“My tummy hurts!” This common childhood cry can mean almost anything, from anxiety about school to acute appendicitis. It’s usually not serious. But how do you know when your child needs a doctor’s attention?

“Determine the severity of the pain. If the child is complaining about stomach pain, but is still playing, laughing and eating, chances are it’s nothing serious,” says Pennsylvania pediatrician William J. Cochran, M.D., chairman of the American Academy of Pediatrics’ gastroenterology and nutrition section. “If the child is complaining about very severe pain and is not doing these things as he normally does, have the child seen by a doctor right away.”

One common problem, gastroenteritis, looks like an emergency but usually isn’t. Caused by a virus, it strikes fast and hard with abdominal pain, vomiting and diarrhea. Most cases ease up quickly. But if it doesn’t — or if your child exhibits dehydration, a bloated abdomen and an altered mental state — see the doctor.

“Dehydration is serious,” Dr. Cochran adds. “Watch out for vomiting and/or diarrhea, decreased fluid intake, decreased urine output and a decrease in the production of tears.”

“If the child is complaining about very severe pain and is not doing these things as he normally does, have the child seen by a doctor right away.”
— William Cochran, M.D.

When in doubt, call your pediatrician. For minor problems, ask about over-the-counter remedies that might ease discomfort and treat or prevent dehydration.

Time to See a Doctor Here are three good reasons to take a troubled tummy to the doctor at once: Severe pain that starts near the navel and spreads to the lower right part of the belly. This can mean appendicitis. Belly pain with blood in either the vomit or stool. Green liquid vomit. This could be bile, a sign of torsion — a twisting of stomach or intestines that must be treated quickly.