Dr. Robert Needlman
Specialist in pediatric behavior and development.
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 Ask Dr. Needlman
Chronic Stomachaches in a Six-Year-Old | | | QUESTION | | | Dear Dr. Needlman,
My six year-old girl has been complaining of stomach aches for the past six months. I have taken her to the Dr. on two occasions. I first felt that she was doing it for attention, then I noticed that it was happening when she got nervous, excited, or scared. The Dr. says that she may have something called irritable bowel syndrome.
In the last four weeks she has been sent to the clinic five times. I just don't know where I am going wrong. We give her lots of attention and do special things. She has always been an over achiever and scared of failure. It is getting to the point that she wont even play games because she is afraid of losing. Please help me help her... Thank you.— Christie in Dallas, TX | | | ANSWER |
April 6, 2001 | | | Dear Christie,
There are many causes of chronic stomachaches. (Stomachaches that happen just once are an entirely different story; I'm just talking about the ones that come again and again in a child who seems otherwise well.) It's helpful to think about both medical and psychological causes:
On the medical front, a careful examination by her doctor should look for the common, and not so common, causes of recurrent stomach aches. For example, the doctor will make sure that your daughter continues to gain weight normally (many of the more concerning causes of stomach aches also cause weight loss), and has normal bowel movements. Constipation is the most common cause for chronic stomachaches in children, and the pain can be very severe. Reactions to certain foods also can cause recurrent pains. As part of the medical examination, the doctor might decide to send stool samples to test for parasites. A common cause, for example, is a parasite called Giardia. Often a doctor will spread this evaluation over more than one visit in order to look for the common problems first and then move on as necessary.
On the psychological front, worry and stress are very common causes of abdominal pain in school-age children. Often the children who have this problem are high-achievers, like your daughter, who put themselves under a lot of pressure. Sometimes there is an external source of pressure (for example, a tense relationship with a teacher or child at school). Sometimes family stresses also contribute to a child's chronic stomach pain.
The best way I know to handle recurrent stomachaches is to attack the problem on all fronts simultaneously: Have a thorough medical evaluation and follow-up with the doctor; at the same time, try to root out any unnecessary sources of stress in your child's life. Sooner, rather than later, ask your child's doctor forw a referral to a child psychologist or behavioral pediatrician who is familiar with treating abdominal pain.
Relaxation training and biofeedback are often helpful for tension-related stomachaches.— by Robert Needlman, M.D., F.A.A.P. |
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