abdominal syndrome. Difficulties in diagnosing abdominal syndrome in children. Probable mechanisms of development of abdominal syndrome in ARVI. Abdominal pain syndrome: etiology, pathogenesis and therapy issues

abdominal pain it is pain in the abdomen, a very common complaint in patients. Abdominal pain is one of the most common complaints of patients. It can be completely different: after all, in the abdominal cavity next to each other there are many organs: the stomach, liver, gallbladder, pancreas, intestines, and very close - the kidneys and ovaries. Each of them hurts in its own way and requires its own treatment. In some cases, you can get by with home remedies, and sometimes you need to urgently call an ambulance.

Causes of abdominal pain

There are two most common type of pain:

Spasmodic (convulsive) abdominal pain (colic). It usually manifests itself in undulating attacks, the intensity of which increases or decreases. The pain is caused by deformations in the intestine (stretching or compression), and, as a rule, is a consequence of hyperactive peristalsis. Such pain is caused by excessive gas formation in the intestines, infectious inflammatory processes or stress.

Constant abdominal pain. This type of abdominal pain is characterized by a relatively constant and steady course. Patients often describe it as "burning in the abdomen", sharp, cutting or "hungry" pain. This type of pain is the result of severe inflammation of the abdominal organs, ulcerative lesions, attacks of gallstone disease, abscesses or acute pancreatitis.

The most dangerous and unpleasant conditions are united in the concept of "acute abdomen" ( acute pancreatitis, peritonitis). The pain is most often intense, diffuse, general health: poor, often the temperature rises, severe vomiting opens, the muscles of the anterior abdominal wall are tense. In this situation, it is impossible to give any painkillers before the doctor's examination, but urgently call an ambulance and be hospitalized in a surgical hospital.

Appendicitis in the early stages is usually not accompanied by very severe pain. On the contrary, the pain is dull, but fairly constant, in the lower right abdomen (although it can begin in the upper left), usually with a slight rise in temperature, it can be single vomit. The state of health may worsen over time, and as a result, signs of an “acute abdomen” will appear.

There are also such abdominal pain that are not associated with diseases of the intestines or other internal organs: neurotic pain. A person may complain of pain when he is afraid of something or does not want to, or after some psycho-emotional stress, shocks. At the same time, it is not at all necessary that he feigns, the stomach can really hurt, sometimes even the pain is very strong, resembling an “acute stomach”. But they don't find anything on examination. In this case, you need to consult a psychologist or neurologist. You can also visit a cardiologist if abdominal pain is part of vegetative-vascular dystonia, while the child, in addition to abdominal pain, may have sweating, fatigue, increased heart rate.

Often, abdominal pain is accompanied by other unpleasant symptoms, such as:

sweating;

rumbling (especially when taking a horizontal position or changing position).

Symptoms are important factors indicative of bowel dysfunction, stomach, biliary tract or inflammatory processes in the pancreas. Chills and fever usually accompany dangerous intestinal infections or blockage of the bile ducts. A change in the color of urine and feces is also a sign blockage of the bile ducts. In this case, the urine, as a rule, acquires a dark color, and the feces lighten. Intense cramping pain accompanied by black or bloody stools indicates the presence of internal bleeding and requires immediate hospitalization.

abdominal pain

Intense abdominal pain that keeps you awake at night. It may appear before or after meals. Pain often precedes bowel movements, or manifests itself immediately after the act of defecation. "Cutting" pain, characteristic of intestinal ulcer, manifests itself immediately before eating. Intense pain due to gallstone disease, like pain in pancreatitis, usually develops after eating. The most common causes of abdominal pain are irritable bowel syndrome and biliary dyskinesia.

For people suffering from irritable bowel syndrome, the appearance of pain immediately after eating is characteristic, which is accompanied by bloating, increased peristalsis, rumbling, diarrhea, or a decrease in stool. The pain subsides after defecation and the passage of gases and, as a rule, do not disturb at night. Pain syndrome in irritable bowel syndrome is not accompanied by weight loss, fever, anemia.

Inflammatory Bowel Disease, accompanied by diarrhea (diarrhea), can also cause cramping and pain, usually before or after a bowel movement. Among the sick psychogenic disorders gastrointestinal tract abdominal pain as the leading symptom occurs in 30% of cases.

