the Connection Between Abdominal Bloating and Back Pain in Teens

Abdominal bloating and pain accompanied by spinal pain?

My daughter is a 14-year-old second-year junior high school student who is suspected of having Asperger's syndrome combined with psychosomatic symptoms.
She has been taking Buspirone for six months.
A month ago, she visited an orthopedic doctor due to back pain, and an X-ray showed only a slight lateral curvature of the lower lumbar spine.
The doctor advised her to start physical therapy, but despite ongoing treatment, there has been no improvement.

Four days ago, she experienced severe gastrointestinal bloating and had difficulty with bowel movements, only passing a small amount each time.
She has been unable to release gas, accompanied by back pain, headaches, and nausea.
She first consulted a gastroenterologist, who prescribed gastrointestinal medication along with a mild laxative.
The next day, she had three bowel movements, but the quantity was still minimal, and the bloating persisted.
In the morning, she woke up with severe back pain and muscle aches in her limbs.
She mentioned that lying down alleviates the pain, and as a result, she has been unable to attend school for two days.
I am unsure if these symptoms are related and which specialist she should see.
I believe we should first address the gastrointestinal issues with a gastroenterologist, but I am also concerned about the persistent back pain.
Could it be ankylosing spondylitis? She can only bend forward halfway.
Alternatively, could her symptoms be a result of autonomic nervous system dysregulation causing multiple issues? I am at a loss regarding which specialist to consult or if we should go to a large hospital's emergency department for evaluation.

Afen, 40~49 year old female. Ask Date: 2019/05/02

Dr. Xu Peiqi reply Family Medicine

Hello, Afun.
I can see that you are very concerned about your daughter, and I understand how difficult this must be for you.
Currently, it seems that we cannot completely rule out a connection between her spinal pain and gastrointestinal discomfort.
Her spinal pain is somewhat unusual, and I recommend that she seek further evaluation.
She may need to see a neurologist, neurosurgeon, or orthopedic specialist, and an MRI may be necessary depending on the physician's assessment.
Although the gastrointestinal issues appear to be independent, it would still be beneficial to mention them to the doctor.
As for whether it is ankylosing spondylitis, we will need to wait for the results of the examinations to determine that.
Dysautonomia is not the primary suspected diagnosis; we should first rule out other issues.
The gastrointestinal problems should definitely be evaluated by a gastroenterologist.
One possible connection could be that the anti-inflammatory and analgesic medications for her spinal pain may have gastrointestinal side effects, which is also a possibility.
When visiting the gastroenterologist, it would be helpful to discuss her recent spinal condition and any medications she has taken.
Wishing you and your daughter all the best.
Thank you for your inquiry.

Reply Date: 2019/05/02

More Info

Understanding the connection between abdominal bloating and back pain in teenagers can be quite complex, especially when considering the various underlying factors that may contribute to these symptoms. In your daughter's case, it appears that she is experiencing a combination of gastrointestinal issues and musculoskeletal pain, which may or may not be related.

Firstly, abdominal bloating can be caused by a variety of factors, including dietary habits, gastrointestinal disorders, and even stress or anxiety. In teenagers, common causes of bloating include constipation, which can lead to a buildup of gas and discomfort. Since your daughter has experienced difficulty with bowel movements, this could be a significant factor in her bloating. The presence of gas that cannot be expelled can lead to increased abdominal pressure, which may also contribute to discomfort in the back, as the body compensates for the abdominal discomfort.

The connection between abdominal issues and back pain is not uncommon. The abdomen and back are closely linked through the muscles and nerves that support the spine and abdominal organs. When the abdomen is distended or in pain, it can lead to muscle tension in the back as the body tries to adjust to the discomfort. Additionally, if your daughter is experiencing significant abdominal pain, she may be adopting a posture that places additional strain on her back, leading to further discomfort.

Regarding the spinal issues, you mentioned that your daughter has been diagnosed with a slight scoliosis in her lumbar spine. Scoliosis can sometimes lead to uneven muscle tension and discomfort in the back, which may be exacerbated by other factors such as abdominal bloating or gastrointestinal distress. The fact that she is experiencing severe back pain, especially in conjunction with her gastrointestinal symptoms, warrants a thorough evaluation.

Given the complexity of your daughter's symptoms, it may be beneficial to approach her care from a multidisciplinary perspective. Here are some recommendations:
1. Gastroenterology Consultation: Since your daughter is experiencing significant gastrointestinal symptoms, it is essential to continue working with a gastroenterologist. They can help identify any underlying conditions such as irritable bowel syndrome (IBS), food intolerances, or other gastrointestinal disorders that may be contributing to her symptoms.

2. Physical Therapy: If her back pain persists, a referral to a physical therapist may be beneficial. A physical therapist can provide exercises to strengthen the core muscles, improve posture, and alleviate back pain. They can also address any issues related to her scoliosis and help her develop strategies to manage her pain.

3. Psychological Support: Given that your daughter has a history of anxiety and is on medication, it may be helpful to involve a mental health professional. Anxiety can exacerbate physical symptoms, and addressing her mental health may lead to improvements in her physical symptoms as well.

4. Holistic Approach: Encourage your daughter to engage in gentle physical activity, such as walking or swimming, which can help with both her gastrointestinal symptoms and back pain. Additionally, mindfulness practices, such as yoga or meditation, may help her manage stress and improve her overall well-being.

5. Follow-Up Care: If her symptoms do not improve or worsen, it may be necessary to seek further evaluation, possibly including imaging studies or additional tests to rule out any serious underlying conditions.

In conclusion, while there may be a connection between your daughter's abdominal bloating and back pain, it is essential to address each symptom comprehensively. A multidisciplinary approach involving gastroenterology, physical therapy, and psychological support may provide the best outcomes for her health. If her symptoms are severe or if you have concerns about her condition, do not hesitate to seek immediate medical attention.

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