I am getting a lot of phone calls and texts with concerns about tummy aches. I have even started seeing patients in the office with complaints of “my tummy hurts”, and we are just in the first week of school. I know that school nurses are dealing with this common complaint as well. Amazingly, I don’t see very many complaints of tummy aches during the “lazy days of summer”…but once school starts they seem to become more prevalent.
Don’t get me wrong…while the tummy aches are real and painful, they are usually not due to anything serious. In many cases I see, the abdominal discomfort may be due to a bit of anxiety and stress that often comes as children get back into the classroom. While the child may not be aware of “stress”, their body does sense it and the gut responds with abdominal pain.
The children that I am already seeing are all healthy and growing well. They do not appear to be “ill” when I see them, but will complain that their tummy hurts. When I have them point to where the pain is, they typically point right around their belly button (periumbilical). If asked to point to the one place where it “hurts the most” they typically still cannot localize it…it’s just all over! Having generalized pain is typically a good sign, rather than having point tenderness in one area. Upon further questioning they do not have a fever, have not had vomiting or diarrhea, DO NOT wake up in the middle of the night with abdominal pain and often cannot remember if they “pooped“ today or yesterday but usually swear that their “poop” is “normal” . (I am not always sure about that - stool history in kids is quite hit and miss!)
A few of the children say that eating makes their tummy ache worse while others report it feels better if they eat. They typically are not having issues with a specific food. (It also depends what they are given to eat - often they will eat their favorite food if given the opportunity).
For some of the children the pain is “bad enough” that they come home from school, but once home their parents report that after an hour or so they seem better. Other children stay in school, but the minute a parent picks them up they start saying “my tummy hurt all day at school”!
I remember that one of my sons often had tummy aches during the school year and we were talking about it the other night (he is now an adult). He says he remembers being worried about school and “hiding” in the morning when it was time to go to school (I would be looking all over for him as his older brother was already out the door, and anxious that he would not get to school on time, while I had the younger brother on my hip as I searched the house). Talk about getting a stomach ache…mine was in knots by the time I would get to work. It would only be several hours later when I would get the phone call from the school nurse that he was there with a tummy ache. He now says that he remembers that by the time he was 8 years old it all just changed and it went away.
Many times all it takes is a little reassurance that the tummy ache is not serious. I tell the children that everything on their exam is normal which is a good thing. Sometimes it seems to help a tummy ache if I prescribe the child some extra fiber and maybe a Tums a good source of calcium too). Who knows if it is placebo effect… but just by doing something they feel a bit of relief. The one thing I do know…they need to keep going to school and it usually gets better once they are settled back into a school routine.