We have previously touched upon some common causes of acute and chronic abdominal pain, like constipation and lactose intolerance. There are, in fact, an enormous number of disorders in which pain in the area of the abdomen plays a role. Some of them can be quite difficult to diagnose without modern technology that includes using a tube to look inside, getting a biopsy, and sending tissue to a lab. Others may be revealed to an expert by a careful recounting of symptoms. Let’s talk about three really important disorders. Identifying them properly will change your child’s life.

The first is celiac disease. While many people think they have gluten intolerance, most of the time there is another explanation for pain after eating wheat products. But true celiac disease can be truly disabling. Gluten is a protein found naturally in certain grains such as wheat, barley, and rye. Unlucky individuals form antibodies when exposed to gluten, and the result is damage to the lining of the intestine. Pain, bloating, diarrhea, persistent fatigue are common. Difficulty maintaining clear thought may ensue, and other issues like joint pain, anemia, rashes, and inability to digest food may confuse the issue. Children with celiac disease have trouble growing or gaining weight. Definitive diagnosis requires a biopsy of the intestine, and treatment requires life-long dietary restriction. Because children often don’t have the capacity to understand that even a few crumbs can trigger an attack, celiac disease can be very difficult to prevent without help from family, teachers, and friends. The disease may start at any time.

A second chronic but intermittent disorder is irritable bowel syndrome, caused by the body’s abnormal response to a normal diet. Cramps are common, and some patients have either diarrhea or constipation. Because there is no real test for irritable bowel syndrome, the diagnosis may take a long time. Treatment may include medications that reduce the nervous system response of the intestine. Medicines that are also used for anxiety or depression may be very effective as well. Often a change in diet, such as reducing fiber intake, is recommended, but there is no magic treatment.

The third disorder is really a collection of serious problems called inflammatory bowel disease. The cause is not understood, but we see damage to the intestine erupt, beginning as soon as early adolescence. Without treatment, symptoms persist. Diarrhea, usually with blood and mucus, is debilitating. Weight loss, fatigue, and growth problems are the consequences. Treatment requires very powerful medications. Fortunately, tremendous strides in the treatment of inflammatory bowel disease have made a real difference in treatment.

Please be attentive if your child keeps complaining of tummy aches. Most of the time, it’s a simple matter, but your pediatrician can almost always help you relieve the pain.

Robert B. Golenbock, MD, is currently retired. He has cared for children in the Danbury area for 43 years, including at the Center for Pediatric Medicine. The CPM is located at 107 Newtown Rd, #1D, Danbury, CT, 06810. For more information, please call (203) 790-0822 or visit their website at https://centerforpediatricmedct.com.