Back to school brings about many changes in routine for the whole family. These changes can also be a time when physical symptoms appear in children. One of the most common is stomach aches. It is frustrating as a parent trying to navigate why your child is complaining. Is it the food you prepared last night? Or the drive-through food that you grabbed out of convenience? Has your child been exposed to illness from other kids at school or is this a matter of anxiety or even bullying? Because it can be confusing navigating why tummy aches occur in children, here is a guide to help.
This kind of chronic stomach pain is called Functional Abdominal Pain and it is:
1. More common than you think: 30% of school-aged kids experience recurrent stomach pain.
2. Not explained by any diagnosed condition (i.e. you don’t already know that your child is prone to stomach pain because of a medical condition).
3. Possibly triggered by constipation, infection, stress, or mental disorder.
4. Serious enough to necessitate missing school or at least a request for absence.
5. Believed to be caused by nerves that are so sensitive that they react to normal intestinal activity.
The good news is that more times than not, the condition is NOT serious and the child will grow out of the chronic stomach pain. The more challenging news is that this type of stomach pain isn’t the easiest to treat and it can be caused by foods, routines, anxiety from family or school environment.
Depending on the history of presentation, your pediatrician or naturopathic doctor may order tests to help find the root cause. Some of these tests could be:
• Urinalysis: rules out a urinary tract infection.
• X-Ray: rules out blockage and constipation.
• Blood tests, stool tests, and other imaging: rule out serious conditions such as irritable bowel disease and acute infection.
If you go to a naturopathic focused doctor you will likely also have functional tests done such as:
• Food allergy/ intolerance panels
• Organic acid testing (chemicals that affect anxiety and depression)
• Testing for heavy metals or solvents
It is important to note that one out of five children in the US are diagnosed with a seriously debilitating mental health problem and many more suffer from undiagnosed depression or anxiety. Many of those children also experience digestive distress. Learning to cope with stress well promotes mental health and thus a reduction in stomach pain (assuming it isn’t due to explained medical conditions). Stress relievers for kids of all ages include support from elders, predictability of environment and expectations, healthy nutrition and adequate sleep. Some children benefit from a child therapist as well.
If your child is diagnosed with Functional Abdominal Pain, the following are treatment approaches:
1. Diet Diaries/Food Allergy and Intolerance Testing to detect food reactions. This is a place where I start all my pediatric stomach pain patient investigation because food reactions are very common in our population.
2. Psychosocial Interventions: Cognitive Behavioral Therapy, Biofeedback, Hypnotherapy, Family Therapy, Meditation, Guided Imagery.
3. Naturopathic Medicine: herbs and supplements to improve digestion, calm the nerves, reduce pain, etc.
4. Bodywork: Craniosacral Therapy, Visceral Manipulation, endermology and massage.
5. Chinese Medicine: acupuncture or acupressure
6. Homeopathic Medicine
7. Pharmaceuticals
Any child suffering from functional abdominal pain should be managed by a doctor, who should coordinate and supervise all treatment approaches. It is important to enter treatment knowing that it will be a process of discovery that necessitates persistence and patience from parents.
