• Relaxation and behavioral therapy: Stress and anxiety can make the pain worse. Physical therapy, biofeedback or acupuncture may help. A pediatric psychologist can offer support.
• Diet: Your child’s doctor may recommend changes depending on symptoms. For example, avoiding spicy foods and carbonated drinks, or adding high-fiber foods. If needed, our dietitians can create a nutrition plan.
• Medications: Your child’s doctor may prescribe medication if the pain is disrupting your child’s daily routine.

Treatment depends on the cause of the stomach pain. Your child’s doctor may recommend diet changes and/or medication. Surgery may be needed for serious conditions.

Sometimes your child’s belly nerves become hypersensitive to pain. The stomach can keep sending pain signals even if tissue or nerve damage has healed.

We believe pain loves an audience. Asking your child about their pain can make the pain cycle worse. Your child will scan their body looking for pain and find it. Distract your child from the pain instead.

Children with chronic abdominal pain often stop doing normal activities and miss school. Encourage your child to return to normal routines. Pain can subside when children return to living as they normally do.

Moderate exercise can also help by strengthening the immune system and reducing pain signals.

A healthy, balanced diet is important for any child, especially those with chronic abdominal pain. Avoid spicy foods or drinks high in sugar. Help your child:

• Develop a sleep routine.
• Engage in relaxing activities, with no screens for at least an hour before bedtime.
• Avoid afternoon naps.
• Avoid caffeine drinks, such as soda, especially in the afternoon.
• Use their bed only for sleep. Use a chair instead for homework or reading.

When your child’s belly hurts, nerves tell the brain something is wrong. If your child’s brain doesn’t feel well, it may signal the belly that something is wrong and cause pain.

Depression and anxiety don’t directly cause pain, but they can make pain worse. If your child has symptoms of depression or anxiety, seek treatment. Our pediatric psychologists can help.

Medication can reduce pain and calm belly nerves. But coping skills, positive thinking and other strategies can be even more helpful to children with chronic pain. You also may consider stress management, physical therapy, biofeedback and acupuncture.

Develop skills to manage pain and cope with stress. See below to learn about belly breathing and guided imagery. Reward or praise your child when they practice good coping skills.

Practice positive thinking to help your child avoid spiraling into negative thoughts. Here are examples of how to turn a negative thought into a positive one.

Belly breathing can reduce pain and stress. Watch this video or read the directions below to learn how.

1. Lie on the floor or sit up straight with your feet supported.
2. Put one hand on your chest and the other over your belly. You want the hand on your belly to move while the hand on your chest stays still.
3. Imagine you have a balloon under your belly button that inflates as you inhale and deflates as you exhale.
4. Breathe in through your nose for three seconds, like you are smelling freshly baked cookies. Pull the air deep into your lungs. Feel your belly expand, like a balloon blowing up. Notice that the hand on your belly is moving but the hand on your chest is not.
5. Exhale slowly through your mouth, like you are blowing out candles on a birthday cake. Feel your belly go back in, like a balloon deflating. Again, make sure the hand on your belly is the one moving.
6. Breathe in slowly again through your nose for three seconds, then exhale for six seconds.

Continue this pattern for five to 10 minutes, keeping an eye on your hands to make sure the air is going into your belly, not your chest. You may have a parent or a friend do this with you to help you perfect the technique together.

Taking a “journey” with your child can help lower stress and pain. Read this script to your child:

Find a comfortable position, sitting or lying down. Allow your body to relax as you create a picture in your mind.

Imagine yourself walking on a path through a forest. The path is soft beneath your shoes, a mixture of soil, fallen leaves, pine needles and moss. As you walk, your body relaxes and your mind clears, more and more with each step.

Breathe in the fresh mountain air, filling your lungs. Exhale. Breathe out all the air. Feel refreshed. Take another deep breath in and breathe out completely, letting your body relax further.

Continue to breathe slowly and deeply as you walk through the forest.

The air is cool but comfortable. Sun filters through the trees, making a moving pattern on the ground in front of you.

Listen to the sounds of the forest: Birds singing. A gentle breeze blowing. The leaves on the trees swaying in the soft wind.

Your body relaxes more and more as you walk. Count your steps and breathe in unison with your strides.

Continue to breathe like this, slowly and deeply, as you become more and more relaxed.

As you walk through the forest, feel your muscles relaxing and lengthening. As your arms swing in rhythm with your walking, they become loose and relaxed.

Feel your back relaxing as your spine lengthens and the muscles loosen. Feel the tension leaving your body as you admire the scenery around you. Your legs and lower body relax as well, feeling free and loose.

As you walk through the forest, you begin to climb up a slight incline. You easily tread along smooth rocks on the path.

The breeze continues to blow through the treetops, but you are sheltered on the path, and the air around you is calm.

Small saplings grow at the sides of the path. You are surrounded by green. Some leaves on the trees are a delicate, light green. Some are deep, dark forest green. Many trees have needles that look soft and deep green. The forest floor is thick, green moss.

Tall trees grow on either side of the path. Picture the variety of trees around you. Some have smooth, white bark. Others are darker, with coarse, heavy, deeply grooved bark. Enjoy the colors of the bark on the trees — white, tan, brown, red, black and many combinations of color. You admire the rough, brown bark of pine trees and enjoy the fresh pine scent.

Smell the forest around you. The air is fresh and filled with the scent of trees, soil and mountain streams.

You can hear the sound of water faintly in the distance. The gentle burbling of a creek.

As you walk through the forest, you are gaining elevation and getting closer to the sound of a stream.

Continue to enjoy the forest around you.

As you near the top of the mountain, you hear the stream very close. The path curves up ahead. You can see sunlight streaming onto the path. As you round the corner, you hear the water and see a clearing in the trees up ahead.

You are growing tired from your journey. Your body feels pleasantly tired and heavy.

Imagine yourself walking toward the clearing and the stream. Stepping stones make an easy path across the stream and toward the edge of the mountain. Step on each large flat stone to easily cross the small, shallow stream.

Up ahead is a large, smooth rock, like a chair, waiting for you to rest. The rock is placed perfectly, high up on a beautiful lookout. Sit or lie down on the rock if you wish. It is very comfortable. You feel comfortable and at ease. The sun shines on you.

Looking around, you see mountains in the distance. Faint and blue. You can look down from your viewpoint into a valley with trees and a blue lake. Across from you is another mountain.

Feel the sun warming your body as you relax on the rock. Enjoy the majestic landscape around you and feel your body relaxing even more. Your body becomes warm and heavy.

Continue to breathe the clean, fresh air.

You feel so relaxed.

Calm.

At peace.

When you are ready to leave this peaceful place, slowly begin to reawaken your body. Know that you can return to this forest in your imagination whenever you like.

As you reawaken, keep with you the feeling of calm, peace and relaxation.

Wiggle your fingers and toes to wake up your muscles. Shrug your shoulders. Stretch if you want to.

When you are ready, open your eyes and return to full wakefulness, feeling alert and refreshed.

There are many programs and resources that help kids feel better and more in control of their symptoms. Here are a few we recommend:

• Self-hypnosis – Information about hypnosis and audio recordings you can use.
• The Comfortability – Guided imagery to help with pain.
• Imaginaction – Audio guides to help kids gain more control over how they feel.
• KidEvolve – Many mindfulness programs for kids, including course 8 for pain management.
• Yoga Videos – Some of the best yoga videos for kids.
• Muscle Relaxation – Video guide for kids.