Diagnostics

The location of the pain is one of the main factors in the diagnosis of the disease. Pain centered in the upper abdomen is usually caused by disorders in the esophagus, intestines, bile ducts, liver, pancreas. The pain that occurs with cholelithiasis or inflammatory processes in the liver is localized in the upper right part of the peritoneum; (may radiate under the right shoulder blade). Ulcer pain and pancreatitis, usually radiates through the entire back. Pain caused by disorders in the small intestine is usually concentrated around the navel, while pain caused by large intestine, are recognized in the middle of the peritoneum and below the navel. Pelvic pain is usually felt as pressure and discomfort in the rectal area.

At abdominal pain syndrome, pain, as a rule, of low intensity, is concentrated in the upper middle part of the abdominal cavity, or in its lower left section. Pain syndrome is characterized by a variety of manifestations: from diffuse dull pain to acute, spasmodic; from permanent to paroxysms pain in the abdomen. Duration of painful episodes from several minutes to several hours. In 70% of cases, the pain is accompanied intestinal motility disorder(diarrhea or constipation).

Treatment

The most common cause of abdominal pain is the food we eat. You should contact gastroenterologist If you:

often experience severe abdominal pain;

observe the loss of your usual weight;

lose your appetite;

suffer from chronic gastrointestinal diseases.

Irritation of the esophagus(pressive pains) caused by salty, too hot or cold food. Certain foods (fatty, cholesterol-rich foods) stimulate the formation or movement of gallstones, causing gallstone attacks. colic. It is no secret that many people have intolerances to certain types of foods, such as milk, milk sugar, or lactose. Eating them leads to spasmodic pains in the abdomen, bloating and diarrhea.

Abdominal pain is divided into:
acute - develop, as a rule, quickly or, less often, gradually and have a short duration (minutes, rarely several hours)
chronic - characterized by a gradual increase (these pains persist or recur for weeks and months)

According to the mechanism of occurrence of pain in the abdominal cavity are divided into:
visceral
parietal (somatic)
reflected (irradiating)
psychogenic

Visceral pain occurs in the presence of pathological stimuli in the internal organs and is carried out by sympathetic fibers. The main impulses for its occurrence are a sudden increase in pressure in a hollow organ and stretching of its wall (the most common cause), stretching of the capsule of parenchymal organs, tension of the mesentery, and vascular disorders.

Somatic pain due to the presence of pathological processes in the parietal peritoneum and tissues with sensory endings of the spinal nerves.
Radiating pain is localized in various areas remote from the pathological focus. It occurs in cases where the impulse of visceral pain is excessively intense (for example, the passage of a stone) or in case of anatomical damage to the organ (for example, strangulation of the intestine).

Radiating pain is transmitted to areas of the body surface that have a common radicular innervation with the affected organ of the abdominal region. So, for example, with an increase in pressure in the intestine, visceral pain first occurs, which then radiates to the back, with biliary colic - to the back, to the right shoulder blade or shoulder.

Psychogenic pain occurs in the absence of peripheral exposure or when the latter plays the role of a triggering or predisposing factor. A special role in its occurrence belongs to depression. The latter often proceeds hidden and is not realized by the patients themselves. The close relationship between depression and chronic abdominal pain is explained by common biochemical processes and, first of all, by the lack of monoaminergic (serotonergic) mechanisms. This is confirmed by the high efficacy of antidepressants, especially serotonin reuptake inhibitors, in the treatment of pain. The nature of psychogenic pain is determined by the characteristics of the individual, the influence of emotional, cognitive, social factors, the psychological stability of the patient and his past "pain experience". The main features of these pains are their duration, monotony, diffuse nature and combination with other localizations (headache, back pain, throughout the body). Often, psychogenic pains can be combined with other types of pain mentioned above and remain after their relief, significantly transforming their nature, which must be taken into account in therapy.

The causes of abdominal pain are divided into intra-abdominal and extra-abdominal.

Intra-abdominal causes: peritonitis (primary and secondary), periodic illness, inflammatory diseases of the abdominal organs (appendicitis, cholecystitis, peptic ulcer, pancreatitis, etc.) and small pelvis (cystitis, adnexitis, etc.), obstruction of a hollow organ (intestinal, biliary , urogenital) and ischemia of the abdominal organs, as well as irritable bowel syndrome, hysteria, drug withdrawal, etc.

