When basic diagnostic tests – such as a FBC, urine test, or ultrasound scan – show no abnormalities, and the symptoms disappear on school-free days, the cause could lie outside the digestive system. In such cases, we are dealing with psychosomatic disorders, meaning the body’s reaction to the nervous system overload.
This mechanism is pure physiology. Intense stress or anxiety activates the autonomic nervous system, leading to the release of stress hormones: cortisol and adrenaline. These substances directly affect internal organs – they cause real contractions of the smooth muscles of the stomach, accelerate intestinal peristalsis, or trigger tension headaches.
From a medical point of view, psychogenic pain is real pain. Child is not pretending. Their body physically reacts to difficult emotions that their immature psyche cannot yet process in any other way. At our Polish clinic in London, we understand that for parents in the UK, navigating between the education system and their child’s health can be challenging. We also know exactly how stress affects child’s development and daily functioning. We are aware that the first consultation can be difficult, which is why our specialists ensure a safe and friendly atmosphere – for both the young patient and their concerned parents.
Our child psychologist provides support to children and adolescents regardless of the type of difficulties they are experiencing. We help not only patients with a confirmed diagnosis, but also those who have not been diagnosed and are struggling with school problems or low self-esteem.
What Are Psychosomatic Disorders in Children?
This is a condition in which strong emotions or chronic stress trigger physical symptoms of illness, even though there is no infection or inflammatory process in the body. Children cannot verbalise their fear or frustration, so their nervous system “releases” this tension into the body. In medicine, this is called somatisation.
This is not a deliberate action nor an attempt at manipulation. This mechanism is based on physiology and on the close connection between the brain and the rest of the body – especially the digestive system.
How Does It Work on a Biological Level?
A key role is played by the gut–brain axis. Intestines are almost as densely innervated as the brain, which is why they react extremely quickly to psychological states. In a stressful situation (e.g. before going to school), child’s body enters “fight or flight” mode.
- Brain sends a danger signal.
- Adrenal glands release stress hormones: adrenaline and cortisol.
- Blood is redirected away from the stomach to the muscles, causing constriction of blood vessels in the abdomen, slowed digestion, or sudden intestinal peristalsis.
The result is real symptoms: nausea, diarrhoea, severe abdominal pain (often around the navel), or tension headaches. Child experiences this pain in exactly the same way as with food poisoning or flu. Pain receptors send a genuine signal to the brain. The only difference lies in the cause – it is not a virus, but excessive activation of the autonomic nervous system.
How Can You Tell an Infection from a Stress Reaction?
Distinguishing between infection and stress-related symptoms can be difficult, because in both cases child suffers. However, there are clinical features and symptom patterns that allow for an initial assessment of the source of the problem.
The key is to observe your child in a broader context – not only in the morning, but over the
whole day and over a longer period of time.
Symptoms Suggesting a Medical Cause (Infection or Inflammation)
- Pain that wakes the child at night. This most often indicates functional (stress-related) pain – symptoms usually disappear during sleep because the brain switches off conscious stress perception. If your child wakes up crying from pain, the cause is almost always organic.
- Associated symptoms. Fever, visible weight loss, blood in the stool, persistent vomiting, or diarrhoea that does not improve after leaving the house.
- Specific localisation of pain. Pointing to a precise area other than the centre of the abdomen (e.g. the right lower quadrant).
Stress-Related Abdominal Pain
- Pain “around the navel.” Stressed children usually point to the middle of the abdomen. Pain is difficult to localise precisely.
- Time pattern. Symptoms appear regularly on school days (often in the morning or on Sunday evening) and disappear on Friday afternoons, weekends, and during holidays.
- Sudden improvement. If, after the decision “you’re staying home today,” symptoms resolve within an hour and your child returns to normal activity, this strongly suggests an emotional cause.
Before abdominal pain is considered stress-related, paediatrician must exclude physical causes. Basic investigations usually include a full blood count with differential, general urine test, parasite testing, and abdominal ultrasound. Only normal results with persistent symptoms provide grounds for a diagnosis of psychosomatic disorders.
