Back to School at FamilyEducation.com
|

Expert Iconexpert advice MORE

Chronic Stomachaches

Pediatrics Expert Advice from Shari Nethersole, M.D.

Q: My almost 11-year-old daughter seems to have a stomachache almost constantly. She has been diagnosed with gallstones, but her doctor doesn't think they are causing the pain. She's also tired a lot. She doesn't like school much this year and is bored. Could that be the cause of the stomach pain and tiredness? No one can seem to find any other cause.

A: Abdominal pain is a very common complaint in children, and the majority of children who have it do not have any major underlying disease or illness. For what ever reason, the abdomen seems to be the focal point for many of life's woes, and complaints of pain often are worse when a child is tired or bored. Certainly sadness, anxiety and depression can contribute to a child's appreciation of any abdominal discomfort they may have.

Some of the simple things that can cause complaints of stomachache in children are constipation and overeating. Some children hold in their bowel movements all day, either because they are too busy to go or they don't want to use the bathroom at school. This can cause some true discomfort by the end of the day. Similarly, the child who gets a stomachache after lunch every day may be eating too much and overdistending the stomach.

If a child has no other symptoms besides the pain it can be difficult to sort out the cause. One thing that I often have patients do is to keep a "diary" of the pain. Write down when the pain occurs, what part of the abdomen it was located in (high up or low down, right or left side, or all over) , how long it lasts, what was going on at the time, what relationship it had to eating, etc. By looking at this type of diary over a week or two, it is sometimes possible to determine the cause, or at least the associated factors. Once you've generated a diary like this, you can review it with your child's physician, and you can both play detective as you figure out the associations. Things such as lactose intolerance might not be suspected without recognizing the association of the symptoms with the use of milk products. A child whose pain only occurs at bedtime may have some nighttime fears or other anxieties.

One general guideline with assessing the significance of stomachaches is to determine if they interfere with the child's activities. A child who complains of a stomachache and then wants to go out and play 10 minutes later is less likely to have a serious disorder. A child who complains of pain and doesn't want to go to a birthday party or a special outing is more concerning.

There are some symptoms that should make you more concerned about stomachaches, and if these occur, further evaluation should be done: Chronic diarrhea, persistent vomiting, fever, blood in the stools, burning with urination, abnormal menstrual periods, and weight loss might indicate more serious disorders.

More on: Expert Advice

Shari Nethersole is a physician at Children's Hospital, Boston, and an instructor in Pediatrics at Harvard Medical School. She graduated from Yale University and Harvard Medical School, and did her internship and residency at Children's Hospital, Boston. As a pediatrician, she tries to work with parents to identify and address their concerns.


Please note: This "Expert Advice" area of FamilyEducation.com should be used for general information purposes only. Advice given here is not intended to provide a basis for action in particular circumstances without consideration by a competent professional. Before using this Expert Advice area, please review our General and Medical Disclaimers.

stay connected

Sign up for our free email newsletters and receive the latest advice and information on all things parenting.

Enter your email address to sign up or manage your account.

Facebook icon Twitter icon Follow Us on Pinterest

editor’s picks

highlights

Handwriting Headquarters
We've got handwriting practice worksheets, handwriting tips, and answers to your child's writing struggles, just in time for back to school. Brought to you by BIC.

11 Coolest Lunch Boxes for Kids
Send your child's lunch to school in style! Check out our picks for the 11 best lunch boxes with great features from BPA-free accessories to spill-resistant fabric.

7 Important Back-to-School Safety Tips
Follow these back-to-school safety tips to make sure your child stays safe on the way to school, in the classroom, and while on the playground.

Kindergarten Readiness App Wins Gold
Our Kindergarten Readiness app won the Gold Award of Excellence in the educational category at the 2014 Communicator Awards. This valuable checklist comes with games and activities to help your child practice the essential skills she needs for kindergarten. Download the Kindergarten Readiness app today!

Join BIC on our mission to save handwriting and Fight For Your Write! Writing helps kids become better readers, boosts their confidence and sparks their creativity. Visit BICFightForYourWrite.com to sign our petition to save handwriting!