If your child complains of a stomachache, he is not alone.


 “Up to 70% of kids have experienced a stomachache at some time in their life, so it is extremely common, and pediatricians do a lot of work reassuring parents, though most of the time it is benign,” said Dr. Silvana Bonilla, pediatric gastroenterologist from Boston Children’s Hospital. “The two most common diagnoses we make in the clinic are constipation and acid reflux.”


  A stomachache can be mild or severe and experts advise parents to be sensitive to their child’s feelings and not dismiss it too easily. 


  “I recommend a little tender loving care and maybe a tummy rub. And if the pain continues, offer to sit outside the bathroom while the child sits on the toilet,” said Dr. Varuna Tuli, department head for pediatrics from Franciscan Hospital for Children in Brighton. Focus on clear fluids, like water or broth. A warm compress or bath may provide relief.


Is anxiety or stress the culprit?


 Be in tune with what is going on in your child’s life. 


  “Anxiety is a common cause of stomachaches, so it is common during the school year to see kids with abdominal pain triggered by stress, which is in the realm of irritable bowel syndrome,” Bonilla said.


  There are tests to determine if your child has irritable bowel syndrome. “Parents are surprised because they think irritable bowel syndrome is not a diagnosis that is made in kids,” he added.


  Being supportive and encouraging, and maintaining an open dialogue with your child can make a big difference in helping to ease an anxious stomach. “It is important to see how your kid is feeling, if there is something making him stressed or anxious, if there is a social history of him being bullied at school, if his relationship with his friends and teachers is OK. Sometimes only addressing that takes the pain away,” Bonilla said.


  Once the cause is addressed, stomachaches improve. Stress management is essential, so you want to be sure your child has positive ways of coping, like healthy pastimes, meditation, yoga or talking to a trusted adult or counselor. “If the kid is more of a personality of being anxious or a high achiever he is more at risk for stomachaches,” Bonilla added.


  The medical community is always looking for new treatments for tummy troubles that could also be caused by stress or anxiety. 




  “There is a lot of data recently about how lots of cognitive behavioral therapy interventions are sometimes performing as well as medication,” Bonilla noted. The goal of cognitive behavioral therapy is to produce healthier behaviors and beliefs.  Alternative remedies are options, too. “There are other techniques like guided imagery, hypnotherapy and acupuncture, which is part of Chinese medicine,” Bonilla said.


 Often, with lifestyle modifications the stomachache will go away.


  “The most useful tip is to allow your child to decide how much he will eat and to make mealtimes predictable and pleasant, always including fresh fruit and vegetables to prevent constipation,” Tuli said. Children should not overeat and parent should ensure children do not right eat before going to bed. Making good dietary choices is helpful.


 


Medical causes & tummy maintenance


  If you decide a visit to the pediatrician is necessary, letting your child know what to expect at the visit can make him feel more at ease. 


  “The doctor will ask you lots of questions about dietary habits, frequency and type of bowel movements, whether there are stressors in school, food sensitivities and will likely do a tummy exam,” Tuli explained. 


    “For constipation, we always recommend good hydration and a good intake of fiber in the form of fruits and vegetables, and for acid reflux, we want the kids to avoid spicy foods, carbonated beverages, and juices, particularly orange and lemonade,” Bonilla added. Make sure your child does not share utensils or personal items with friends, washes his hands before and after eating and after going to the bathroom, and gets lots of sleep.


  A stomachache can represent a potential stomach flu, formally known as gastroenteritis, which is the not the same as traditional flu. Gastroenteritis usually includes diarrhea and vomiting and parents need to ensure the child stays hydrated. The illness runs its course in 7 to 10 days.


   In terms of medicine, there is a gold standard. 


  “Probiotics are revolutionizing the world of gastroenterology and pediatrics and are over-the-counter without many side effects,” Bonilla said.   


  Probiotics are live bacteria and yeast that are beneficial to your health, particularly your digestive system. Yogurt contains probiotics, as well. “Miralax or fiber gummies are available over the counter and may also offer some relief,” Tuli added.