Dr Phil Kieran: Is excitement the only cause of my son’s tummy pain?

In your son’s case, the pain seems to be associated with events he is keen to attend. This may suggest some difficulty with regulating moods. Picture: iStock 

My son is aged eight and often complains of stomach pain. It typically happens before a party or a special day at school. The excitement seems to be too much for him.

Occasionally, the pain has been so intense he has stayed at home. Once the pressure is off, he recovers quite quickly. I don’t think he’s making it up. I’m between a rock and a hard place: Do I let him grow out of it, or do I seek medical attention?

This is a tricky situation for many parents. You don’t want to ignore a complaint, but, equally, you don’t want to make a big deal out of something unless it’s necessary.

Abdominal pain, or tummy ache, in children is common and can have hundreds of causes. In your son’s case, there is a pattern of emotional change, like excitement or stress, causing it, and then, once the circumstances settle down, the pain goes away.

I would be keen to ensure he doesn’t have any ‘red flag’ symptoms that might warrant further investigation. These would be pain on waking from sleep, fever, sudden weight-loss, severe loss of appetite, or change in bowel habit, particularly any blood or mucus passing with the stool. If he has any of these symptoms, I would suggest a visit to your GP, but if none of these applies, it sounds like this is something you can manage at home.

I would agree it’s unlikely your son is pretending to be in pain. He most likely does feel stomach discomfort and cramping when he is excited or worried.

This sounds very likely to be a condition called recurrent abdominal pain in children. They usually grow out of it.

Try not to reinforce the behaviour. That is key.

Where the pain is triggered by anxiety, for example, about difficulties at school, staying home and relaxing can make it more likely that it will recur.

Chat to your child and see if there is anything stressing them out or worrying them that triggers the pain.

In your son’s case, the pain seems to be associated with events he is keen to attend. This may suggest some difficulty with regulating moods.

All children can struggle to manage their moods (I know plenty of adults who have this difficulty, too). Teaching them tools to identify how they feel and how they manage it is really useful for their whole lives.

Check your local bookstore or online for books on naming and identifying moods.

I have always found the When I’m Feeling series, by Trace Moroney, excellent, and it is likely available at your local library. Coupling this with a tool like the Areas of Regulation can help your son develop emotional awareness.

From what you describe, I don’t suspect there’s a serious medical issue underlying your son’s tummy aches, and this phase will likely pass. However, this might be a good opportunity to start open conversations around mood and social issues that could be valuable in his teenage years.

It is also an opportunity to teach him tools that will help him for the rest of his life.

• If you have a question for Dr Phil Kieran, please send it to [e-mail]