From Our 2013 Archives
Childhood Tummy Aches May Be Tied to Adult Anxiety, Depression
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The researchers compared 332 young adults, aged around 20, who had abdominal pain as children to 147 participants who did not. Of those who had suffered from stomach pain, 51 percent had an anxiety disorder during their lifetime, and 30 percent had one currently. By contrast, only 20 percent of adults without stomach pain as children had an anxiety disorder.
"A decade later, individuals who had stomach pain continued to have high rates of anxiety disorders, even if they no longer had stomach pain," said study author Lynn Walker, a professor of pediatrics at Vanderbilt University in Nashville, Tenn.
Moreover, 40 percent of young men and women who had abdominal pain as children had depression during their lifetime, compared with 16 percent of adults who didn't have stomach pain, according to the study, which was published online Aug. 12 and in the September print issue of the journal Pediatrics.
Exactly how stomach pain and anxiety are linked is not entirely clear, but "anxiety related to the pain, or even anxiety related to other things in the child's life, can exacerbate the pain and lead to increased suffering and disability," Walker said.
To break the cycle early, parents of children who complain of stomach pain should first take their child to the doctor to see if anything is going on medically, she said.
"If no significant disease is found, parents should encourage their children to continue their regular activities even if they are having pain or anticipate that they might have pain," Walker said. "When children stay home from school and other activities, they get behind in schoolwork and peer relationships, which increases stress, which in turn increases their suffering."
It spirals from there. "As they discontinue activities and isolate themselves socially, they have more time to focus on the pain and worry about it," she said. "As they fall behind their peers, they have additional things to worry about."
In the study, social anxiety disorder -- a paralyzing fear of being judged by others -- occurred among a quarter of children with stomach pain.
Experts agreed that parents should seek help early for kids with recurrent stomach pain to try to reduce the risk of anxiety and depression.
"Parents should take an active role in their child's life by seeking both medical attention and supportive counseling for their child. This will prevent potential worsening of anxiety, and will help children learn better ways of coping with stressors that may exacerbate their pain," said Dr. Scott Krakower, a child and adolescent psychiatrist at Zucker Hillside Hospital in Glen Oaks, N.Y.
Parents should take chronic stomach pain seriously from the get-go, said Dr. Sarah Rebstock, director of the Pediatric Pain Medicine Outpatient Clinic at Children's National Medical Center in Washington, D.C. "Get referred early if your child has two weeks or longer of stomach pain," she said. "Don't wait."
Although the study tied childhood stomach problems to adult anxiety and depression, it didn't establish a cause-and-effect relationship.
Dr. Mark Lowenheim, a pediatric gastroenterologist at St. Charles Hospital in Port Jefferson, N.Y., was quick to caution that not every child who has abdominal complaints will need to see a mental-health professional.
"Certainly there is a subset of children who have abdominal pain who also have anxiety and depression, so it's not a surprise that they also have a higher incidence of anxiety and depression as adults, but this is not a given," he said.
SOURCES: Lynn Walker, Ph.D., professor, pediatrics, Vanderbilt University, Nashville, Tenn.; Sarah Rebstock, M.D., director, Pediatric Pain Medicine Outpatient Clinic, and complex pain medicine program, Children's National Medical Center, Washington D.C.; Scott Krakower, D.O., assistant unit chief, child and adolescent psychiatry, Zucker Hillside Hospital, Glen Oaks, N.Y.; Mark Lowenheim, M.D., pediatric gastroenterologist, St. Charles Hospital, Port Jefferson, N.Y.; September 2013 Pediatrics