From butterflies in the stomach to having "gut feelings," your gut and your brain are closely connected. Sometimes, though, that connection can be uncomfortable. Stress and anxiety can cause significant gastrointestinal (GI) issues, especially in children.
"A lot of people have GI symptoms if they get stressed enough, but some, like children, have a lower threshold for that physical sensitivity," says Stevie Puckett-Perez, Ph.D., a pediatric psychologist for the gastroenterology program at Children's Health℠ and Assistant Professor at UT Southwestern.
This means that it can be common for a child to complain their stomach hurts or to have GI issues before a big event, like the first day of school or an important test. While most stomach aches are not dangerous, they can still affect your child's day and make you worry. It is important to recognize how stress and anxiety can play a role and ways to help your child feel better.
How can emotions like stress or anxiety affect the stomach?
Stress and anxiety are among the top triggers for most gastrointestinal issues, especially in kids. The reason for that, says Dr. Puckett-Perez, is because the neurotransmitters that control our mood are the same ones that control pain and digestion.
The location of neurotransmitters in the gut is another reason there's a connection between gut issues and mood. Most of the body's serotonin, the neurotransmitter that controls mood, is in the gut.
Most people will experience a functional GI symptom at some point in their lives. Kids tend to be much more sensitive to them.
"It's important to remember that this pain is not in your child's head," says Dr. Puckett-Perez. "These are real and legitimate symptoms, and your child might need extra support navigating them."
How can you tell if a stomach ache is caused by stress?
It's hard to pinpoint the root causes of belly pain, constipation, diarrhea, indigestion and nausea in kids. This challenge is a particular problem for young kids who might have trouble communicating what is wrong. Parents can look for other signs of stress, which could help indicate if your child's GI issues are related to their emotions.
Changes in sleep, appetite or developmental skills could be indicators your child is experiencing stress. Clinginess or reversion to earlier developmental changes could also indicate stress for young children.
You can also evaluate your child's environment. Did they change schools recently? Do they have a big test coming up? Did their routine change? Any of these changes, which can feel big and hard to process for your child, can lead to stress.
What are common triggers of tummy issues in children?
It takes a lot of stress for most adults to get GI symptoms. For kids, minor mood changes can cause problems in the gut. Even events like a birthday or getting a new phone can lead to changes in the gut that cause symptoms.
"Those triggers don't necessarily have to be negative since your belly doesn't differentiate between good and bad stress," says Dr. Puckett-Perez. "Meeting a new friend or starting school can also trigger these issues."
Physicians often see an increase in functional GI disorders at certain times of the year, including the start of school, STAAR testing and finals week.
How can I help my child manage stress and GI symptoms?
If your child's belly pain is caused by stress, you can work to remove any stressors that are easy to change. For example, consider how to establish morning or bedtime routines, so kids always know what to expect during those periods. If your child has an occasional upset stomach before a stressful or exciting event like a test or starting a new school year, try reassuring them by sharing encouraging words of advice.
For things like school that you can't change easily, you can help your child by teaching coping skills, including giving them a toolkit of activities they can use in response to pain:
- Address daily schedule, habits or routines
- Manage symptoms like food allergies or constipation
- Practice belly breathing
- Process worries
- Take short breaks
- Use a heating pad or TENS unit
- Use muscle relaxation activities
You can also talk to your child's school to let them know your child is experiencing these conditions. That way, the school can work with you to have accommodations in place, and kids can know they have an escape route if they start to feel sick. Accommodations can include:
- A place to stretch
- Being able to bring a water bottle or heating pad to the classroom
- Free restroom passes
- Passes to see the nurse to lie down
When it comes to school, even if leaving the classroom for a few minutes is disruptive, it's better than missing a full day.
When should my child see a doctor for stomach pain?
If your child is experiencing new GI symptoms that a doctor has not evaluated, it is better to see a physician to ensure there are no underlying physical causes. It's also important to see a doctor if the pain is persistent or disruptive to your child's ability to function or if your child is not responding to remedies that have previously worked for them.
Your child's doctor can help determine the cause of their stomach pain. If the doctor finds stress to be the root cause, your child's pediatrician, gastroenterologist or psychologist can help you put a plan in place for steps you can take when your child is hurting.
"It's important to remember none of these symptoms are intentional or faked," says Dr. Puckett-Perez. "Your child is not trying to avoid school or activities. They are experiencing abdominal symptoms triggered from being in stressful settings."
Learn more
The highly experienced GI specialists at Children's Health can help identify, diagnose and treat digestive issues in children. Learn more about our programs.
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