Stomach pain: why does my child have it?

Stomach pain and vomiting in anxious children is a common symptom. It’s a physical “demonstration” of what they’re feeling. That’s because all our bodily systems are linked. 

The simplest explanation of how that works when we’re anxious or stressed goes something like this...

Some of the hormones and chemicals that are released to help us deal with a real, dangerous situation manage to get into the digestive system (see my page on palpitations for a comment on woolly mammoths and hunter-gatherers). 

These hormones and chemicals interfere with digestion and cause stomach pain – and we know the outcome of tummy problems!

stomach pain 2

Your anxious child might complain of:

  • Headache
  • Tummy ache (ie stomach pain)
  • Feeling sick
  • Being sick
  • Feeling faint
  • Feeling dizzy
  • Feeling ill

Hopefully, you’ve proved by now (perhaps because it’s happened a few times before) that your child is not actually ill in the medical sense, so you’re wondering if they’re anxious about something. 

In fact, researchers concluded a while ago that most stomach aches in children that couldn't be explained by an illness were due to emotional problems, chief of which is anxiety. Here's some detail:

That research group, back in 2004, consisted of half the group having chronic stomach aches, the others not. Data results suggested:

  • 81% of those with stomach aches had anxiety or depression, especially those under 12.
  • 79% of the stomach ache group suffered from separation anxiety, generalised anxiety or social phobia.
  • anxiety problems started usually around age 9, about three years before the stomach ache pattern began.
  • kids with stomach aches were significantly more likely to disrupt lessons.

However... do consider these factors about stomach pain:

Does your child 

  • have blood in their poo?
  • a sharp pain lasting more than 6 hours?
  • a swollen belly?
  • a hard belly?
  • diarrhea?
  • a temperature?

If so, please consult your doctor. Much better to be safe than sorry. 

Otherwise, read on!

In a moment, have a look at the possible causes of anxiety to see if any of them shed a light on why your child has these symptoms.

But the most important thing right now is to have a few strategies to help ease the stomach pain and fear of vomiting that you child has.

The reason is that once they’ve spent a morning lying on the bed with a headache, or on the sofa having already been sick, their brain gets the message that what they’re worried about really has to be avoided in future – because it makes them ill.

That’s the last message we want them to get. And it’s a tricky one to avoid because, as parents, we want to protect them.

It’s just so easy to fall in with their wish to not go to school, not attend a club, not visit a separated parent – or whatever is bothering them.

So I guess the first job, then, is for you to not give in but to immediately start using some calming techniques with your child.

Strategies for calming an anxious child who has a stomach pain or headache

It’s impossible to ignore the physical feeling of stomach pain and nausea just by trying to. So one of these is a better bet:

  • Deep relaxed breathing: they need to make their tummy expand like a balloon as they breathe in, and then breath out normally but more slowly. Then repeat a few times. They can count 4 in and 5 out if it helps.
  • Change of posture: if they’re sitting, stand and walk around; if walking around, try running in the garden or lying flat on the floor.
  • Change of occupation: simply do something different. If you’re making a chocolate cake and leave out the chocolate you still have a cake but it’s not a chocolate one! So a change of occupation brings something different in its wake.
  • Change of focus: they’re probably thinking of the pain. Suggest naming all the red things in the room; or counting how many books they have; or checking they have 6 different kind of clothes; or naming types of vehicle.
  • A sip of water or small snack: but avoid fatty, processed or high-carb food. A segment of apple might be better. Chewing is a distraction anyway.

The general aim is to put a stop to the stomach pain and vomiting reaction that is caused by our ancient fight/flight response. 

That response was crucial in hunter-gatherer days, but can be over-activated nowadays in situations that are not life threatening.

Your child unconsciously believes that a particular event is life threatening. It may seem it to them – but you will know otherwise when you hear the detail of what it is!

And it most likely won’t be the main event (eg going to school or a party) – it will probably be some smaller aspect of it.

So when your child is calmer and feeling better, you need to help them talk.

After calming your child down, talk with them about what exactly is worrying them.

Put aside a special time when you're not distracted by your phone or making a meal or watching TV (or whatever).

They need to know you've really listened to them, and validated how bad it feels for them when they have stomach pain or feel like they’ll be sick. Until then, they will not listen to a word you say.

But when they’re assured of your concern and care, you can introduce the idea that their stomach pain and sick feeling is a physical response to some worry they have, and that you will help them sort the worry out, step by step.

A point to consider

The most helpful thing – from a mental health point of view – is to make sure your child doesn’t get into a habit of avoiding scary things that can be sorted. If they do, their life will become more and more restricted and their mental health will go downhill over the years.

A "fishy" activity that may help

Giving away anxieties graphic

My awful image above is just a reminder for you. I’m sure you and your child can produce something much nicer!

You’ll need to adjust this activity to suit the age of your child, but the gist is as follows:

Draw (or ask your child to draw) 3 images on a piece of paper. Either small pieces, one image per piece, or a large sheet with all three on it, spaced out.

Feel free to swap the images if you think of a better one when you’ve read this. For example, one child suggested to me it should be a balloon instead of a fish. Take your child’s advice!

The fish: This represents worries that no one can really do anything about right now – neither you nor your child – so these worries need to be allowed to float away (get them to imagine it as a fish swimming away).

The hammer: This represents things your child can start doing for themselves to make the situation better (after planning it with you) – a tool is used to make things right.

The gift: This represents worries that are not for your child to worry about – they should be given to an adult. Thank your child for trusting you with the “gift” and assure them you’ll deal with it.

A really powerful way to make the idea stick is to shut their eyes and imagine the fish floating the worry away, their hammer mending the worry, or the gift being handed over to you for safekeeping.

So…

While you and your child are talking about their worries, start writing them down on slips of paper.

There may be quite a few, or just one or two. 

When they’re all written down, your child can start agreeing which group each one belongs to.

(Keep the fish/hammer/gift piece of paper safe for future use if another worry session starts.)

An example of a worry to go in the fish group might be “I’m worried there will be a war”.

An example of a worry to go in the hammer group might be “I’ll be late for school and get into trouble”.

An example of a worry to go in the gift group might be “The bully will pick on me”.

Whatever the worry, there is a place for it – and getting it into words and writing it down and putting it where it belongs is hugely helpful in putting an end to stomach pain, nausea, vomiting and headaches.

If your child is old enough, you can teach them to recognise the onset of physical symptoms and to tell you. 

Then you can use this, or another exercise, to stop the physical reaction and deal with the mental/emotional one. 

There are lots of activities and strategies in the strategies section to try as well.

A book about giving worries away – for preschoolers

Virginia Ironside’s book The Huge Bag of Worries (illustrated by Frank Richards) is a brilliant story about not carrying round an oversized bag of worries. It reinforces the activity above in a different way.

cover for Huge Bag of Worries book

Takeaway

  • Stomach pain in anxious children is often linked to their emotional state.
  • Symptoms like stomach pain and vomiting can be physical manifestations of stress and anxiety.
  • Strategies to help include relaxed breathing, changing activities, and distraction techniques.
  • Discussing worries and engaging in creative activities can help in managing anxiety so that physical symptoms subside.
  • It's crucial to understand and address the emotional roots of physical symptoms.

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