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September 15, 2003

Aches and Pains

Question from Palm Harbor, Florida, USA:

My seven year old daughter, who has had type 1 diabetes for nine months, constantly complains about her tummy burning and aching all the time. Is this common in children with diabetes? What causes this?

Answer:

There are many possibilities — and certainly issues to discuss with your daughter’s diabetes team.

I think that commonly, the “stress” perceived and integrated by children is sometimes greater than we adults appreciate. After all, we as parents are stressed when our children are ill. The child can be stressed too, and the child can parlay the parents’ stress. So I’ve clearly seen children with type 1 diabetes who have gastric reflux disease and “early ulcers.” An easy tool, I think, is to give your child a swig of liquid antacids to see if this leads to pretty quick relief of her tummy ache. If so, I think that is a pretty good measure of whether the discomfort relates to increased and irritating stomach acid. If so, then a full course of acid blockers (like Tagamet) might be helpful.

Other possibilities more commonly seen with type 1 diabetes include celiac disease and Addison’s disease. Both can be associated with stomach and intestinal problems. These must be screened for by your daughter’s diabetes team. Both have similar autoimmune causes as does the diabetes.

You should feel comfortable talking with your daughter’s diabetes team about her concerns. She should not have to have on-going tummy aches as part of this diagnosis.

DS

[Editor’s comment: See Chronic Abdominal Pain in Childhood: Diagnosis and Management for some additional information.

WWQ]