome. Okay. Moving on to the fourth area that can contribute to tummy pain in children. And this is when tummy pain is really the sign of a bigger issue. Now I do want to say this is the minority of cases. This is absolutely occasional.

It's not definitely not every second child or not even one in a hundred children. This is a more rare situation, but important to rule out if you've got a child that has ongoing tummy pain. And I've certainly done this for my son because I just wanted to tick all the boxes just to make sure that it wasn't anything other than a basic food intolerance. When tummy pain is sign of a bigger issue, you can have conditions such as undiagnosed celiac.

contributing to tummy pain. And this is an absolute cause of ongoing tummy pain when everything else seems normal. So when they've had wheat, especially pasta meals, bread meals, but it can be at a different time to wheat as well. And it's just because the gut is inflamed. Okay. So we need to remove that wheat, remove that gluten, get it out for the rest of their life. At this stage, the only management is a lifelong crumb free gluten free diet.

Tummy Troubles in Kids — Celiac, IBD, or IBS? Understanding the Root Causes (19:03.022)
But definitely undiagnosed celiac can cause tummy pain in children. Now, celiac disease is around 3 % of the population. Even rarer is a condition called inflammatory bowel disease. The incidence of celiac is about one and a half percent, probably wouldn't be more than 2%, not even 2 % in Australia. So it's not hugely common, but it's common enough and it's being

better diagnosed these days, so we are picking up Celiac disease more and more often in children because doctors are doing more routine blood tests for it. It's easier to pick up these days. So Celiac disease could definitely be one of those medical causes of tummy pain in children, but granted it's rare. And inflammatory bowel disease is even rarer. So that's about 0.5 % of the population. But again,

Important to rule out in a child that's got ongoing tummy pain that you can't really put your finger on what it is for six, 12 months. We need to screen for everything here. That's when I'd be looking for those more rare medical causes of tummy pain. Now, IBS, which is irritable bowel syndrome is a lot more common. And that is one of the...

biggest contributing factors to tummy pain in adults and also children. So often children will be referred to me for dietary elimination to try and improve their tummy pain and their symptoms. And they have a diagnosis of IBS or irritable bowel syndrome. And that's effectively the diagnosis when you can't find anything, but there's a lot of ongoing tummy pain. That's when you call it IBS. So IBS

is a lot more common in Australia. The incidence of IBS is quite high. Up to 30 % of Australians suffer from IBS. And when you look at the literature in kids, it ranges anywhere from about 4 % to 16%. Definitely IBS is a thing and it's a significant contributing factor to tummy pain in children of any age, but definitely

Understanding IBS in Children — Diagnosis, Triggers, and Treatment Options (21:21.848)
primary school children and high school children. as they move into teens, that's often when we will see more and more of these IBS like symptoms. Now definitely lactose intolerance, fructose intolerance, these carbohydrate intolerances, very common. They could be put into that bucket of IBS. So the incidence of irritable bowel syndrome, and this really needs to be diagnosed by a pediatric gastroenterologist.

Looking at the literature, it's anywhere from about 4 % to about 16%. But as I said before, IBS will be diagnosed once everything else has been ruled out. And this again, it's not your average child in the classroom. This is for those children that have significant ongoing gut issues and they can't, no one can work out what's going on, but they've ruled out celiac, they've ruled out...

inflammatory bowel disease, they've ruled out anything nasty contributing to the symptoms. So they get a diagnosis of IBS. And when your child, if your child ever has a diagnosis of IBS or even adults, then absolutely a big chunk of the time, we can make a big difference to symptoms through dietary modification. So that's one of those times when you do want to know whether they've got IBS or not, because you can make a big difference to their

day to their life, to their wellbeing by making dietary changes and improving their symptoms. So definitely if you suspect that your child has some sort of gut issue contributing to the symptoms because nothing's working and it's been going on for years, then I would recommend going to see a pediatric gastroenterologist and just doing some investigations to make sure there's nothing underlying that's medical.

And if it's not, then they will probably get a diagnosis of IBS. Really it's gut sensitivity with no clear medical cause, but absolutely we can often make a big difference to the quality of life of children and adults with dietary changes to those with IBS. So tummy pain will be caused by a whole host of conditions. So tummy pain will be caused by many different factors. And just in summary, we've got.

Tummy Pain in Kids — When to Seek Help and What Parents Can Do (23:39.8)
Sickness and infection being a primary cause. We've got anxiety and emotional stress being a primary cause. We've got food intolerances, allergy sensitivities being a primary cause. And then we've got underlying medical conditions. More rare, less common, but definitely can be a contributing factor. Tummy pain can be acute. It can come and go very quickly or it can be chronic. And that's when you really need to make sure that you're on the right path and have the right.

a diagnosis so that you can manage it best. So your child is not missing days and weeks of school. So they are able to eat a varied diet because often children with tummy pain will self-select to avoid certain things, especially if it goes on for weeks and months and years. This can sometimes mean that they're missing valuable nutrition and valuable food groups because they're avoiding certain foods because they're worried about them hurting their tummy. So it's really important that if you

Do see your child doing this, that you seek nutritional help because we can absolutely substitute foods to make sure that they're getting what they need and keeping the symptoms at bay. And that's really my role to help parents with. So I hope that's been helpful little 101 on why your child might have tummy pain. Look with babies, it's similar in terms of they can have tummy pain for various reasons and colic is a big one.

I haven't talked a lot about babies and colic today, but definitely a milk protein allergy is a key contributing factor to colic and irritability in babies. And I can talk more about that another time. But if you've got a baby or a child with significant gut issues, please reach out, send me a DM on Instagram, send me an email, hit my website. You'll find a lot of information on how you can get help with kids with gut issues on my website, nourishwithKarina.com.

And yeah, I think if you are considering reaching out to me, keeping a bit of a food and symptom story is helpful just for yourself as well, because you can see what they're eating, what their symptoms are, and it absolutely helps to create that picture, which then helps to create a good plan forward. Anyway, on that note, I will love you and leave you. Thanks for joining me today. I hope that's been really helpful for you.

Thanks for Listening — How to Support the Show (25:58.56)
If you found this podcast episode helpful, please leave me a review. Hit the star rating and leave me a comment. Love to hear from you. I wish you a beautiful week and I'll chat to you soon. Bye for now.