Ruth Marie Zumwalt, age 11, of Pocatello, Idaho, for her question:
WHAT CAUSES A STOMACHACHE?
The word "stomachache" is just about meaningless when it is given as an indication of a pain. Most children, and a good many adults, are likely to refer to almost any kind of discomfort between the chest and the hipbones as a stomachache.
A more accurate, if slightly less polite term, is "bellyache."
A stomachache may be due to unwise eating: too much turkey and all of the trimmings at a family dinner celebration, for example. It may also be due to stage fright for a would be actor or a complaint and stress from a child with a test coming up in school the next day.
Many of the miseries of a stomachache are said to be self limited, meaning that they get better by themselves, with or without medicine.
But abdominal pain may also be a sign of a number of really serious diseases. Severe pain and pain that lasts more than a few hours or that keeps coming back may be a sign of serious trouble and should have the immediate attention of a doctor. Only a doctor can determine whether a persistent pain is due to a minor problem or a life threatening disease.
The process of determining which of a number of possible disorders is causing a patient's symptoms is called differential diagnosis.
In young children, even more than in adults, the complaint of stomachache may mean almost anything. It may mean that a youngster is coming down with one of the contagious diseases or that he simply feels sick to his stomach. Rarely, pain may be due to appendictis or pneumonia, but these conditions are so serious that the possibility ought to be considered.
It is better to ask the doctor about an ailment that turns out to be trivial than to run the risk of neglecting something important.
In many cases, however, a child's complaint that his stomach hurts is more likely to be due to emotional problems than to disease.
The child who refuses his breakfast and complains of a stomachache may have a physical upset or may simply be afraid of what the day may bring. A bullying schoolmate, a strict teacher or a parent. inspired fear of failing can often make a child miserable.
This sort of repeated problem, even in a child who seems to be otherwise perfectly healthy, should not be taken lightly. If ordinary measures and a conference with the child's teacher do not help, consultation with a child psychologist may be needed. The problem may not remain "all in the mind." Even children get ulcers.
Doctors tell us that it cannot be overemphasized that self treatment with laxatives can be very dangerous and even fatal, especially in appendicitis.
In many ordinary stomach upsets, the body will rid itself of offending substances without help. If inflammation is present anywhere in the digestive tract, more irritation with self treatment is the last thing that is needed.