Kids Love Dr. Barton

"Mommy, my tummy hurts!"

by Dr. Douglas Barton, M.D., Pediatrician 04/16/2009

How many times has this disrupted the balance in your house? Everyone’s getting ready for school. Mary needs to get her backpack together and get her shoes on. Johnny is just sort of dragging along. Suddenly, you hear the dreaded words, “My stomach hurts.” Not again, you think. This is the third time this week. You’ve ignored the first few complaints and sent him to school anyway, but maybe he really does have something going on.

The problem with stomach aches is that they are very common, there are many causes for the pain, and very rarely is there anything really wrong. So what’s a mom to do to restore balance? Needless to say, stomach aches are a very difficult problem in pediatrics.

So, if there’s usually nothing wrong, why do children say their tummy hurts? It turns out that many of the chemicals in the brain that affect mood (neurotransmitters) also have some effects on the bowels. So one explanation is that varying amounts of stress, exercise, and sleep affect the bowels and subsequently, can cause abdominal pain. I believe that, often, simple day-to-day life for a child causes just enough tension to create belly aches. For this kind of belly ache, I assume that the children really do feel a pain and that a parent acknowledging the pain can be very helpful. Providing a TUMS may be just enough to acknowledge the pain and let the child know that you’re treating it.

Another consideration should always be diet. Many children are sensitive to many foods. Milk is probably the most common culprit and a trial period off all lactose-containing products may solve the problem in a couple of days. Another common one is too much fiber at one sitting. Fiber is good, but works best if given in gradual amounts. Fiber also helps with constipation, which, if prolonged, can cause some crampy abdominal pain.

So when do you worry about abdominal pain? The usual red flags are blood in the stools, frequent diarrhea, alternating diarrhea and constipation, vomiting, weight loss, pain that interferes with regular activity, or pain that keeps children up at night. Any of these symptoms might cause me to investigate further. A family history of a significant disease such as Crohn’s would also cause me to look further. Clearly, abdominal pain that lasts for several days to weeks should also prompt at least a basic evaluation. As usual, if you have concerns, please speak with your pediatrician.




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