My child keeps complaining of stomachaches but tests show nothing wrong — what's going on?

Recurrent functional abdominal pain affects 10–15% of school-age children. After ruling out medical causes (celiac disease, food intolerances, constipation, UTI), the most common explanation is stress and anxiety manifesting physically. The gut-brain connection is well-established: the gut contains more neurons than the spinal cord, and emotional distress directly affects digestion. The pain is REAL — never tell a child they are faking. Help identify triggers: is the pain worse on school mornings? Before tests? After social conflicts? Teach relaxation techniques (deep breathing, progressive muscle relaxation). Ensure adequate fiber, water, and physical activity. Avoid reinforcing illness behavior (staying home from school when possible), while validating their experience. Cognitive behavioral therapy has strong evidence for functional abdominal pain. Consult your pediatrician about whether further evaluation or a mental health referral is appropriate.