Students and stomach aches: When to call the doctor (320x240)
Dr. Priya Raj looks at the warning signs of when a repeated tummy ache may be cause for larger concern.

Tummy aches are one of the most common reasons for a visit to the school nurse. However, how can you determine when to seek medical help? Dr. Priya Raj, assistant professor of pediatrics-gastroenterology at Baylor College of Medicine and Texas Children’s Hospital, looks at the warning signs of when a repeated tummy ache may be cause for larger concern.

“Many children often complain of tummy aches, especially when they head back to school, which can be attributed to a range of issues,” Raj said. “We tend to hear repeat complaints from the younger elementary school students, especially.”

In these younger students, tummy aches may be caused by the stress of being in a new routine and social situation or from experiencing homesickness. Students also may complain of upset stomachs due to new foods in their diets or excess physical activity during sports practice, recess and physical education class.

“Children are being exposed to new foods, not only from the cafeteria but also from their peers. It is not uncommon for kids to show signs of food allergies or intolerances when they enter grade school,” Raj said.

When students return to school, they may come into contact with germs of other children, so a contagious gastrointestinal (GI) infection could be the culprit. Often this is also associated with other clinical symptoms like vomiting, diarrhea or a fever. If that is the case, it may be necessary to visit a physician for proper diagnosis and treatment.

Older students who are going through standardized tests, finals or college applications may develop stomach pains and other related symptoms like nausea due to stress.

“It is also important to remember the possibility that young female students may be entering their first menstrual cycles, which can lead to an unfamiliar abdominal pain,” added Raj.

Common stomach ache remedies include hydration, soothing medicines such as antacids and mild pain relievers.

If meals from the school cafeteria are causing the distress, parents may want to consider packing lunch for their kids, so they have access to foods they enjoy and are familiar with.

“Around the beginning of the school year, we see an increase in the number of children complaining of abdominal pain. The brain and the gut share a very intimate relationship and stress or anxiety can often be a trigger. If the tummy aches persist once the child comes home, disrupt normal daily activities, wake the child up from sleep or occur over holidays or weekends, it may be time to consult a physician,” Raj said. “In addition, if the child has a fever, an unusual rash, bloody bowel movements or vomiting, or experiences weight loss, these could be ‘alarm signs’ suggestive of a more serious underlying issue such as food intolerances or other gastro-related conditions, such as inflammatory bowel disease or peptic ulcers,” Raj said.

Overall, Raj recommends an open discussion between parents, their children and the school nurses and teachers to determine if frequent stomach aches are a means for attention or an indicator of a more serious problem.