Children’s Health: When a tummy ache is more than a tummy ache

Stomach aches are some of the most common health issues children face on a regular basis, ranging from issues with indigestion to a more serious and chronic illness like Crohn’s disease. But it can often be difficult for parents to differentiate between gastrointestinal (GI) problems, which may require professional medical help, and ones that may only need over-the-counter medication.

In most cases, a child should see a professional for a stomach ache if they have difficulty eating, persistent vomiting, pain in the lower right side of the belly where the appendix is, blood in their stool, a fever over 100.4°F, or if they are unable to pass stool.

Look out for other symptoms that may be related to their gastrointestinal system such as hives, paleness, dizziness, facial swelling, or if your child says it hurts to urinate or if they are lethargic or seem to be much sleepier than usual.

These problems are incredibly common in children and are created by a number of factors. Inflammatory bowel diseases (IBD) are ones that affect any part of the gastrointestinal tract, from the mouth to the anus, and approximately 20%-25% of all IBD cases are in children. Other conditions, like Irritable Bowel Syndrome (IBS), are seen in approximately 17% of high school-age children.

Gastrointestinal disorders often lead to complaints of abdominal pain. Functional GI conditions are created by extra sensitivity of the GI tract. Sometimes these conditions are hereditary and can be found in children who are otherwise healthy. The most common pediatric functional GI condition is functional abdominal pain.

Children with this disorder experience recurrent pain in the middle of their stomach. If brought to a health care professional, they can determine what is causing the pain: likely a combination of constipation, stress or diet.

It may also be beneficial to have your child keep a symptom diary and note what they eat and drink, what they did each day and how their stools were in order to determine what may be causing the problem.

It’s important to remember that “feeling sick” may be caused by stress. Stress can appear in physical symptoms such as stomach aches and headaches. If a child makes excessive trips to the school nurse or complains of frequent stomach aches during certain situations, that child may be experiencing significant stress.

“It's important for parents to understand that the brain and the gut are connected, and that stress and anxiety often lead to GI complaints. These complaints can then affect a child’s school attendance, food intake and social life. A referral to a pediatric gastroenterologist can help in differentiating true GI disease from functional GI symptoms,” said Dr. Glendon Burress, a pediatric gastroenterologist at Ascension Saint Alexius.

Of course, not every stomach and GI issue is the same. Crohn’s disease is one type of inflammatory bowel disease, but can lead to serious complications like obstructions inside the body, abnormal connections between different parts of the digestive tract, malnutrition and a heightened risk of colon cancer.

Norovirus is often referred to as a stomach flu and is a common cause of inflammation of the GI tract. It can affect both the stomach and intestines and leads to symptoms such as sudden onset of nausea and vomiting, diarrhea, stomach cramps and a low-grade fever, chills, or body aches.

Digestive health conditions can affect your child’s physical and emotional health. Consulting with your pediatrician is always your best source if you are worried about your child’s health, and can help guide you to the appropriate care.

• Children's health is a continuing series. This column was provided by Ascension Illinois.