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Tuesday, June 18, 2013
My Son Has Stomach Cramps
My 9 year old son has been getting stomach cramps after eating for the last two weeks. He passes stools 1-2 times a day and has sometimes had a little bit of blood in his stools. It does not seem to matter what he eats, whether its meat, fish, bread, potatoes or veg he still gets pain. Can you please advise
Stomach pain is a very common symptom in children and adults alike, and its occurrence around meals is a good clue about what the problem may be. It sounds as though the pain with eating is a new symptom, but it is becoming persistent. It also sounds as though other symptoms such as fever, vomiting, diarrhea, rash, or joint swelling are not present.
The four most likely problems a nine-year-old who has been previously healthy may have associated with abdominal pain are:
1. peptic ulcer disease (It runs in families and is more likely in kids who worry a lot and are high performers.)
2. gall bladder inflammation and gall stones (This also runs in families and is more prevalent among overweight children. The pain is usually worse at 2 AM and 2 PM when the gall bladder is most active)
3. reflux (backward movement of stomach contents loaded with acid into the esophagus, burning the tissues in the upper stomach and lower esophagus; especially common after meals when the stomach is full and food pushes back against the top muscles in the stomach holding the food in the stomach). Reflux may become a problem among children as they move into their older school-age years because they experience more stress in school and sports around performance and also they often eat outside the home more often, including fatty, spicy foods that promote reflux symptoms.
4. Common, but not usually associated with eating, is stomach pain because of life stress. Adults often think kids don't have stress but they surely do, and for many of the same reasons adults do - family problems at home, problems at work (which for kids is school), pressure to perform well in sports and become competitive in other after-school activities. Social demands also increase as kids approach puberty. Many of us develop physical symptoms that reflect the stress and mental pain we are feeling. The pain is very real although there may be no identifiable health problem.
As your son's parent, you know a great deal about the family health history, his style of coping, how things are going at home and academically. Children are least likely to share information about the bullying they are experiencing, pressure to perform from coaches, and their discomfort in social interactions.
It is a good idea to start with a visit to his doctor for an exam to assure you that all is basically normal or to get treatment started if there is a problem. If there is no physical illness, it may be helpful for you both to see a child psychologist or licensed independent social worker who can help identify the sources of stress causing the pain and help your son learn more effective ways to handle the stresses of daily life, which will only increase in middle and high school.
Mentioning the occasional blood in the stool is a good idea as well. It is not uncommon if your child tends to have dry, hard to pass stools that create small, painful tears in the anus and rectum. An examination will help to suggest other possible causes as well.
It is important to bear in mind that stomach pain is a symptom that often has no quick, easy answer as to the problem. It will help if you and your son can keep a 3 or more day record of his food and beverage intake throughout the day, how much sleep he gets at night, as well as his bowel movements and their consistency, and the exact times when the stomach pain occurs and for how long. If you bring this information with you to the doctor visit, it will help identify the problem source more quickly.
I hope this information is helpful and wish you a speedy resolution of the problem.
Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University