I didn't have room yesterday on this Blog to add more thoughts about stomach aches in kids. I would never, ever say a child had a "functional" stomach ache unless I was sure that there was not a medical problem. Kids can have ulcers just like adults and they can have ulcerative colitis. One thing that most doctors fail to do is to get or take a diet history. I have been told multiple times by medical students and house staff that I am the only doctor they have ever been around who took a diet history. What I often do is to ask the child's parent to keep a three-day record of everything their child eats and then mail it to me. I have seen some quite amazing and really incredible diet histories! No wonder a child was having stomach aches eating only fast food and lots of fried food with few or no fruits and vegetables.
One of the other reasons that children can have stomach aches is when they they have an unrecognized learning disability. This can be a reading problem, a writing problem, or an auditory processing problem and it may be combined with hyperactivity. If you can't understand what is going on in school or are always in the lowest reading group or at the bottom of the class academically, you can easily see why stomach aches could result. There are some so-called neurological soft signs that can be detected on a physical examination which can help a physician consider a learning disability. Of course, if a complete physical examination is not done, these will not be detected. If they are, present, a child needs to be tested by an experienced child psychologist to see if a learning disability is present. School psychologists may or may not have adequate time and experience to detect a learning disability.