Jan 22

Anxiety and tummy ache in children

Why the pain is real and how to support your child without feeding the fear

When your child says “my tummy hurts”.

Tummy pain.

Feeling sick.

Not wanting breakfast.

Saying they might be sick before school.

When a child says this, it is real.

Their tummy does hurt.

They do feel sick.

This is not exaggeration.

It is not manipulation.

And it is not something they are making up.

For many children, especially those navigating anxiety or neurodivergence, tummy pain is one of the clearest physical signs that their nervous system feels overwhelmed.

Anxiety rehearses a future that hasn't happened yet

Anxiety is the brain rehearsing a future that has not happened yet.

It is fuelled by feelings, not facts.

When school feels too much or the day ahead feels uncertain, anxiety steps in and says:
“What if something goes wrong?”
“What if I can’t cope?”
“What if today is awful?”

The brain treats these thoughts as real threats.

What is actually happening in the body

When anxiety kicks in, the brain’s guard dog, the amygdala, takes over.

This part of the brain is brilliant at keeping us safe , when there is a real danger.
But it is not good at logic or perspective.
Once it senses danger, it sets off the fight or flight response.

This response was essential thousands of years ago when humans were hunting and avoiding real physical threats. Bears. Wild animals. Immediate danger.
We are no longer hunting bears.
But our nervous systems have not updated.
Modern life creates constant stressors:
school pressures
social worries
sensory overload
transitions
uncertainty

The body responds in exactly the same way as if it was a physical threat.

As part of fight or flight:
the heart pumps faster to move blood to large muscles
digestion slows down
the body tries to become lighter and faster

Digesting food is not a priority if the brain thinks it needs to run.

So the body does what it can:
it creates nausea
it causes tummy pain
it may even make a child sick

This is why children often feel sick or have tummy aches before school.

It is anxiety preparing the body to fight or flee.
The pain is very real.

Why ignoring it does not help

Anxiety does not disappear if it is ignored.
And it does not improve if it is forced into silence.

Facts about anxiety:
it loves attention
it grows when it is fed with too much time and energy
it does not go away on its own
you did not cause it
your child cannot simply “get over it”

At the same time, avoiding everything that causes anxiety teaches the brain:
“This really is dangerous.”

So caregivers are often stuck in the middle:
do I push them into school?
do I keep them home?

There is a third option.
Support without feeding the fear.

How to support anxiety-related tummy pain

1. start with belief
“I believe you” is powerful.
Say it out loud.
“I believe your tummy hurts.”
“I believe you feel sick.”
This calms the nervous system and builds trust.
Dismissing pain increases fear.

2. get curious about the “why”
Put your curiosity hat on.
What is underneath the worry?
friendship difficulties
noisy lunch halls
transitions into school
uncertainty about the day
When you understand the “why”, you can reduce some of the triggers that feed anxiety.
Small environmental changes often help more than big emotional talks.

3. explain what is happening in the brain
Children often cope better when they understand their body.
Explain anxiety in simple terms:
“This is your brain trying to protect you.”
“It thinks something scary might happen.”
Give the anxious part of the brain a name.
Jack
Billy
Dingo
“This is Jack making my tummy feel funny.”
This helps children separate themselves from the anxiety rather than feeling it is part of them.

4. name it to tame it
“Anxiety” is an umbrella word.
Help your child identify what is underneath:
overwhelm
fear
loneliness
disappointment
feeling lost
Naming emotions reduces their intensity and helps the brain feel safer.

5. calm the body first
Anxiety is physiological. It is based in Polyvagal nerve theory.
It changes:
heart rate
breathing
muscle tension
digestion
The only part of the nervous system we can consciously control is breathing.
Slow breathing helps, but not too slow.
Useful tools include:
box breathing
5, 4, 3, 2, 1 grounding
These signal safety to the body.

6. contain worry with “worry time”
Worry time can be incredibly helpful.
Set aside:
10–15 minutes a day
at a predictable time
labelled clearly as “worry time”
This is when worries are welcomed.
You listen.
You do not fix.
You do not rush.
This containment teaches the brain:
“My worries are heard.”
“They do not need to shout all day.”

A note for caregivers

Supporting an anxious child is exhausting.

School refusal, tummy aches, and daily distress take a toll on the whole family.
You are not failing.
And your child is not broken.
Anxiety is not a character flaw.
Tummy pain is not imagined.
With understanding, small environmental tweaks, and consistent support, children can learn that they can cope with anxious feelings.

If you are looking for structured, evidence-based tools to support anxiety, emotional regulation, and school-related stress, the twigged toolkit for adhd is designed to help caregivers support children in real life, one small step at a time.

Progress over perfection matters here.

Every calm moment counts.
gee eltringham

The founder

I started twigged out of both personal urgency and professional insight.
As The Toolkit Therapist and parent to a neurodivergent child, I experienced first hand the overwhelm and isolation families often face after a diagnosis.
Frustrated by the lack of practical, empathetic support, I set out to create what I couldn’t find: simple, evidence-based tools that make everyday life easier.
Read more of the twigged blog and follow twigged on socials.