Features

Causes of tummy ache

DEAR READERS:

T. Lyn has only recently moved to Portmore, St. Catherine. Her daughter, M., is six years old and is attending a new school. M. often cries for tummy ache before school in the days, and once her mother had to leave work and get her from school.

So far visits to family physicians have not revealed any cause for the pain. T. has spoken with her daughter's class teacher who is very pleasant and who says that M, is performing adequately.

Nevertheless, T thinks that M's problem could be emotional as she has not been troubled with this pain in the past and she is missing her best friend (and neighbour) from her last school.

T. asks Lifeline to give an opinion.

The presentation of abdominal pain (tummy ache) in youngsters which serves to prevent their attendance at school is neither new nor rare in occurrence.

Many children suffer with Functional Abdominal Pain Syndrome where nothing organic can be discovered to be wrong and the pain is not related to constipation, eating or any other specific activity.

LIFE EVENTS

The pain is usually felt around the navel. One frequently occurring symptom in this disorder is that LIFE EVENTS, which are disturbing to the child can be identified.

This could be the migration or death of a parent or sibling, difficulties with a teacher at school, problems with school work or schoolmates, or, as is the cause with M, trying to fit into a new school environment while missing one's previous friends.

Also of significance is that sexual and emotional abuse can also present with 'tummy ache'. Often other symptoms are associated with this disorder. These are:

- History of abdominal pain recurring over 3 month

- Some loss of daily functioning

- Little or no association of the abdominal pain with body functions such as eating or defecating

- Fatigue

- Dizziness

- Nausea

- Headaches

- Vagues muscle pain

This child should always be extensively evaluated by a physician to rule out a physical cause of the pain such as abdominal migraine headache, irritable bowel syndrome or functional dyspepsia, peptic ulcer disease.

The condition functional abdominal pain syndrome can only be diagnosed after extensive investigations have ruled out the above mentioned physical causes of abdominal pain.

The management of this problem is long term and requires review of the educational options, strict dietary management, psychological assessment and counselling.

The parent will need to be very observant of the child and their contacts both in the house and at school and to this end will need to work closely with the teacher and guidance counsellor.