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Tuesday, March 11, 2014
9 Year Old with Stomach Pain
You have had mother`s ask this questions A mother asked Dr. Gottesman a question about her 9 year old daughter that had stomach pains after she ate. Another mother`s 6 year daughter is having the same problem-for 2 years also. What was the outcome of this little 9 year old girl? My son is 9 years old and has had this problems for about 3 years now. His doctor said kids have nervous stomach, but never has done no test on my son. He has stomach pain right after he eats, sometimes vomiting and diarrehea always. He is like this with anything he eats, he is allergic to milk. Please can you tell me what I should do to help my son!
Stomach pain is common in children particularly school aged children. The cause in many cases is unknown and the diagnosis of chronic recurrent abdominal pain of childhood is given. Some might call this a nervous stomach and some pain in children is clearly anxiety related. It is important to remember that there are as many nerve endings in the GI tract as there are in the brain and movement disorders and bowel distention may cause pain in a child that is not serious in nature.
The challenge for the practicing physician is to determine what abdominal pain in a child is serious. Benign abdominal pain is typically around the belly button, does not awaken the child at night, is relatively short in duration and not associated with vomiting or diarrhea. A few laboratory tests and a good physical exam can exclude more serious problems including inflammatory bowel disease, celiac disease or carbohydrate malabsorption. A careful examination looking at growth and the pattern of growth of the child, the presence of oral ulcers, finger clubbing, blood in the stool or anal disease is sufficient to exclude serious disease. Laboratory tests including blood tests for celiac disease, a blood count and assessment of inflammatory markers, serum liver chemistries and stool for blood and ova and parasites (in patients with diarrhea) should be performed. In both of the described cases, the prolonged duration pain if associated with normal growth should suggest that there is no serious treatable condition. Both cases might merit some modest work-up to exclude more serious conditions as described above.
James E Heubi, MD
Professor and Associate Chair of Pediatrics
College of Medicine
University of Cincinnati