Children’s health: Spotting GI problems early: What parents need to know
Stomachaches are a common part of childhood. Whether it’s food related, a nervous stomach, or a mild virus, most digestive complaints in kids come and go quickly. But sometimes, those symptoms can signal something more serious.
Knowing when to pay closer attention can help parents get their child the care they need sooner.
“Parents see the day-to-day patterns in their child’s health,” said Joseph Runde, DO, a pediatric gastroenterologist at Lurie Children’s. “The key is recognizing when something isn’t improving, or is getting worse over time.”
Growth changes can be an early clue
One of the most important signs doctors watch for is how a child is growing. At every checkup, pediatricians track height and weight on a growth chart. Most children follow a steady pattern.
“If a child suddenly drops off their usual growth curve, that’s something we take seriously,” Dr. Runde said.
Poor weight gain, weight loss, or slowed height growth may mean the body is not absorbing nutrients properly. Conditions like inflammatory bowel disease (IBD) can affect both digestion and normal growth.
Persistent or patterned abdominal pain
Occasional stomach pain is normal. But pain that keeps coming back, or interferes with daily life, is different.
Doctors become concerned when pain:
• Happens several times a week for weeks
• Wakes a child from sleep
• Gets worse over time
• Occurs in the same spot or away from the belly button
Pain paired with other symptoms like diarrhea, vomiting, fever, or blood in the stool should also be checked.
“If the pain has been going on for more than a month and is impacting school or activities, it’s worth a closer look,” Dr. Runde said.
Blood in the stool: Don’t ignore it
Seeing blood in a child’s stool can be alarming. In some cases, it may be caused by a small tear from constipation. But it should always be discussed with a pediatrician.
More concerning signs include:
• Dark or black stools
• Blood mixed throughout the stool
• Repeated episodes of bleeding
• Blood along with pain, diarrhea, or weight loss
• Mucus mixed with blood
Persistent bleeding can lead to complications like anemia, so early evaluation is important.
Changes in eating habits
Some digestive issues show up in how a child eats rather than what they say.
Children may:
• Take very small bites or chew excessively
• Avoid certain textures like meat or bread
• Take a long time to finish meals
• Say food feels “stuck”
• Drink excessive amounts of water with meals
“These can be signs that swallowing is uncomfortable,” Dr. Runde said. “Sometimes parents think it’s just picky eating, but it can point to an underlying issue.”
If eating changes are new, worsening, or linked to weight loss, they should be evaluated.
Ongoing diarrhea or constipation
Most kids have occasional constipation or loose stools. But when these changes last for weeks, it may signal a problem.
Concerning diarrhea patterns include:
• Lasting more than 2-3 weeks
• Happening multiple times a day
• Containing blood, mucus, or undigested food
• Waking a child at night
• Disruptive to school or daily activities
• Causes dehydration
For constipation, warning signs include:
• Painful bowel movements
• Stool withholding
• Fear or discomfort
• Ongoing symptoms despite diet changes
• Accidents in toilet-trained children
• Blood from hard stools repeatedly
“Changes in bowel habits are one of the hallmark symptoms we look at,” Dr. Runde said.
Symptoms beyond the gut
Some digestive conditions like celiac disease, irritable bowel disease (IBD) and Eosinophilic Esophagitis (EoE) cause symptoms in other parts of the body.
These may include fatigue/ low energy, headaches, itchy rashes or trouble focusing for celiac; joint pain/swelling, skin manifestations, eye inflammation or delayed puberty for IBD; and difficulty swallowing pills, prolonged meals, history of food refusal in early childhood and allergic conditions (asthma, eczema, food allergies) for EoE.
“These symptoms might not seem related to digestion at first,” Dr. Runde said, “but they can be important clues.”
Family history matters
A child’s risk for certain GI conditions can be higher if family members have them. Parents should share any history of:
• Celiac disease
• Inflammatory bowel disease
• Eosinophilic esophagitis
• Other autoimmune conditions
• Early-onset colon cancer
“Genetics don’t guarantee a child will develop a condition,” Dr. Runde said. “But it helps guide our level of concern when symptoms are present.”
Trust patterns, not just moments
The goal is not to worry about every stomachache. Instead, experts encourage parents to look for patterns: symptoms that persist, worsen, or affect daily life.
“Trust what you’re seeing,” Dr. Runde said. “If something doesn’t feel right, it’s OK to ask questions and seek answers.”
If concerns arise, starting with a pediatrician is the best first step. Early diagnosis and treatment can make a big difference, helping kids feel better and get back to being kids.
• Children's health is a continuing series. This column was provided by Ann & Robert H. Lurie Children's Hospital of Chicago.