Medipedia

Understanding Gut–Brain Interaction Disorders in Children

Has your child ever complained of ongoing tummy pain, bloating, constipation, diarrhoea, or frequent burping, only for tests and scans to come back normal?

For many parents, this situation can be both frustrating and worrying. You can see that your child is uncomfortable, missing school, or avoiding meals, yet medical results don’t point to an obvious cause. It may leave you wondering whether the pain is “just a phase” or something that will eventually go away on its own.

Let’s understand this better with Dr Foo Hee Wei (Simon), Consultant Paediatric Gastroenterologist & Hepatologist at Sunway Medical Centre Velocity, as we explore a group of conditions that are increasingly recognised in children and adolescents.

When the Gut and Brain Are Closely Connected

The digestive system is not just a series of organs that process food. It is closely linked to the brain through a complex network of nerves, hormones, and chemical messengers. This connection, known as the gut–brain axis, plays an important role in digestion, gut motility, and pain perception.

When this communication becomes overly sensitive or disrupted, children may experience real physical symptoms, even in the absence of infection, inflammation, or a structural problem detectable on tests.

This group of conditions is called Disorders of Gut–Brain Interaction (DGBI).

In simple terms, the gut may be working, but it is responding too strongly or irregularly to normal signals. Just as adults may feel “butterflies” in the stomach during stressful moments, children can develop persistent digestive symptoms when this system becomes imbalanced.

What Does This Look Like in Everyday Life?

Children with gut–brain interaction disorders may experience symptoms that come and go, or persist over time. These can include:

• Recurrent tummy pain without a clear pattern
• Bloating or a feeling of fullness after small meals
• Constipation or loose stools
• Nausea, vomiting, or frequent burping
• Symptoms that worsen during school days, stressful events, or changes in routine

What often causes concern is that medical examinations, blood tests, scans, and even scopes may appear completely normal.

It is important to understand that this does not mean the pain is imagined or exaggerated. The discomfort is real, and children are not “making it up.” Instead, the way their gut processes signals and sensations is different.

Why Do These Symptoms Occur?

There is rarely a single cause behind gut–brain interaction disorders. Instead, symptoms usually develop due to a combination of factors, such as:

• Sensitive gut nerves, which react more strongly to normal stretching or movement
• Changes in gut movement, causing food to move too slowly or too quickly
• Alterations in gut bacteria, which can affect digestion and sensation
• Emotional stress or anxiety, which can directly influence gut function
• Past infections or illnesses, which may leave the gut more sensitive afterwards

Because these factors overlap and influence one another, it is not always possible to identify one clear trigger. This can be frustrating for parents seeking a definite answer, but it also explains why a broader, more personalised approach to care is often needed.

Focusing on Comfort, Function, and Confidence

When managing disorders of gut–brain interaction, the aim is not just to label a condition, but to help your child feel better and return to normal daily activities.

Care plans are individualised and may involve:

• Adjusting eating habits gently, without overly restrictive diets
• Supporting regular bowel routines
• Addressing stress or emotional triggers in an age-appropriate way
• Providing reassurance to both the child and the parents
• Monitoring progress over time rather than relying on one-off tests

With the right guidance and follow-up, many children experience significant improvement. Most are able to attend school, participate in activities, and enjoy meals again without constant discomfort.

It may be helpful to consult a doctor if your child:

• Has persistent tummy symptoms lasting several weeks or months
• Frequently misses school or avoids activities due to pain
• Experiences symptoms that disrupt sleep or appetite
• Feels anxious or distressed because of ongoing discomfort
• Red flags - unexplained weight loss, anaemia, lack of energy, fever

Early assessment can help rule out other conditions, provide reassurance, and guide appropriate management before symptoms begin to affect quality of life more deeply.

Digestive symptoms without clear test results can feel unsettling, but they are far more common than many families realise. Disorders of gut–brain interaction are recognised medical conditions, and support is available.

With proper care, understanding, and patience, children with these conditions can continue to grow, learn, and thrive.

If your child has ongoing digestive concerns and you would like professional guidance, book an appointment with Dr Foo Hee Wei (Simon), Consultant Paediatric Gastroenterologist & Hepatologist at Sunway Medical Centre Velocity. Our team is here to help your child feel better, regain confidence, and return to everyday life with comfort and ease.