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Is it Just an Upset Stomach or Something Worse?

Dr. Malaika Stoll helps adults identify when kids are suffering from more than just run-of-the-mill digestive problems

Know a child or teenager suffering from frequent stomach aches, nausea, diarrhea, or other digestive issues? If so, you’re not alone. Many young people are suffering from digestive issues that can be caused by anxiety, stress or other mental health issues, which have soared during the pandemic.

Chronic digestive problems should be brought to the attention of a doctor, especially if accompanied by weight loss, fever, bleeding, or other concerning symptoms, said Dr. Malaika Stoll, Blue Shield of California senior medical director.

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Dr. Malaika Stoll

“The doctor may order labs and studies to test for certain diseases,” Stoll said. “Often, all these tests will come back negative, leaving families without a clear diagnosis, and wondering what they can do to help.”

For kids without serious problems, a good next step is taking a look at diet. For a caregiver, this may include helping a child or teenager to identify and avoid foods that may trigger symptoms. In addition, consider that stress, anxiety, and other mental and emotional factors can also contribute to digestive problems.

“Our mind and our gut are connected,” Stoll said. “It’s why we get butterflies in our stomach before a big presentation, and why our appetite is affected by our mood and stress levels. This is normal, but sometimes teens need help understanding and managing this connection.”

Talk about what’s going on

Parents and children  don’t always talk openly about what is going on emotionally, and some parents may not recognize that their children are stressed, anxious or facing mental health challenges.

If stomach pains are accompanied by diarrhea and/or constipation and these symptoms occur over several months, it might be irritable bowel syndrome, or IBS.

“This condition can be associated with stress or anxiety,” Stoll said, "and it is very common in teens, affecting 15% to 20% of them. While parents may be looking for an easily treatable cause of gut symptoms, such as an infection, IBS can take time to diagnose and treat.”

Stoll, a family physician with three teens of her own, urges parents to be empathetic, and to keep an open mind about what may be contributing to their child’s digestive problems.

Dr. Stoll’s tips to help a child struggling with digestive other issues:

  • A few stomach aches are normal, but if your child has stomach pain, diarrhea or constipation that occur frequently over a couple months, see a doctor to rule out infections or allergies.
  • If your child is losing weight, has fevers or other concerning symptoms, seek medical help immediately. If you are worried that a child has an eating disorder, such as anorexia or bulimia, seek professional help immediately
  • To learn more about how your child is doing emotionally, choose an appropriate time —not when your child just got home from school or is studying for a test — to ask them how they are doing with school, friends, or extra-curricular activities. That can be followed by more specific questions, for example: “Do certain situations make your belly symptoms worse?” Help your teen to be more aware of their health, mood and triggers.
  • Consider having your teen keep a journal to track when symptoms occur, and if they are related to certain foods, times of day, classes, or activities. Eliminating trigger foods and reducing the causes of stress can help alleviate symptoms. 
  • Make sure your teen is getting enough sleep, healthy meals and regular exercise, which can help with digestion and also reduce stress.
  • Sleep and meditation apps such Headspace (available on Blue Shield’s Wellvolution digital platform) also can help reduce stress, and teens love apps.
  • As well as seeing a medical doctor, consider therapy as a way of teaching coping skills and reducing stress.  

“Mental health is just as important as physical health, and with COVID we have seen a large increase in mental health issues," Stoll said. "Unfortunately, there is sometimes still stigma around emotional and mental health, that these are someone’s fault or are signs of weakness. We need to work hard against this misinformation.”

For more information on understanding depression and anxiety in children and teens, please visit Blue Shield’s BlueSky website. BlueSky is a multi-year initiative to support youth mental health, in collaboration with the California Department of Education and leading nonprofit organizations. It provides access to clinicians in middle and high schools, trains educators on spotting mental health issues and empowers students with in-person and online mental health resources. You can also visit Blue Shield of California’s mental health page here.