Talking about digestive health is never glamorous.
But stomach aches, cramps, and nausea are some of the most common complaints pupils bring to the first aid room.
❗ In 2025, more than 180,000 incidents recorded on Medical Tracker were related to digestive issues, almost a quarter of all recorded incidents that year.
Importantly, many stomach aches are not caused bacterial or viral infections. There can be many different causes, from short-term illnesses and food intolerances to long-term conditions such as Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD).
Understanding some of the common causes of stomach aches and pains, as well as knowing the signs to look out for when it comes to long-term conditions, can help school staff respond appropriately and provide the right support when a pupil feels unwell.
That's why in this week's issue of the First-Aid Room, we’re diving right into the thick of it, unfiltered, from stomach bugs that can make their way around schools, to longer-term conditions such as IBS and IBD, and take a closer look at the symptoms school staff may notice when a pupil’s digestive health is affecting their day.
By design, schools are environments where infections spread quickly, and digestive illnesses are no exception. Children share spaces and surfaces, friends and foods, and when a stomach bug starts circulating, it can move through classes and year groups very quickly.
Gastroenteritis, or stomach flu, is one of the most common infectious illnesses seen in schools (and in the UK! Around 20% of the population develops gastroenteritis symptoms each year).
It is particularly common in young children and occurs when an infection affects the stomach and bowel. Gastroenteritis can be caused by bacteria or viruses, with rotavirus being a common cause in young children.
Symptoms may include:
👉 Sudden, watery diarrhoea
👉 Feeling sick
👉 An upset stomach
👉 Vomiting, and projectile vomiting
👉 A mild fever
👉 A loss of appetite
👉 Aching
👉 Headaches
👉 Dehydration due to the loss of fluids
Symptoms can develop within a day of the infection and, in most cases, they clear up on their own after a week.
Norovirus is highly contagious and spreads rapidly in enclosed environments where people are in close contact, such as schools and nurseries.
While it’s often called "the winter vomiting bug”, outbreaks can occur at any time of the year.
It causes sudden nausea, vomiting, and diarrhoea and can affect a large number of pupils and staff in a short period.
Because norovirus does not respond to antibiotics, the priority is hydration, rest, and preventing further spread.
In most cases, symptoms clear up on their own after 2 to 3 days, but for young children and babies, there is a risk of more serious and prolonged symptoms, which may require medical treatment.
Staff should call 999 if a pupil:
Vomits blood or has vomit that looks like ground coffee, or is yellow-green or green
Complains of a stiff neck and pain when looking at bright lights
Has a sudden, severe headache or stomach ache
❗ Keep an eye out for dehydration in cases of stomach bugs: Vomiting and diarrhoea can cause a significant loss of fluids, and young children have a greater risk of becoming dehydrated. Encourage pupils to drink plenty of water and look out for signs of dehydration, particularly if symptoms are persistent.
Gastroenteritis, norovirus and other stomach bugs spread easily in a busy school environment, particularly through contaminated hands and surfaces. Good hand hygiene and regular cleaning can help reduce the spread of infection.
What to do when a pupil is unwell at school:
💡 Good to know: The UK Health Security Agency advises that any pupil or staff member with diarrhoea or vomiting should not return to school until they have been free of symptoms for at least 48 hours.
If multiple pupils or staff members become unwell in a short period, it’s important to act quickly to prevent further spread. Schools should contact their Health Protection Team for advice when an outbreak is suspected.
Some ways schools can help prevent the spread include:
👉 Setting up a dedicated bathroom for affected pupils where possible
👉 Pausing shared activities, food-related activities and communal play with shared materials during the outbreak
👉 Supervising handwashing routines and reinforcing hygiene messages across the school
👉 Reminding students and staff that alcohol-based hand gels do not kill norovirus – thorough scrubbing with liquid soap and warm water for over 20 seconds is essential
👉 Communicating with families so they can monitor their children at home
👉 Asking pupils or staff members who are unwell to stay home until at least 48 hours after their symptoms have completely stopped.
👉 Arranging a deep clean of the school once the outbreak has resolved and no new cases have been reported for 48 hours, where possible
🎯 If your school uses Medical Tracker, you can log first aid room attendances quickly and accurately, making it straightforward to identify clusters of similar symptoms across a short period. If several pupils report vomiting or diarrhoea within the same day or week, having a clear record helps you escalate to your Health Protection Team with the information they need.
Not every stomach complaint that walks through the first-aid room door is infectious. For some pupils, digestive symptoms are a regular part of their lives, and understanding the conditions behind them can help school staff provide better, more consistent support.
IBS is a long-term condition that affects the digestive system, causing recurrent abdominal pain, bloating, and changes in bowel habits, such as diarrhoea, constipation, or a combination of both. Symptoms may be better some days and worse on others (flare-ups).
