Health professionals use the term “cope” to describe how we respond to difficult or unwanted situations. Children or adolescents who have bowel disorders need help to cope effectively with symptoms of recurrent abdominal pain and unpredictable bowel symptoms as they go about their daily lives.
A physician or therapist who is knowledgeable about functional gastrointestinal (GI) disorders can help provide the family and the child with positive skills to help respond effectively. Here are some techniques that help:
Develop Coping Strategies
Parents can help their children cope by helping them learn to distract themselves and engage in activities even though they are not feeling comfortable.
- Continue going to school, even if they have some discomfort. Abdominal pain by itself isn’t a reason to stay home.
- Engage in relaxation training.
- Practice stress management.
Help with schoolwork
When children have been out of school for quite a while because of symptoms or medical tests they may feel very behind. Even though school may have not been stressful at the start, it is now stressful because they’ve got a huge pile of work to catch up on.
- Break the schoolwork down into little steps of things that they need to do so it won’t be so overwhelming.
- This may involve negotiating with the school as well, for extended deadlines or combining assignments for a reduced workload.
Address bathroom concerns
Kids may be concerned that they may not have time to get to the bathroom or can’t have the time to do so between classes without being late. The doctor and parents will need to work with the schools on why it’s okay for this child to be late.
- Sometimes it helps to work out a system where the child can get up and go to the bathroom without asking and drawing attention to him or herself.
- There are concerns that kids have about the cleanliness and privacy in bathrooms. Perhaps arrange with the school that the child could use a bathroom at a time when other kids aren’t as likely to be there.
- There can also be situations where the child is afraid to go to bathrooms outside of his own home. In that case, with the parent’s help, have the child gradually begin to get comfortable using a bathroom at a friend’s house or at the mall, for example, so that he gets desensitized to a fear of strange bathrooms.
Get a note from the doctor
Some doctors have a standard letter that they will write to the school saying that the child has a gastrointestinal disorder that requires him or her to use the bathroom more frequently.
- It doesn’t need to say what disorder.
- It should explain that the child may not have a lot of anticipation of when she needs to use the bathroom.
That note can relieve the child tremendously. Just knowing that she can use the bathroom when she needs to, can decrease the need to have the note.
Practice talking about it
Children who have missed school sometimes have the experience that people make comments like, “Oh you’re just trying to get out of school or faking it,” or “Why have you been out,” or “What’s wrong with you?”.
- Kids need to have rehearsed a response to these types of questions. They may be afraid that they are going to have to say nothing is wrong and that’s going to reinforce the notion that they were just faking it.
- Help the child work on saying, “I had something wrong with my stomach and it’s getting better but it still bothers me sometimes.”
- The child should feel okay with a vague response and not feel they have to provide a long explanation of what is wrong.
- It helps to remind them that the other kids don’t want to know all that much.
Adapted from IFFGD Publication: Helping Children and Adolescents Cope with Abdominal Pain #838 from an IFFGD interview with Lynn Walker, PhD, Professor of Pediatrics and Professor of Psychology, Vanderbilt University, Nashville, TN.