The SM-Doctor surgeon spoke about abdominal pain in a child

For the parents of every child, there is nothing worse when their child is sick. Especially at an early age, when the baby still cannot tell, or even show, what and where he hurts. Even if the child showed or explained where he has unpleasant, painful sensations, you should not self-medicate, but should immediately consult a doctor.

Pediatric cardiology in Saratov sees children at different ages and allows us to identify possible disorders in the early stages, and in addition to cope with the disease in the active phase.

Instructions for parents

If every parent knew what a variety of diseases are hidden under the ordinary children’s complaint “stomach ache,” I would not be surprised that even the most experienced doctors sometimes puzzle over the causes of this symptom. What is this: reluctance to go to school or a symptom of a serious illness? When to sound the alarm? How can you help your child get rid of discomfort and pain faster?

The first question that parents are usually interested in is: what does the child feel when he complains of abdominal pain?

Let's start with the fact that pain is a subjective sensation that occurs as a result of exposure to irritants that cause various disorders in the body. Even the fetus has the ability to perceive pain. As a result, the child feels the same burning, whining, tingling, and stinging sensations as adults, but due to his age he cannot always describe them.

So how can you figure out what exactly is hurting your child’s stomach? To understand this, one article is not enough, but let’s try to highlight the main reasons for this condition.

The very first thing the doctor will pay attention to when examining your child is age. The diagnostic search is based on one algorithm in the case of a five-month-old baby and completely differently if a sixteen-year-old boy comes to the appointment. Therefore, I propose to consider the possible reasons and tactics of parents’ actions in each period of childhood.

Who to contact if you have a lump in your throat

The feeling of a lump in the throat is treated by a psychotherapist or psychiatrist. During the consultation, the doctor will assess the condition and determine the amount of assistance needed.

Help can be obtained in any clinic where there is a license to provide assistance in psychotherapy, psychiatry and neurology and where a psychiatrist or psychotherapist conducts an appointment.

ROSA Clinic

is a specialized and licensed clinic that provides assistance for all types of disorders accompanied by a feeling of a lump in the throat.
Our specialists
are ready to come to your home for consultation; you can also see a doctor in our clinic.

Treatment is most often carried out at home. If necessary, it is possible to be hospitalized in our own hospital, equipped with modern diagnostic equipment and where it is possible to carry out active treatment.

Newborns and infants

The most difficult category of children to diagnose.
They will not be able to show, describe or even hint to you where it hurts now, or whether it hurts at all. In this case, it is important to distinguish the transient state of the child from the pathological one. Transient states, that is, transient ones, are associated with the anatomical and functional immaturity of the digestive organs, the nervous system, the formation of intestinal microflora, and the formation of a sleep/wake rhythm.

In infants, especially the first 6 months of life, the most common functional disorders are regurgitation, infant colic and functional constipation. In more than half of children they are observed in various combinations, less often - as one isolated symptom. It should be noted that for a healthy child, regurgitation up to 5 times a day (volume less than 3 ml) and stool up to 5-6 times a day (without pathological impurities) are quite acceptable.

Infant colic is characterized by the “rule of three”:

• colic begins in the first three weeks after birth;
• lasts about three hours a day;
• mainly occur in children in the first three months of life.

Infant colic is observed from birth and lasts mainly until 4-5 months.
In some children they last up to 6-7 months. In this case, the general condition of the child is not disturbed; normal weight gain is noted. Among the pathological conditions that occur with abdominal pain, children of this age may develop congenital malformations of the gastrointestinal tract, enterocolitis, intussusception and volvulus, strangulated hernia, and urinary tract infection. Parents are usually alarmed by “reasonless” anxiety that does not go away after feeding and sleep. The baby wiggles his legs, blushes, tenses, and refuses to eat. It is important to assess the nature and frequency of stool and regurgitation.

Nature and areas of localization

In infants in the first 3-4 months of life, repeated abdominal pain, which often occurs at the same time of day or night and leads to strong cries, is characteristic of the so-called “three-month colic”. Often, gentle massage or stroking will relieve discomfort. In any case, contact your pediatrician to rule out other causes.

Table - Types and characteristics of abdominal pain in a child

In children of early and middle school age, if discomfort appears, you can observe for a while. As a rule, abdominal pain is localized in the navel area, occurs only during the day and is sometimes accompanied by bloating, as well as alternating constipation and diarrhea.

You should contact your pediatrician if your child experiences the following symptoms:

• periodic pain in the same place away from the navel;
• waking up at night due to discomfort in the abdominal area;
• colicky attacks, which are accompanied by sweating;
• discomfort during urination;
• persistent or frequent diarrhea for 4 weeks;
• blood in the stool, repeated vomiting, streaks of blood or bile juice in the vomit;
• noticeable weight loss, lack of weight gain, or stunted growth;
• prolonged increase in temperature.

Possible causes with warning symptoms include intestinal diseases, such as inflammation, celiac disease (gluten intolerance), food allergies, narrowing of the intestine, kidney malformations, kidney or gallstones, inflammation of the pancreas and other rare abdominal diseases.

