How to tell the difference in kids—and how integrated care can help
Written by Anna Katherine Black, PhD
Licensed Clinical Psychologist
GI Psychology
Parents often wonder: “Is my child’s stomach pain due to anxiety, a GI condition, or both?” The truth is, it can be difficult to separate emotional distress from gastrointestinal (GI) symptoms—especially in children. This is because of the gut-brain connection, the constant two-way communication between the digestive system and the nervous system.
Many kids with stomach problems experience anxiety, and many kids with anxiety report stomach problems. So how do we untangle the two? And more importantly, how do we help kids feel better?
The Gut-Brain Connection in Children
The gut and the brain are closely linked through nerves, hormones, and immune pathways. When a child feels anxious, stress signals can cause the gut to tighten, speed up, or slow down—leading to symptoms like nausea, diarrhea, or constipation (Rome Foundation, 2024).
At the same time, GI disorders themselves—such as irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD)—can increase stress and anxiety in kids. This creates a cycle where the gut and the brain keep amplifying each other’s distress (Crohn’s & Colitis Foundation, 2023).
Is It Anxiety, a GI Disorder, or Both?
Here are some clues parents and clinicians can use to differentiate:
- Anxiety-related stomach problems often occur during stressful events (before school, tests, or medical procedures) and may come with headaches, racing heart, or trouble sleeping (American Psychological Association [APA], 2022).
- GI disorders are more likely to show persistent symptoms (such as chronic diarrhea, constipation, or blood in stool), especially if there are changes in growth, appetite, or weight (American College of Gastroenterology [ACG], 2023).
- Overlap is common: Research suggests that up to 30–60% of children with IBD also experience functional GI symptoms like abdominal pain, even in remission (Palsson et al., 2024).
This means a child can have both a GI condition and anxiety—and each may worsen the other.
Why Integrated Care Matters
Traditional medical care often treats the gut and brain separately. But when symptoms overlap, kids benefit most from integrated care—a team approach that includes both gastroenterologists and behavioral health specialists (NIH, 2021).
One growing specialty is the gastropsychologist: a licensed psychologist trained in gut-brain therapies. These professionals use tools like cognitive behavioral therapy (CBT), clinical hypnosis, and relaxation training to reduce both anxiety and GI symptoms (Keefer & Keshavarzian, 2006).
A randomized controlled trial found that gut-directed CBT improved abdominal pain, anxiety, and coping in children with functional GI disorders (Sweeney et al., 2021). Similarly, clinical hypnosis has been shown to reduce symptom severity and improve quality of life in pediatric GI patients (Mawdsley et al., 2008).
What Parents Can Do Now
If your child struggles with stomach problems and anxiety, here are a few steps you can take:
- Keep a symptom diary: Track when symptoms occur, what was happening before, and how your child felt emotionally.
- Talk to both medical and mental health providers: Ask if integrated care or a referral to a gastropsychologist might help.
- Normalize the experience: Let your child know they’re not “making it up”—their brain and gut are connected, and real physical symptoms can come from stress.
Practice calming routines: Deep breathing, gentle movement, or guided relaxation before school or bedtime can reduce both anxiety and gut discomfort.
Hope Through Integrated Care
When kids have both anxiety and GI symptoms, it’s not a sign of weakness or “all in their head.” It’s a sign that the gut-brain connection is at play—and that treating both together is the key to relief. With integrated care, children can build resilience, reduce symptoms, and get back to being kids again.
Explore our resources or schedule a free consultation to learn how our team can support your family!
References
American College of Gastroenterology. (2023). Pediatric gastrointestinal disorders. American College of Gastroenterology. https://gi.org
American Psychological Association. (2022). Children and anxiety: What parents should know. American Psychological Association. https://www.apa.org
Crohn’s & Colitis Foundation. (2023). Anxiety and depression in IBD. Crohn’s & Colitis Foundation. https://www.crohnscolitisfoundation.org
Keefer, L., & Keshavarzian, A. (2006). Feasibility and acceptability of gut-directed hypnotherapy for patients with inflammatory bowel disease: A brief report. Alimentary Pharmacology & Therapeutics, 24(5), 759–766. https://doi.org/10.1111/j.1365-2036.2006.03036.x
Mawdsley, J. E., Jenkins, D. G., Macey, M. G., Langmead, L., & Rampton, D. S. (2008). The effect of hypnosis on systemic and rectal mucosal measures of inflammation in ulcerative colitis. Alimentary Pharmacology & Therapeutics, 27(6), 454–461. https://doi.org/10.1111/j.1365-2036.2008.03601.x
National Institutes of Health. (2021). The brain-gut connection. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov
Palsson, O. S., van Tilburg, M. A., & Whitehead, W. E. (2024). Behavioral sleep interventions for youth with functional abdominal pain: A randomized controlled trial. Neurogastroenterology & Motility, 36(3), e14562. https://doi.org/10.1111/nmo.14562
Rome Foundation. (2024). Disorders of gut-brain interaction (DGBI). Rome Foundation. https://theromefoundation.org
Sweeney, C., Chen, E., & Szigethy, E. (2021). Cognitive behavioral therapy for children with functional abdominal pain: A randomized controlled trial. Journal of Pediatric Psychology, 46(9), 1051–1062. https://doi.org/10.1093/jpepsy/jsab050