Extra-abdominal causes abdominal pain include diseases of the chest organs (pulmonary embolism, pneumothorax, pleurisy, diseases of the esophagus), polyneuritis, diseases of the spine, metabolic disorders (diabetes mellitus, uremia, porphyria, etc.), exposure to toxins (insect bites, poisoning) .

Pain impulses originating in the abdominal cavity are transmitted through nerve fibers of the autonomic nervous system, as well as through anterior and lateral spinotolamic tracts.

Pain that is transmitted through the spinotolamic tracts:
characterized by a clear localization
occur when the parietal peritoneum is irritated
while patients clearly indicate pain points with one, less often with two fingers
this pain is associated, as a rule, with an intra-abdominal inflammatory process extending to the parietal peritoneum

Vegetative pain most often they cannot be definitely localized by the patient, often they are diffuse in nature, localized in the middle part of the abdomen.

!!! It should be noted that in the diagnosis, differential diagnosis, the determination of the localization of the pain syndrome is a very important factor.

Starting to examine the patient, the doctor must immediately mentally divide the abdomen into three large sections:
epigastric in the upper third
mesogastric or paraumbilical
hypogastric, represented by the suprapubic part and the pelvic area

!!! In the diagnosis, the doctor must remember another important differential diagnostic rule - if the patient complains of pain in the epigastric region, it is necessary to exclude the cause in the chest. At the same time, do not forget that the cause of the pain syndrome may depend on inflammatory, vascular, tumor, metabolic-dystrophic, congenital diseases.

!!! Anyone who adheres to these differential diagnostic rules avoids many, often serious mistakes.

Based on the foregoing, it should be noted most common causes of pain in the upper abdomen: These are diseases such as:
angina pectoris
myocardial infarction
pericarditis
pleurisy
lower lobe pneumonia
pneumothorax

The most common causes of pain in this localization are:
peptic ulcer of the stomach and duodenum
gastritis
duodenitis

The manifestations of diseases of the liver and biliary tract are important:
hepatitis
liver abscesses or subdiaphragmatic abscesses
metastatic liver lesions
congestive hepatomegaly
cholangitis
cholangiocholecystitis
cholecystitis

In recent years in hospital pain syndrome is becoming increasingly important pathology of the pancreas and, above all, pancreatitis.

In making a diagnosis should always be remembered about high small bowel obstruction, high and retrocecal location of the appendix.

Not quite typical symptoms can be observed with pyelonephritis, renal colic.

With certain clinical manifestations and history data should not be forgotten about the possibility of damage to the spleen.

Pain syndrome in the umbilical and mesogastric region often seen in:
gastroenteritis
pancreatitis
appendicitis in the early stages of pain
diverticulitis of the sigmoid colon, more often in people over 50 years of age and also in the early stages

The differential diagnosis rarely includes mesenteric lymphadenitis, thrombosis or embolism of the mesenteric vessels. A severe clinical picture is observed with small bowel obstruction or gangrene of the small intestine.

Very difficult differential diagnosis with pain in the hypogastric region, and especially in women. Diseases such as appendicitis, colonic obstruction, diverticulitis, hernia incarceration, pyelonephritis, renal colic can be joined by cystitis, salpingitis, pain during ovulation, ovarian and fallopian tube torsion, ectopic pregnancy, endometriosis.

Thus, the diagnosis, differential diagnosis of abdominal pain syndrome in the clinic of internal diseases remains a very difficult task.

Let us consider in more detail some nasologically specific abdominal syndromes.

Renal-visceral syndrome

It is usually defined in two ways: cardialgic and abdominal.

cardialgic- occurs paroxysmally, coincides with an exacerbation of the process in the kidneys (renal stones, pyelonephritis). Pain sensations differ in duration, are projected into the region of the apex of the heart, the left side and lower back, are accompanied by autonomic disorders - thirst, blanching of the face, cold sticky sweat, acrocyanosis.

