Ask the Reflux Mom: Is It All in Her Head?
Last week, I answered a question from a mom who was concerned that her teen daughter was missing school due to frequent stomach aches. It is very important to rule out a physical reason for stomach aches and stomach pain. See Teen with a Stomach Ache for more information about some of the many reasons for a stomach ache and how to figure out the cause of the symptoms.
What if you talk to the school nurse, keep a symptoms diary and see the doctor and there is no diagnosis? It has been my experience that getting a diagnosis and treatment for Gastroesophageal Reflux Disease can be extremely quick or slow. Sometimes the symptoms are so common and classic that the doctor can diagnose the problem from a mile away. Other children, like mine for instance, don’t have the most typical symptoms and the road to diagnosis is rather slow and roundabout. It may take extra time and several visits to the pediatrician and specialists to figure it out.
In some instances, the doctor will refer a child or teen to a counselor or psychologist for evaluation of stomach pain or stomach aches. While it is unlikely that stress or anxiety will cause a digestive problem such as reflux, stress can worsen an underlying medical problem. Certainly it is common for your stomach to react when you are under stress. Think about how your stomach feels when you are about to make a presentation or drive during rush hour gridlock. A full load of college prep classes, competitive sports and final exams may cause her stomach to churn even more than usual.
You and your daughter may be upset by this type of referral and think that it means the doctor doesn’t believe her. In reality, the doctor may be trying to find the best balance of treatments to really and truly fix the problem. Sometimes parents have told me the counselor or psychologist interviewed their teen and came to the following conclusion: her head is ok but she has a stomach ache!
Another reason to see a counselor is to help a teen cope with her feelings about having a chronic health condition such as Gastroesophageal Reflux Disease or Irritable Bowel Syndrome. It can be enormously helpful to discuss positive ways to cope with a chronic disease when everyone else just doesn’t understand or it is an embarrassing topic of discussion. Parents, friends, teachers and doctors may unknowingly make a comment that is hurtful or seem to place the blame on her. She may have some strong feelings about feeling misunderstood.
If your doctor suggests a visit to a counselor, try to put a positive spin on it for your daughter, explore all approaches to her care and help her find the right combination of activities, diet and medical treatments to help her manage the discomfort.