Your child’s stomach hurts again. Maybe it happens just before a test. Other times it shows up on Sunday night or during busy school weeks. You feel torn. Is something really wrong? Are they trying to skip something? Or should you call their health care provider?
Stomach pain is one of the most common complaints in children. And in many cases, there is a strong connection between stress and what is happening in your child’s belly.
To help make sense of it, we asked Ismaeel Bakhsh, MD, a pediatrician with Banner Health, what parents need to know about stress, the gut and how to step in and help their child.
Why stress hurts your child’s stomach
Your child’s brain and gut are constantly talking to each other. They are connected through nerves and chemicals called the gut-brain axis. In fact, this connection is so strong that the gut is often called the “second brain.”
“When a child feels stressed, their body releases stress hormones like adrenaline and cortisol. These hormones prepare the body to fight or flight,” Dr. Bakhsh said. “In these situations, the body sends more blood to the heart and muscles and less to the stomach and intestines.”
This fight-or-flight response is what causes butterflies in your stomach before a test or a presentation. For children, these butterflies can become stronger. Your child might say their tummy hurts, ask to use the bathroom over and over or feel like they might throw up.
“Children’s brains, especially the parts that handle emotions, are still developing so they might not have the tools to fully understand or handle stress,” Dr. Bakhsh said. "So the stress shows up in their body, through physical symptoms.”
What does a nervous stomach look like?
Stress-related stomach pain often follows patterns. Once you know what to look for, those patterns can become easier to spot.
You might notice:
- Complaints of stomach pain before school or activities
- Pain that fades later in the day
- Nausea without illness
- Changes in appetite
- Frequent visits to the school nurse
- Bathroom changes (constipation or diarrhea)
- Trouble sleeping before school days
Sometimes, your child may not say they feel nervous or worried. Instead, stomach pain becomes the signal that something feels hard.
Common triggers, especially in spring
While stomachaches can happen year-round, certain seasons bring more stress for kids. Common causes include:
- Test pressures: Standardized tests, finals and report cards weigh on children who want to do well.
- Big transitions: Moving up to middle school, switching teachers or graduating from elementary school can feel huge.
- Social changes: Friend groups may change or have drama.
- Schedule overload: Sports playoffs, recitals and school events pile up. Less downtime means less recovery time.
- Sleep changes: Longer evenings and time changes can throw off bedtime routines.
Add in social media pressure and a constant stream of news and even the most easygoing kid can feel stretched thin. Kids may feel pressure to perform or fear the unknown.
How to tell if it’s stress or something else
“Look for patterns,” Dr. Bakhsh said. “It is very common before tests and big exams, with pain that skips weekends and shows up on Sunday evenings or Monday mornings.”
Signs your child’s stomachache may be from stress include:
- The pain comes and goes: It appears before school, big tests or sports games or during big changes
- There are no other clear symptoms: If your child has a fever, vomiting or weight loss, a physical illness is more likely. With stress-related pain, your child might have mild nausea and a fluttery feeling in their belly.
- The pain improves with distraction: If your child feels better when they play with friends, watch a show or relax at home, it may be tied to emotions rather than a physical issue.
- Your child shows other signs of stress: They have trouble sleeping, are irritable, avoid school or activities or worry a lot.
What you can do to help
When your child says their stomach hurts, it can put you in a tough spot. You don’t want to make it worse by reacting too much but ignoring it feels wrong too. Dr. Bakhsh said you don’t have to choose between the two. He shared simple ways you can help support your child.
Start with a calm conversation
Ask open-ended questions:
- When does your stomach hurt the most?
- What were you thinking about before school?
- Is anything making you feel worried lately?
Listen without rushing to fix the problem. Let your child know their feelings matter by saying something like, “That sounds really hard.”
Help your child name their feelings
Younger kids may not understand words like anxiety. Help them connect feelings to their body. You might say:
- Sometimes when we feel nervous, our tummy can hurt.
- I wonder if your body is telling us something feels hard right now.
Teach calming tools
When stress hits, your child needs ways to calm their body. Even a few minutes can help them reset the stress response. Try:
- Deep belly breathing: Inhale slowly through the nose, exhale through the mouth
- Quiet time: Reading, drawing or listening to music
- Movement: A walk, stretching or playing outside
Keep routines steady
Predictable routines can help kids feel safe and in control. Focus on:
- Regular meals
- Consistent bedtime
- Time for rest and play
Encourage healthy habits
Physical and emotional health are linked. Support your child with:
- Balanced meals
- Plenty of water
- Daily physical activity
- Enough sleep (nine to 12 hours each night, depending on age)
Limit doomscrolling
TikTok, the news and group chats can fuel worry. Set screen limits, especially before bed. Talk about what they see online.
Involve the school
Let your child's teacher and school nurse know what's happening so they can help, without making the stomach pain the main focus.
[Also read: How to Help Your Child Cope With Stress.]
When to seek extra support
Even though stress is a common cause, it’s important to know when to check in with a health care provider. Talk to your child’s provider if:
- Pain happens often and doesn’t improve
- It keeps your child from school, friends and activities they love
- Your child seems sad, withdrawn or extra anxious
- Your child has unexplained weight loss or no interest in food for days
- You feel stuck, worried or unsure what to do next
Your child’s provider can rule out medical causes like anxiety or depression and connect you with extra support, like a counselor, therapist or specialist who works with children. Asking for help shows strength, not weakness.
[Also read: Spotting Signs of Mental Health Issues in a Child or Teen.]
Takeaway
Stomach pain in children is common and sometimes it is related to stress. Your child isn’t making it up. Their body is reacting to something that feels overwhelming.
Respond with calmness, curiosity and support. This can help your child feel safe and improve their overall well-being, not just their stomach pain. If you need help, contact their health care provider or a behavioral health specialist. You can also schedule an appointment with a Banner Health specialist near you.
Frequently asked questions
Why does my child’s stomach hurt before school?
This often happens because of stress or anxiety. The body reacts to pressure, especially before tests, social situations or busy school days.
Can stress cause real stomach pain?
Yes. Stress hormones and nerves can affect the stomach, leading to pain, nausea or discomfort.
How can I tell if it's not stress?
Look for signs like fever, vomiting, diarrhea, weight loss or long-lasting severe pain. These symptoms could mean there's a medical problem.
What can help a nervous stomach?
Simple routines, reassurance, breathing exercises and finding what stresses your child can help reduce symptoms.
When should I see a doctor?
Call your provider if symptoms are severe, if there are other warning signs or if they affect your child’s daily life and school.