Differential diagnostic symptoms of renal cardialgia are as follows:
1. atypical nature and localization of pain (long, aching nature, often combined with lower back pain)
2. pain is relatively poorly relieved by nitroglycerin, validol, valocordin, etc. 3. sensory disorders (hyperesthesia with elements of hyperpathy) are also determined on the inner surface of the shoulder, the anterior surface of the chest, in the lower back and groin
4. there are no significant abnormalities on the ECG or there is an unexpressed pathology (diffuse changes in the myocardium, occasionally slight signs of coronary insufficiency)
5. heart pain regresses as kidney failure is treated.

In patients suffering from sclerosis of the coronary arteries, paroxysms of renal pain (like many other exogenous and endogenous factors) can provoke attacks of coronary disease.

Abdominal syndrome develops against the background of an attack of nephrolithiasis or in acute renal failure and is manifested by pain of a transient nature in the epigastrium, back and lower back, nausea, belching, heartburn, not associated with food intake, hiccups, decreased or lack of appetite and other dyspeptic disorders. The presence of these symptoms mimics diseases such as cholecystitis, appendicitis, pancreatitis, gastritis, peptic ulcer.

Making a correct diagnosis is facilitated by:
1. no changes in X-ray examination of the gastrointestinal tract and hepatocholecystopancreatic system
2. the appearance at the height of the pain syndrome, changes in the urine characteristic of renal pathology (albuminuria, hematuria)
3. application of special examination methods (urography).

One of the types of pain of central origin is abdominal migraine . The latter is more common at a young age, has an intense diffuse character, but may be local in the paraumbilical region. Concomitant nausea, vomiting, diarrhea and vegetative disorders (blanching and coldness of the extremities, heart rhythm disturbances, blood pressure, etc.), as well as migraine cephalgia and its characteristic provoking and accompanying factors are characteristic. During paroxysm, there is an increase in the velocity of linear blood flow in the abdominal aorta. The most important mechanisms of pain control are endogenous opiate systems. Opiate receptors are localized in the endings of sensory nerves, in the neurons of the spinal cord, in the stem nuclei, in the thalamus and limbic structures of the brain. The connection of these receptors with a number of neuropeptides, such as endorphins and enkephalins, causes a morphine-like effect. The opiate system works according to the following scheme: activation of sensitive endings leads to the release of substance P, which causes the appearance of peripheral ascending and central descending nociceptive (pain) impulses. The latter activate the production of endorphins and enkephalins, which block the release of substance P and reduce pain.

Abdominal syndrome - mask

This is a specific mask. algic-senestopathic variant- pain, spasms, burning sensations, numbness, tingling, pressure (paresthesia), etc. in the abdomen. Patients experience heaviness, "overflow", "bursting", "vibration" of the stomach, "bloating" of the intestine, nausea, painful belching. The pains are often long-term, constant, aching, bursting dull character, but periodically against this background there are short-term, strong, lightning-like. Pains appear periodically (the greatest intensity at night and in the morning), they are not associated with the intake and nature of food.

Usually, there is a decrease in appetite, patients eat without pleasure, lose weight, suffer from painful constipation, less often diarrhea. The most constant manifestations of this syndrome, in addition to pain, include flatulence - sensations of bloating, overcrowding, rumbling of the intestines. Patients repeatedly call an ambulance, are urgently delivered to hospitals with suspicion of an acute disease of the gastrointestinal tract, adhesive disease, food poisoning.

They are usually diagnosed gastritis, cholecystitis, pancreatitis, colitis, peptic ulcer of the stomach and duodenum, solaritis, biliary dyskinesia, appendicitis, adhesive disease, dysbacteriosis, and some of them undergo surgical interventions that do not reveal the alleged pathology.

In some cases, after undergoing surgery, somatic symptoms disappear and the patient's general condition improves, which, apparently, is explained by the powerful stressful effect of the operation, which mobilizes the body's defenses and interrupts an attack of depression.

Objective Research Data(examination, indicators of clinical and biochemical blood tests, x-ray examination, analysis of gastric contents and duodenal sounding, coprological examination), as a rule, remain within the normal range, if minor deviations are found, they do not explain the nature and persistence of pain. The lack of effect from the therapeutic treatment of the alleged somatic disease is also important.

Any pain is a warning signal that indicates the appearance of some kind of malfunction in the body. Accordingly, this kind of discomfort should not be ignored. This is especially true of the symptoms that develop in children, since it can indicate the most serious violations of the body's activity, including those that require emergency care. A fairly common symptom of this kind is considered to be abdominal pain, in other words, abdominal pain. Let's talk about the diversity and specificity of complaints of this kind in a little more detail.