Many children have no organic cause for their discomfort. Rather, there is a special sensitivity to bowel movements (overexcitation or irritation of the walls).

Bloating

Occurs due to gas formation in the gastrointestinal tract. It can develop in infants because they swallow a lot of air while sucking and drinking. Babies who eat high-fiber foods and eat plenty of vegetables and fruits are more likely to experience this condition.

If a child is prone to flatulence, a lot can be done for prevention and relief:

• purchase the right bottle and special drops that reduce gas formation;
• massage around the navel clockwise;
• provide sufficient time to chew food thoroughly;
• for prevention, give infusion of fennel, anise and caraway tea;
• minimize the amount of gas-causing foods (cabbage or legumes).

Gymnastic exercises - for example, lying on your back with your legs in the air "riding a bicycle" - as well as walking in the air, help improve the condition.

Constipation pain

Characterized by rare passage and hardening of feces. The child constantly complains of discomfort during bowel movements, so he is reluctant to go to the toilet. The situation could become a real problem.

To alleviate the condition, it is recommended:

• move a lot and drink enough;
• Eat a high-fiber diet with plenty of fruits, vegetables and whole grains;
• eat soaked dried fruits, flaxseed, wheat bran and yogurt;
• take warm relaxing baths.

Epigastric pain

Discomfort in the upper abdomen may come from one of the organs located there. These include the stomach, duodenum, liver, gallbladder, spleen (left behind the stomach) and pancreas (center behind the stomach).

The causes in children of middle school and adolescence in 50-70% of cases are:

• Heartburn, reflux disease. A burning, ascending pain behind the sternum, in the upper abdomen and possibly up to the neck, as well as temporary sour belching are the leading symptoms. Most often they occur after a heavy meal. With repeated contact with aggressive stomach acid, the lining of the esophagus can become inflamed (reflux esophagitis).
• Irritation of the gastric mucosa. Discomfort is manifested by convulsive attacks that do not depend on food intake. A feeling of fullness, bloating and loss of appetite are often added.
• Inflammation of the gastric mucosa. Common signs of gastritis include a feeling of fullness, lack of appetite, nausea, vomiting, heartburn, belching and bad breath.
• Stomach ulcer. Severe discomfort in the center or left side, which occurs almost immediately after eating. Over time, the discomfort subsides (often until the next meal).
• Duodenal ulcer (duodenal ulcer). Symptoms appear on an empty stomach and occur suddenly at night or a few hours after eating in the upper middle part. The condition improves after eating.

Due to its anatomical proximity to the chest, discomfort in the upper region can also be a sign of pneumonia. Problems in the spine also sometimes cause discomfort that radiates to the stomach.

How can a parent help?

If the child has not passed gas or stool for a long time, and his stomach is tense, give him a gas tube.
If the child's condition does not improve or there is no passing of gas or stool, consult a doctor. In case of prolonged attacks of colic, the child is restless outside of an attack and has poor sleep, it is necessary to exclude neurological disorders that can aggravate the course of physiological intestinal colic. Frequent and profuse regurgitation is also a reason to consult a specialist in order to exclude surgical and neurological pathologies. Fever accompanying the pain syndrome requires professional observation and differential diagnosis.

How to understand what exactly hurts in a child’s chest

First of all, this is not just a whim, but crying, screaming and even hysteria. At this time, the child can clench his fists and pull them to the chest, or he can simply hit himself in this area. Additional symptoms include:

• shortness of breath;
• cardiopalmus;
• difficulty breathing or swallowing;
• less often elevated temperature.

Since there is strong pain in this area, the baby rarely turns over on his stomach, but will lie on his back or side, although he previously loved this position.

The key symptom of compressive pain is a sudden change in mood, and in addition, the child shrinks, taking the fetal position, thus helping himself to cope with such severe pain at the level of instincts. Sometimes sharp redness of the whites of the eyes, red spots on the body in the chest area and face are noticeable.

Pressing pain can make itself felt progressively. One moment everything is fine, the next it’s hard to breathe. In order to exclude all possible causes, and in case of diagnosis and treatment, return to its former healthy state, it is necessary to regularly visit a pediatric cardiologist in Saratov. The first dose is appropriate at the age of 1–2 months, and then every six months, if there are no visible pain syndromes.

Children of early and preschool age

At this age, children are also often unable to answer important anamnestic questions. However, they can still complain and point to their belly. In this category of children, the maturation of organs and systems has already occurred to a greater extent, but the immaturity of nervous regulation does not allow them to clearly localize the source of pain.

It is important to note that among the pathologies that cause abdominal pain syndrome, the leading ones in this age period are gastroenteritis, intestinal colic, mesenteric lymphadenitis, acute abdomen, blunt abdominal trauma and edematous scrotum syndrome. Don't be surprised by the latest diagnosis. It is not for nothing that the immaturity of nervous regulation was mentioned, and therefore in boys pain in the scrotum area can radiate to the lower abdomen. In view of this, do not hesitate to examine the genitals.

