Group A Streptococcus, commonly known as strep throat, is a bacterial infection typically associated with severe pain in the throat and tonsils. Caused by Streptococcus pyogenes, the infection can extend beyond the pharynx, leading to systemic symptoms. Strep throat can definitively cause stomach pain, particularly in certain age groups. While the infection begins in the throat, the body’s response and the bacteria’s presence can provoke gastrointestinal distress, including abdominal pain, nausea, and vomiting.
Why Strep Infections Cause Abdominal Pain
The abdominal discomfort during a strep infection results from two primary physiological responses. One mechanism involves the physical movement of infected material down the digestive tract. When a person swallows, mucus, pus, and bacteria from the infected tonsils travel into the stomach. This influx irritates the stomach lining, triggering symptoms like nausea, vomiting, and generalized stomach discomfort.
A more specific source of abdominal pain stems from mesenteric lymphadenitis. The body’s lymphatic system includes a cluster of lymph nodes located in the mesentery, the membrane attaching the intestine to the abdominal wall. In response to the systemic bacterial infection, these abdominal lymph nodes become inflamed and swollen. This swelling, known as lymphadenitis, causes tenderness and pain, often localized in the lower right side of the abdomen.
Because the pain from mesenteric lymphadenitis is often focused in the lower right quadrant, it sometimes mimics acute appendicitis. This similarity can lead to diagnostic confusion, but the underlying cause remains the body’s generalized immune reaction to the Group A Streptococcus infection. Furthermore, the body’s overall inflammatory response to the bacterial presence contributes to malaise and digestive upset. Toxins produced by Streptococcus pyogenes can also play a role in triggering systemic symptoms, including abdominal pain.
Recognizing Strep Symptoms Beyond the Throat
Gastrointestinal symptoms like stomach pain, nausea, and vomiting are common presentations of strep throat in children and adolescents between the ages of 5 and 15. Younger patients are more likely to experience these abdominal complaints than adults, who typically present with a sore throat, fever, and swollen neck lymph nodes. The presence of abdominal pain in a child with a sore throat should increase suspicion for a strep infection.
These stomach-related complaints rarely occur in isolation and are usually accompanied by other distinct signs of strep throat. A sudden onset of fever and headache are frequently reported alongside abdominal pain. The tonsils and pharynx may appear red and swollen, sometimes displaying white patches or streaks of pus. Strep throat rarely causes a cough, runny nose, or hoarseness, which helps distinguish it from viral illnesses.
A fine, red, sandpaper-like rash, known as scarlet fever, is sometimes seen in combination with abdominal pain and fever, pointing toward a Group A Streptococcus infection. This rash is caused by a toxin released by the bacteria. Recognizing this constellation of symptoms—abdominal pain, vomiting, fever, and lack of a cough—helps differentiate strep-related stomach distress from a simple stomach bug or viral infection.
Treatment and When to Consult a Doctor
A diagnosis of strep throat requires professional confirmation, typically through a rapid strep test or a throat culture. Once Group A Streptococcus is confirmed, the standard treatment involves prescription antibiotics, such as penicillin or amoxicillin. Starting antibiotics promptly is recommended to prevent serious complications, such as rheumatic fever or kidney inflammation.
The purpose of antibiotic therapy is to eliminate the bacteria, which resolves the infection and any associated systemic symptoms, including stomach pain. Most patients begin to feel better within one to two days of starting the medication. It is important to complete the entire course of antibiotics exactly as prescribed, even if symptoms disappear quickly. Stopping treatment prematurely allows bacteria to survive, potentially leading to a recurrence or the development of antibiotic resistance.
While most strep-related stomach pain resolves with treatment, certain warning signs warrant immediate medical consultation. Severe or worsening abdominal pain, especially if localized and intense, requires urgent evaluation to rule out serious conditions like appendicitis. Signs of dehydration, such as significantly decreased urination or an inability to keep fluids down due to persistent vomiting, should prompt a call to a doctor. A lack of improvement in overall symptoms after 48 hours of antibiotic use also indicates a need for follow-up care.