Fussy Eating and Tummy Aches: The Need to Investigate

Fussy Eating and Tummy ache 01
Fussy Eating and Tummy ache

Fussy eating and tummy aches are common concerns among parents of young children. Many children go through phases of fussy eating, preferring certain foods over others, and experiencing occasional stomach discomfort. While these issues may seem like normal parts of childhood, it is important for parents and caregivers to pay attention to any persistent or concerning symptoms. A child who limits the amount of food they eat for example, may be doing so due to discomfort. These learned negative associations between discomfort or pain and eating may compound overtime without children and parents realising that this is part of the problem. To effectively support their extreme fussy eater parents need to investigate.

Identifying potential underlying issues, ranging from gastrointestinal disorders to food sensitivities, is crucial. They may manifest as discomfort, recurrent tummy aches, diarrhoea, constipation, vomiting, gas, or pain.

Several medical conditions ought to be investigated, including

  1. Celiac Disease: A genetic autoimmune disorder where consuming gluten leads to damage in the small intestine. Symptoms can include abdominal pain, bloating, diarrhea, and fatigue.
  2. Irritable Bowel Syndrome (IBS): A chronic gastrointestinal disorder characterized by abdominal pain, bloating, changes in bowel habits, and discomfort.
  3. Food Allergies and Intolerances: Allergic reactions or intolerance to certain foods can cause gastrointestinal symptoms such as stomach pain, diarrhea, nausea, or vomiting.
  4. Parasites: Infections by parasites such as giardia or worms can lead to gastrointestinal symptoms like abdominal pain, bloating, diarrhea, or constipation.
  5. Gastroesophageal Reflux Disease (GERD): A condition where stomach acid flows back into the esophagus, causing symptoms like heartburn, chest pain, and regurgitation.

Understanding Functional Abdominal Pain (FAP)

Sometimes medical investigations conclude that there is no medical reason for the pain or discomfort to persist. Indeed functional Abdominal Pain (FAP) is characterised by recurring abdominal pain without an identifiable organic cause. It is a condition that requires careful consideration. While FAP itself is not life-threatening, it can significantly affect a child’s quality of life and may be indicative of underlying psychological or physiological factors that require attention. (FAP) in children can be a perplexing and distressing condition for both parents and healthcare providers alike. While it lacks a clear-cut cause, its impact on a child’s daily life can be significant.

FAP is characterised by recurrent abdominal pain in children, typically lasting for at least two months, without any identifiable organic cause. It’s important to note that FAP is a diagnosis of exclusion, meaning that other gastrointestinal conditions such as inflammatory bowel disease (IBS), caeliac disease, or structural abnormalities have been ruled out through thorough medical evaluation.

Symptoms of FAP often include episodic or continuous abdominal pain centered around the belly button area. Children may also experience associated symptoms like bloating, changes in bowel habits (diarrhea or constipation), and nausea. While the exact cause of FAP remains elusive, research suggests that a combination of biological, psychological, and social factors contribute to its development and persistence.

Addressing Sensory Hypersensitivities

In her work, Nancy Zucker[1] and her team have established that some children may have sensory hypersensitivities that lead them to perceive normal tummy or bowel sensations as problematic. They may interpret these sensations as signs of impending pain or discomfort, even when there is no underlying issue. It is essential to validate these perceptions while providing reassurance and education about normal gastrointestinal function. Techniques developed by Zucker place children and therapists or parents at the heart of investigating bodily sensations and learning to manage those.

Other helpful techniques

  1. Stress Management Techniques: Teaching children relaxation techniques such as deep breathing, visualization, or progressive muscle relaxation can help reduce stress and alleviate abdominal discomfort.
  2. Cognitive-Behavioral Therapy (CBT): CBT aims to identify and challenge negative thought patterns and behaviors associated with FAP. It can help children develop coping strategies and improve their ability to manage pain and stress.
  3. Hypnotherapy: Hypnotherapy is emerging as a promising adjunctive treatment for children with conditions[2] such as FAP. Through guided relaxation and suggestion techniques, hypnotherapy aims to promote a state of focused attention and heightened suggestibility, allowing individuals to access their subconscious mind and modify perceptions of pain and discomfort.

Tummy aches and fussy in children need to be investigated conjointly. Parents do well to get themselves on a wait list with a gastroentorogist, or an allergist, depending on concerns,  then get a referral from their doctor. When a diagnostic is eastablished, adopting a holistic approach that addresses both medical and somatic aspects of the condition, can help children experience relief from symptoms and improve their overall quality of life and eating.

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Zucker N, Mauro C, Craske M, Wagner HR, Datta N, Hopkins H, Caldwell K, Kiridly A, Marsan S, Maslow G, Mayer E, Egger H. Acceptance-based interoceptive exposure for young children with functional abdominal pain. Behav Res Ther. 2017 Oct;97:200-212. doi: 10.1016/j.brat.2017.07.009. Epub 2017 Jul 29. PMID: 28826066; PMCID: PMC5786377.


Bastek V, van Vliet M. A whole new world of healing: exploring medical hypnotherapy for pediatric patients : A review. Eur J Pediatr. 2023 Jul;182(7):3021-3032. doi: 10.1007/s00431-023-04983-5. Epub 2023 May 5. PMID: 37145215; PMCID: PMC10160735.

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