Back-to-school belly-ache blues may be more than just nerves

Washington, Sept 30 : Back-to-school blues may be more than just nerves, according to researchers, who say that seasonal belly-aches are a result of a complicated and often misdiagnosed medical condition.

"Functional abdominal pain is one of the most common reasons children are referred to our gastrointestinal clinic," said Carlo Di Lorenzo, MD, chief of Gastroenterology, Hepatology and Nutrition at Nationwide Children's Hospital and a faculty member at The Ohio State University College of Medicine.

"Each year, when students return to class, we see an increase in the number of patients complaining of abdominal pain," Lorenzo added.

Functional abdominal pain is estimated to affect as many as 10 percent of children, many of whom also have a history of depression, anxiety, migraine headaches and/or fatigue.

The pain also tends to occur more frequently during times of stress and anxiety, including during school, sports and other activities. Although the cause of the pain isn't clear, the pain itself is very real.

"It really does hurt, and these kids really do suffer. Their parents suffer too, because they are often terribly worried that something very serious may be wrong and they see how the symptoms can interfere with the child's life," said John Campo, MD, chief of Child and Adolescent Psychiatry and a pediatrician at Nationwide Children's Hospital.

"We know that as a group, these kids miss more school than unaffected kids. They don't do as well in school, either," he added.

While most patients are taught techniques cope with pain, such as relaxation training and guided imagery, researchers suggest that use of medications, traditionally used as antidepressants, may help lessen the pain, or prevent it altogether.

The team is conducting clinical trials to test the effectiveness of selective serotonin reuptake inhibitors (SSRIs) in the treatment of functional abdominal pain. SSRIs affect the handling of serotonin in the body.

Serotonin transmits messages of pain to the brain and the local nervous system in the stomach. Researchers hope that changing the way the body handles serotonin may help ease functional abdominal pain. So far, a type of SSRI, known as citalopram, has shown promise.

The doctors recommend that children with recurrent or persistent abdominal pain should be checked.

ANI