Child complains of tummy ache every morning before school? Paediatrician shares possible causes

Tummy ache is often used as an excuse by children to skip school, but sometimes it can have serious underlying causes, shares Dr Sushil Singla.

Complaining of a stomachache when it is time to get ready for school is probably the most common technique to bunk classes that students have employed for ages. But what if this is not simply an excuse to stay at home, but a symptom of an underlying cause?

In an interaction with HT Lifestyle, paediatrician Dr Sushil Singla shared that recurrent abdominal pain in children can have several causes. Constipation, irregular eating habits, indigestion, food-related issues and anxiety can all contribute.

“The pattern of the pain, when it occurs, and the symptoms that come with it can help parents understand what may be happening,” he stated.

What can cause pain that occurs only before school?

If the stomach ache regularly appears on school mornings and improves when the child stays home, such as during weekends and on holidays, emotional stress could be playing a role, pointed out Dr Singla.

“School-related anxiety can stem from exams, academic pressure, homework, difficulties with friends, bullying, separation from parents or fear of a particular situation at school,” he stated. “Children do not always know how to express these feelings directly and may instead complain of physical symptoms such as stomach pain, nausea or an urgent need to use the toilet.”

However, this does not mean the pain is imaginary. As per the paediatrician, stress can affect the gut and can produce very real physical symptoms.

“Parents can gently ask what the child is feeling about school instead of immediately assuming they are trying to avoid it. Changes in sleep, appetite, mood or behaviour may also offer clues,” he noted.

Stomachache in children can have a number of causes. (Pexel)

Trouble with constipation

As per Dr Singla, constipation is another common cause of recurrent tummy discomfort in children. Parents should look for hard or painful stools, straining while passing stool, bloating or a child repeatedly delaying bowel movements.

“Some children avoid using school toilets and hold their stool until they reach home. Regularly ignoring the urge for bowel movement can contribute to constipation and abdominal discomfort,” he warned. “Low fibre intake, inadequate water and a diet high in processed foods may also make constipation more likely.”

Other causes for morning stomach pain

There are a number of other causes that can cause recurring stomach discomfort, according to Dr Singla.

In his words, “Indigestion, food intolerance, urinary problems, infections and functional abdominal pain can also cause recurring discomfort. In some children, abdominal pain may occur even when no structural problem is found.”

“The timing of the pain can be useful,” he noted. “Parents can note whether it happens before breakfast, after certain foods, before a bowel movement or specifically on school days.”

When should parents get it checked?

Occasional stomach pain is common, but Dr Singla believes that recurrent or persistent symptoms should not simply be dismissed.

“Parents should seek medical attention if the pain is severe or worsening, repeatedly wakes the child at night or is accompanied by persistent vomiting, fever, blood in the stool, unexplained weight loss, poor appetite or unusual tiredness,” he stated.

It is also worth consulting a doctor if the pain continues despite improving the child's hydration, diet and bowel habits. Keeping a simple record of when the pain occurs, where it hurts, bowel movements, food intake and whether it happens on school days or weekends can help identify a pattern, shared the paediatrician.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.

Dr Sushil Singla is the director of the paediatrics department at Sarvodaya Hospital, Sector-8, Faridabad. He has over 28 years of clinical experience.