According to a review by Laura Kaminsky and colleagues published in the "Journal of Pediatric Psychology," 10 to 15 percent of all school-aged children suffer from recurring abdominal pain. In the majority of these cases, no anatomical or physiological cause can be identified, even though vomiting may occur. The causes may be psychological. Check with your pediatrician if your child vomits often. Even when the problem is psychological in origin, treatment is available.
School Phobia
While most young children see school as an exciting, enjoyable time spent with peers, some experience intense anxiety instead. School phobia is usually driven by a fear of leaving the safety of home and familiar caregivers. According to the American Academy of Child and Adolescent Psychiatry, anxiety about going to school is most common in the first years of both elementary and middle school as children adjust to their new environments. Most children don't express their fears about school verbally. Instead, their school phobia will manifest in physical symptoms which may include headache, nausea or vomiting.
Make sure you do not subtly reward a child who is school-phobic with extra attention, enjoyable activities at home or exaggerated sympathy. If your child experiences vomiting or other symptoms before school only to have the symptoms resolve when she is allowed to stay home, consult your pediatrician.
Depression
Kaminsky's paper reported that up to half of all children with recurring abdominal pain have symptoms of depression. Just like in adults, depression is a real illness that can benefit from professional help. Depressed children may exhibit tearfulness, withdrawal from friends and family and irritability in addition to physical complaints. Treatments are available, including cognitive behavioral therapy and sometimes medication. Early diagnosis is important for a good outcome.
Abuse
An article published in the "Annals of Family Medicine" stated that children who have suffered physical, sexual or psychological abuse are far more likely than other children to experience abdominal pain, vomiting and other signs of gastrointestinal distress. The lead author of the study, Dr. Miranda von Tilburg of the University of North Carolina School of Medicine, suggests that doctors question children with unexplained abdominal symptoms about possible mistreatment.
References
- Science Daily: Abused Children More Likely to Suffer Unexplained Abdominal Pain, Nausea or Vomiting
- American Academy of Child & Adolescent Psychiatry: Children Who Won't Go To School (Separation Anxiety)
- Journal of Pediatric Psychology: Psychological Correlates of Depression in Children with Recurrent Abdominal Pain