Gastroenteritis, sometimes incorrectly called "stomach flu", regardless of the cause, is usually accompanied by vomiting or diarrhea. Gastroenteritis resulting from infection may be accompanied by an increase in body temperature.

Intestinal colic is one of the most common reasons for going to the hospital to exclude surgical pathology. It manifests itself as severe cramping pain in the abdomen and occurs as a result of intense contractions of the distended intestinal wall. The causes of this condition in 95% of cases are irregular nutrition and errors in the diet.

Mesenteric lymphadenitis is an inflammation of the mesenteric lymph nodes against the background of the infectious process. By 5–7 years of life, the maximum development of elements of lymphoid tissue in the body and in the mesentery, in particular, is observed.

In case of intestinal diseases, favorable conditions are created for the absorption of toxic substances in the distal parts of the small intestine. The regional lymph nodes, which perform a barrier function, take the aggressive blow. Thus, the development of mesadenitis is associated with the penetration of infection and toxins into the lymph nodes.

More details about the problem

Abdominal pain is one of the most common childhood complaints, and fortunately, it is mostly temporary and harmless. Possible causes are varied and range from infections and food intolerances to functional discomfort.

Among the main provoking factors:

• digestive problems;
• intestinal infection;
• lack of bowel movement for several days;
• too fatty or sweet foods, as well as spoiled foods.

Mental problems, fears and stress also manifest as discomfort. It is usually harmless and will go away when the cause is eliminated. In addition, the body's reaction to excitement, anxiety or joyful excitement can also cause this symptom. Most often, the problem disappears quickly and does not require medical intervention.

How can you help?

If there is no stool during the day or insufficient emptying, it is necessary to force a bowel movement in the child.
It is possible to use a microenema or a glycerin suppository. Self-administering a water enema to a child is not recommended due to complications that can arise from a number of surgical diseases. If you refuse to eat, and especially if you are vomiting, do not try to force-feed your child. It is enough to provide him with a drinking regime to normalize the water balance. Self-prescription of pro- and prebiotics, antibacterial and painkillers is unacceptable. The latter can “blur” the picture and make it difficult to diagnose surgical pathology when visiting a doctor.

The use of enterosorbents is permissible; drugs based on simethicone, eliminating gas formation and bloating; drugs that relax the intestinal muscles - antispasmodics. Medicines must be used in accordance with the official instructions.

It should be noted that in children, abdominal pain syndrome in acute surgical pathology may not be as pronounced as in adults. And besides, it does not always have a clear localization even in acute appendicitis, and develops gradually. Therefore, if there is no positive dynamics from your actions within 2 hours, consult a doctor immediately.

How is the feeling of a lump in the throat treated?

Treatment is determined by the causes and mechanism of development of the disease and is selected individually for each patient.

For a recent and non-severe condition

treatment is carried out on an outpatient basis: the doctor conducts a psychotherapeutic session, prescribes medications that the patient takes at home and periodically comes for follow-up consultations.

For moderate severity

- treatment in a day hospital is recommended: daily treatment procedures are carried out (drug infusions, physiotherapy, etc.), which take an hour and a half, but the patient lives at home and goes about his usual business. The average course of a day hospital is about 10 days.

In severe condition

hospitalization in a hospital is recommended. Due to intensive treatment, the condition can be stabilized already in the first hours of stay. The average length of hospital stay is 10 days (from 5 to 30 days depending on the severity of the condition and the body’s recovery abilities).

Main methods of treatment:

• Psychotherapy.
• Drug treatment (pharmacotherapy).
• Physiotherapy.
• Massage and manual therapy.
• Diet therapy.
• Biofeedback therapy.

School age children (from 6 to 18 years old)

At this age, children can already describe their feelings in detail. In this age group, it is important to pay attention to the psycho-emotional status of the child. If a child has recently experienced major emotional events or experienced stress, then it is worth thinking about and not ruling out a similar cause for the child’s well-being as an element of psychosomatics. It is necessary to find out the duration, localization and nature of the pain, the connection with food intake, and the nature of the stool. In girls of puberty, the cause of abdominal pain can often be acute gynecological pathology, such as uterine blood reflux, apoplexy, ovarian torsion, etc., requiring immediate surgical intervention.

How can you help?

Everything is the same as for young children, but in addition you have the opportunity to fully discuss with your child his well-being.
A detailed survey can largely explain the etiology of the pain syndrome. Dear parents! In conclusion, it is important to emphasize that this article is for informational purposes only and reflects only the “tip of the iceberg” of the entire bouquet of possible pediatric pathologies accompanied by abdominal pain syndrome. Of course, abdominal pain can be caused not only by gastrointestinal diseases, but also by metabolic disorders, hematological diseases, the use of drugs and toxins, diseases of the liver, hepatobiliary tract, spleen, lungs, and diseases of the genitourinary system. But these cases are relatively rare, so attention is paid to common causes of abdominal pain.

It’s not for nothing that I started my story with the difficulties of diagnosing abdominal pain syndrome, even by an experienced doctor. In this matter, you need to remember one thing: it is better to seek specialized help in a timely manner than to regret the consequences in the future and deal with complications.

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