Search

Home > Portable Practical Pediatrics > Stomachaches: Worried about the Wrong Organ? (Pedcast)
Podcast: Portable Practical Pediatrics
Episode:

Stomachaches: Worried about the Wrong Organ? (Pedcast)
Category: Kids & family
Duration: 00:00:00
Publish Date: 2016-01-17 19:07:16
Description: Topic Introduction Pediatricians see a lot of children with stomachaches. It is estimated that about 10% of the childhood population have a stomachaches as often as 3X/3months, the definition of a syndrome pediatricians call recurrent abdominal pain. These children not only suffer great pain, but they miss a lot of school and other activities of childhood. Children with recurrent abdominal pain need to have some tests to make sure that they don't have a serious disorder but fortunately, most of the time there is nothing seriously wrong with them. That is not to say that there is nothing wrong, just nothing seriously wrong with their intestines. The lack of a major disease of the gut is great news for these families but leaves everyone with a real dilemma, what is wrong with these children how do you help the child? That's the topic that we are going to explore today so sit back and get ready for another edition of Portable Practical Pediatrics.  Musical Introduction What Happens When a Child Has Recurrent Abdominal Pain? So what happens when a child starts to have frequent stomachaches. What should a parent do? First, I recommend that these children be brought to their pediatrician where their pediatrician will take a history and explore as many factors about the pain as they can. Next comes a physical exam where the pediatrician looks for signs of serious illness such as anemia, enlarged internal organs, weight loss, or jaundice. Finally comes some simple lab tests like a urinalysis, some blood tests, and maybe a stool culture and analysis. Fortunately, most of the time, we find nothing unusual on any of these tests.  The most revealing part of this evaluation turns out to be the history; things that we learn by asking and listening.  Things like how much school the child has missed, is there a bully at school, how are things going at home, is the child sleeping OK, is the child struggling academically, are there expectations on the child that they can't meet etc, etc.  Assuming that the child does not have signs and symptoms of serious gut disease, then what? So, we have probably learned a lot about this child's emotional makeup and found absolutely nothing on their physical exam and laboratory studies. Can we offer the child and their family no help or enlightenment as to what the child's problem is?  No, we actually have a lot to offer them as far as diagnosis and treatment.  Let me explain further.   Which Organ is Causing the Child's Problem? It turns out that most of the time, a child who has recurrent abdominal pain doesn't have a disorder of their intestines, or liver, or gallbladder, or spleen, or really any organ in their abdomen-- no rather they have a disturbance of mood. Isn't it ironic that their parents bring them to the doctor thinking that something is wrong with their stomach and it turns out that, in most cases, there is really something wrong with their brain--the child has a disturbance, an anxious response so to speak, in the way they react to daily stress or to their own gut sensations. In my experience, I find that the children with anxious temperaments are the ones that fall into the cycle of having recurrent abdominal pain. These children are wired from birth so to speak to have a very anxious response to things they find unpleasant and part of that anxious response is an alteration of their intestinal motility. Their brain says to their intestines when they are under stress, either stop moving and get ready to run or empty fast and get ready to run. Yes, they have an anxious temperament, that is the tendency to react to things in an emotional way, that causes them much distress--typically stomach distress. Maybe there is a new baby in the house that is making them nervous, lonely, or unloved, or maybe their diet is very rigid and unhealthy because they are scared to try new foods or textures, or maybe they are afraid of having pain with pooping and therefore have become very constipated,...
Total Play: 0