Question
My 10-year-old daughter often complains of stomach aches. She doesn’t seem to have any other physical symptoms. Could it be related to stress?
Answer
It is reassuring that your daughter seems to be in good health otherwise. The ongoing nature of the complaint without other symptoms excludes an acute infectious process such as gastroenteritis. It is unlikely to be the appendix as it is ongoing in nature, but that would not be impossible. Regardless, one should never assume a diagnosis without a proper history and physical exam and when deemed necessary, other investigations.
A common gastric disorder that can cause ongoing cramps as well as bloating and gas is called irritable bowel syndrome (IBS). And as you suggest, emotional stress can be a trigger. Nerves in our brain are also connected to our colon so it is understandable that stress and anxiety can lead to stomach complaints. A thorough history and a diary of the symptoms can help fi nd out if there are common triggers. These could be anxiety or food triggers, such as dairy, caffeine, fried foods and so on.
While we do not know the cause of IBS, it can run in families. It’s important to monitor your child for any alarm symptoms. Possible red flags include weight loss, black or bloody stools, vomiting or pain that wakes your child up from sleep.
It is important to exclude constipation as a cause of abdominal pain. There are no specific tests to diagnose IBS and usually the history of the symptoms and a physical exam help make the diagnosis.
Diet and lifestyle is the mainstay of treatment. We know exercise is a great way to help reduce stress and improve digestion. If you note that your child appears stressed or anxious, address this with your health care provider to help them learn how to cope. Bring your concerns to your physician to help make the diagnosis in this situation.
Originally published in ParentsCanada magazine, April 2015. Photo by iStockphoto.