The Most Common Hidden Sources of Stress in Children
Adults often measure children’s problems by their own standards, unconsciously downplaying situations that are critical for an immature nervous system. Psychosomatic symptoms are rarely the result of a single trigger. They usually arise from long-term accumulation of tension and emotions.
Child psychology identifies four main groups of stress factors which translate into physical
symptoms:
Performance pressure and fear of evaluation
School is a place of constant assessment of competence. For a sensitive child, fear of public mistakes or failing parental expectations can outweigh the desire to learn.
Peer group dynamics
Isolation, ridicule, or falling out with a best friend. Neuroimaging studies show that social rejection activates the same brain areas as physical pain.
Instability in home environment
Children function like “emotional barometers.” They sense tension between parents even when arguments take place behind closed doors, undermining their basic sense of safety.
Overstimulation
Excessive noise at school, screen exposure, and overly packed schedules of extracurricular activities prevent nervous system recovery and keep it in a constant state of alert.
How to Manage Stress-Related Abdominal Pain in Children
Stress-related abdominal pain is a real physiological response to stress – not a product of child’s imagination. This mechanism results from excessive activation of the sympathetic nervous system, which under the influence of cortisol causes painful contractions of the smooth intestinal muscles. The most effective immediate method of easing these symptoms is applying warmth to the navel area. A hot water bottle or a warm bath dilates blood vessels and mechanically relaxes tense abdominal muscles.
An easily digestible diet is equally important during periods of increased tension. It should be based on light meals such as boiled vegetables and soups. Avoiding sugar and highly processed foods prevents additional intestinal fermentation that could worsen discomfort. Long-term treatment of psychosomatic pain requires regulation of the nervous system through breathing techniques. Deep diaphragmatic breathing stimulates the vagus nerve, which is responsible for calming the body and restoring normal peristalsis. A simple way to induce this breathing pattern in children is slow blowing of soap bubbles, which naturally prolongs the exhalation phase.
Nervous system recovery is also supported by regular sleep and probiotic supplementation, as chronic stress negatively affects the gut microbiota. If home-based relaxation methods do not help and pain interferes with daily functioning, medical consultation may be necessary to introduce mild antispasmodic medication.
When Does Stress-Related Abdominal Pain Require a Visit to a Psychologist?
Waiting for a child to “grow out of it” is a risky strategy. If stress lasts for weeks, brain becomes accustomed to anxiety. Body learns to respond with pain to every difficult situation, forming a habit that later becomes difficult to break without professional help. You should arrange a psychological consultation if any of the following five situations occur:
Pain persists despite medical reassurance
Two or three weeks pass. Paediatrician confirms that child is healthy, test results are normal, but the abdomen or head still hurts.
Daily anxiety
Child gives up activities they once enjoyed. They refuse birthday parties, quit football training, cry in the mornings before school.
Developmental regression
Child starts behaving like a toddler again: bedwetting, thumb-sucking, wanting to sleep with parents, or demanding to be fed despite previously eating independently.
Personality changes
A usually cheerful child becomes sad, withdrawn, and indifferent. Or the opposite – sudden outbursts of anger and aggression without an obvious reason.
Sleep problems emerge
Child cannot fall asleep, wakes at night screaming, or has nightmares after which they are afraid to return to their own bed. Many parents (and children) fear that a psychologist will “interrogate” them. There is no
need to worry. Child therapy looks completely different from adult therapy.
In our practice, we do not sit your child on a couch and force them to talk about difficult matters. We work through play. We draw, build with blocks, act out scenes with puppets. This is the natural language of children. During this play, the specialist identifies what troubles the young patient and teaches them how to cope with stress in ways other than through abdominal pain.
If your child complains of recurrent symptoms and a paediatrician has ruled out illness – do not wait for the problem to grow. Consult our child psychologist. We will help you understand what is happening with your child’s emotions and how to free them from pain.
