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Opinion

Too many tummy aches

YOUR DOSE OF MEDICINE - Charles C. Chante MD -
A tummy ache is a common phenomenon of childhood, and generally, nothing to worry about. But what if a child has chronic abdominal pain? A child with frequent or constant complaints of a tummy ache may miss out on a lot of childhood activities. Abdominal pain might prevent a child from participating in sports, attending parties and might cause absence from school. Frequent abdominal pain in children can also cause a lot of parental concern. What should parents know about child abdominal pain?

"Chronic abdominal pain" is currently defined by the medical profession as "long-standing intermittent or constant abdominal pain." If your child experiences pain that fits this description, there are a few things about diagnosis and treatment that will be useful to know.

Usually, chronic abdominal pain in children is diagnosed as functional, rather than organic. Chief of pediatric gastroenterology, hepatology, and nutrition at the University of Colorado Health Science Center and the Children’s Hospital in Denver, Colorado, explains the difference between functional abdominal pain and organic abdominal pain. "Organic abdominal refers to the organs". If you have organic abdominal pain, that means there is actually something wrong with one of your abdominal organs. "Functional pain means that the organs appear healthy, but something is wrong with the way they are functioning and how the pain impacts the functioning of the child." For instance, irritable bowel syndrome (IBS) in adults or IBS of childhood are common examples of functional abdominal pain.

One way to distinguish a child’s functional abdominal pain from something more serious, like organic pain, is to look for alarm symptoms. Alarm symptoms can include an unexplained fever, persistent vomiting or unintentional weight loss. If your child or adolescent experiences any of these symptoms, further testing may be in order and you should seek the attention of a physician immediately. For functional abdominal pain, pediatricians may recommend a variety of treatments. As an example, a doctor might recommend a child take a medication (like an antidiarrheal or a laxative) for a limited time, to see if it can decrease the frequency or severity of the child’s pain. Also, a doctor might advise homestyle remedies like peppermint oil, warm herbal tea or dietary changes, all of which may be effective in relieving IBS. When children and parents understand the benign and common nature of the problem, there is often a real improvement in symptoms as a result of decrease in anxiety.

Parents should also be aware that psychological factors can affect a child’s abdominal pain, whether that pain is functional or organic. Some of the stressors that may affect a child: "School stress may occur if a child doesn’t like school or is worried about how she’s doing in school. Family stress associated with marital discord or divorce can also cause abdominal pain." The awareness that these things might exacerbate a child’s stress level, and thus cause abdominal pain, will help parents better understand their child’s diagnosis and treatment.

A parent’s reaction to a child’s complaint of abdominal pain can do a lot to affect the child’s stress level. Parents should be sympathetic to their child’s abdominal pain because it’s real, but they shouldn’t transmit stress to the child, because that will make it worse. That the key idea for parents interacting with a child who has abdominal pain is "sympathy with an absence of anxiety."

ABDOMINAL

CHILD

FUNCTIONAL

ORGANIC

PAIN

PARENTS

UNIVERSITY OF COLORADO HEALTH SCIENCE CENTER AND THE CHILDREN

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