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Understanding Abdominal Pain in Children: Insights from a Child Psychiatrist

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Written by Dr. Daniela Gaf, Consultant Child & Adolescent Psychiatrist at The Valens Clinic, Dubai.

The Surprising Link Between Emotional Well-being and Physical Health

In my extensive 13-year journey as a consultant child and adolescent psychiatrist, I’ve encountered a recurring pattern among young patients. Predominantly, these children are grappling with underlying sadness and anxiety, manifesting as physical symptoms.
It’s intriguing yet concerning that a majority of these young individuals report experiencing stomach ache, often paired with nausea and, in severe cases, vomiting. This observation aligns with the increasing recognition of the gut-brain connection in child mental health.

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The Diagnostic Odyssey: From Pediatrician to Psychiatrist

Commonly, these patients’ journeys begin with visits to their regular pediatricians. However, as many parents shared, these initial consultations frequently conclude with no physical abnormalities identified. While basic tests like stool and urine analysis are less burdensome, advanced procedures like blood tests, MRIs, or endoscopies (such as gastroscopy or colonoscopy) can be highly stressful and anxiety-inducing for children.
In my Dubai-based child psychiatry practice, these extensive physical examinations often yield inconclusive results. Only in rare instances do they reveal conditions like gastric inflammation or lactose/gluten intolerance.

Innovative Treatments: The Role of Probiotics

In England, groundbreaking studies are exploring probiotics as a treatment for clinical depression. These studies indicate that probiotics, particularly when combined with antidepressants, can significantly reduce depressive symptoms.
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The Microbiota-Gut-Brain Axis: A New Frontier in Child Psychiatry

Scientifically, we understand the bidirectional communication between the gut and the brain – the microbiota-gut-brain axis. Alterations in gut microbiota are evident in psychiatric disorders. Comprehensive studies (including 16 reviews and 59 case-control studies with 2643 patients) consistently report changes in patients with depression, anxiety disorders, bipolar disorder, and schizophrenia, marked by a decrease in anti-inflammatory bacteria and an increase in pro-inflammatory bacteria.
This discovery is pivotal in understanding why patients with anxiety or sadness frequently experience abdominal pain, a common concern addressed in child psychiatry.

Conclusion: A Dual-Focused Approach in Child Psychiatry

In conclusion, two critical points emerge:
1. Probiotics may offer substantial therapeutic benefits for psychiatric patients.
2. For children and adolescents presenting with recurrent abdominal pain, it is crucial to consider underlying emotional issues like anxiety and sadness before resorting to invasive procedures like endoscopy.