❗Studies have estimated the prevalence of IBS to range between 6% and 14% in children, and between 22% and 35% in adolescents. (Journal of Pediatrics)
❗ A 2024 systematic review found strong links between anxiety and depression and IBS in children, with impaired gut-brain communication playing a central role. (PubMed, 2024)
❗ Diet, stress, or life changes can all impact IBS symptoms: emotional triggers may also manifest as anxiety, depression, fatigue, or difficulty concentrating. (Worcestershire Acute Hospitals NHS Trust)
IBS is not caused by a structural problem with the gut. When it comes to digestive health, the gut and the brain are in constant communication, and IBS is essentially a disorder of gut-brain interaction: the bowel is physically healthy but responds strongly to signals from the nervous system.
This is why stress, anxiety and emotional experiences can directly trigger or worsen digestive symptoms, leading to very real physical effects.
For a pupil who is feeling anxious about an exam, dreading a particular lesson or dealing with a difficult situation at home or with friends, this may mean a sudden stomach ache, feeling sick or urgently needing the toilet.
Schools are not expected to diagnose medical conditions, but if a pupil regularly visits the first aid room with similar complaints, particularly when there doesn’t seem to be an obvious physical cause, it may be worth looking at the bigger picture: a gentle conversation about how they’re finding school, home, their friendships or anything that might be worrying them could help staff understand what might be going on.
Common symptoms of IBS in children and teenagers include:
👉 Nausea
👉 Bloating, uncomfortable and swollen tummy
👉 Abdominal or pelvic pain and cramps, usually worse after eating and often relieved by going to the toilet
👉 Diarrhoea
👉 Constipation
👉 Changes in bowel movements, including straining, urgency, mucus or incomplete bowel movements
👉 Tiredness and exhaustion
Staff might notice:
👉 Repeated requests to use the toilet, sometimes urgently, particularly before or after lunch or during stressful lessons
👉 Regular complaints of stomach pain that do not resolve and have no infectious cause
👉 Reluctance to eat lunch or school meals, particularly on busy or stressful days
👉 Anxiety about being away from the toilets, which can affect willingness to go on school trips or participate in outdoor activities
👉 Periods of increased absence around stressful events such as exams or assessments
It’s important to take these symptoms seriously. IBS symptoms are very real and can have a significant impact on a pupil’s day-to-day wellbeing. Listening to pupils and acknowledging what they’re experiencing can help them feel supported and build trust with the adults around them.
There is no cure for IBS, but there is a great deal schools can do to help pupils manage their condition and feel more confident during the school day.
Some ways to support pupils with IBS include:
Ensuring the pupil has unrestricted access to toilet facilities – a discreet toilet pass can reduce anxiety significantly
Allowing flexibility around lunch and break times where possible, particularly on high-stress days
Being mindful of the pupil's dignity — IBS can cause embarrassment, and handling conversations sensitively matters
Communicating with parents about what triggers symptoms and what adjustments can help
Where appropriate, involving the SENCO or pastoral team to discuss formal support
Ensuring the pupil's individual healthcare plan (IHCP) is in place and up to date if they have a formal diagnosis
🎯 If your school uses Medical Tracker, you can record IBS as a managed medical condition and store relevant details alongside the pupil's Individual Healthcare Plan. First-aid room attendances linked to IBS can be logged and tracked over time, helping staff spot patterns and identify whether symptoms are worsening around particular events or periods of the school year.
Inflammatory Bowel Disease (IBD) is a term used to describe chronic conditions that cause inflammation in the digestive tract, such as Crohn's disease and ulcerative colitis.
While IBD and IBS can present with similar symptoms, they are very different conditions. IBD involves structural changes to the gut and inflammation and requires a medical diagnosis and treatment.
Again, schools are not expected to diagnose medical conditions, however, if a pupil's symptoms include severe abdominal pain, blood in their stools, significant weight loss, fatigue, persistent fever or delayed growth, alongside digestive symptoms, parents and carers should be advised to speak to a healthcare professional.
Pupils with IBD may require significant flexibility and support at school, including unrestricted toilet access, consideration during exam periods, and sensitivity around absences for hospital appointments and treatment. A detailed individual healthcare plan is essential.
Whether a pupil has a one-off stomach bug or a long-term digestive condition, the way school staff respond can make a real difference to their comfort, their confidence, and their willingness to ask for help in the future.
A pupil who is met with calm, matter-of-fact support and whose parents are kept informed is far more likely to manage their condition well and stay engaged with school.
Digestive health is not, and probably never will be, an attractive topic. But for the pupils who experience these symptoms and long-term or chronic conditions, talking about it truly matters.
1 Handwashing Technique with Soap and Water, NHS Poster (PDF)
Although a great deal of care has been put into writing, researching, and reviewing this issue, The First-Aid Room is designed to inform and support school staff, not to replace professional medical advice or your school's own policies. Every pupil is different, and the guidance in this issue should always be read alongside individual healthcare plans and relevant statutory guidance. When in doubt, seek medical advice. In an emergency, call 999.