Abdominal pain syndrome in children often causes parents to visit doctors, and may be an indication for hospitalization in an inpatient department. The appearance of such an unpleasant phenomenon can be explained by a variety of factors - from SARS and up to surgical pathologies.

Diagnostics

In the last ten years, the main assistance in clarifying and even establishing the correct diagnosis for abdominal pain syndrome in pediatric practice has been an ultrasound examination of the peritoneal organs, as well as the retroperitoneal space.

No special preparatory measures are needed for the implementation of ultrasound. Children usually skip one feeding. Young children should pause for three to four hours, schoolchildren under ten years old will have to fast from four to six hours, and older ones - about eight hours. In the event that it is not possible to carry out an ultrasound scan in the morning on an empty stomach, it is allowed to be performed later. However, at the same time, certain foods should be excluded from the child’s diet - butter and vegetable oil, eggs, fruits and vegetables, sour-milk products, seeds and various frankly unhealthy foods. In the morning, you can give the patient a little lean boiled meat or fish, buckwheat porridge and some unsweetened tea.

The reasons

Abdominal syndrome in children at an early age can be triggered by excessive gas formation - flatulence, which causes intestinal colic. In rare cases, such a nuisance is fraught with the development of intestinal intussusception, requiring immediate hospitalization. In addition, at an early age, ultrasound helps to detect abnormalities in the structure of organs.

In school-age children, complaints of abdominal pain are often a sign of a chronic variety of gastroduodenitis. In addition, they may indicate dyskinesia and reactive changes in the pancreas. In this case, the doctor will select the appropriate treatment for the child, which will eliminate the symptoms and lead to recovery.

Among other things, quite often abdominal pain syndrome in children develops due to acute or chronic diseases of the kidneys or bladder. Accordingly, an important role is played by the examination of the urinary system. Ultrasound of these organs is carried out twice - with a well-filled bladder and shortly after emptying it.

It is also necessary to take into account the fact that abdominal pain may be a consequence of the formation of the menstrual cycle. In this case, their appearance is often explained by the occurrence of functional ovarian cysts, which require systematic monitoring by ultrasound, and usually disappear on their own.

Acute pain in the abdomen that develops at night often causes the child to be hospitalized in the surgery department, where he is already undergoing a mandatory ultrasound. So a similar symptom is often explained by the appearance of an acute surgical pathology, for example, acute appendicitis, intestinal obstruction (mechanical or dynamic type), intestinal intussusception, etc. Such conditions require immediate surgical intervention.

Sometimes nocturnal abdominal pain syndrome indicates the appearance of changes in internal organs that can be corrected by conservative methods and do not require hospitalization.

In rare cases, the occurrence of pain may also indicate the development of neoplasms. Such diseases require prompt diagnosis and immediate treatment. Again, ultrasound and a number of other studies will help to identify them.

Treatment

Therapy of abdominal pain syndrome in children depends directly on the causes of its development. Parents are strongly discouraged from making their own decisions and giving the child some painkillers, antispasmodics, etc., since such a practice is fraught with serious consequences. It is better to play it safe and once again seek medical help.

Additional Information

With the development of abdominal pain syndrome in pediatric practice, the main difficulty for correct diagnosis is the difficulty in describing the child's sensations, localization of pain, their intensity and irradiation. According to doctors, little children very often describe any discomfort that occurs in the body as abdominal pain. A similar situation is observed when trying to describe a feeling of dizziness, nausea, painful sensations in the ears or head that the child does not understand. At the same time, it is extremely important to take into account that many pathological conditions can also manifest as pain in the abdomen, such as diseases of the lungs or pleura, heart and kidneys, as well as lesions of the pelvic organs.

> Abdominal syndrome

This information cannot be used for self-treatment!
Be sure to consult with a specialist!

What is abdominal syndrome?

Abdominal syndrome is a symptom complex, the main criterion of which is abdominal pain, which has no direct connection with acute surgical pathology. The cause of abdominal syndrome can be diseases of the abdominal organs, lungs, heart, nervous system. The mechanism of pain formation in this pathology is associated with an inflammatory process in the peritoneum due to exposure to toxic substances or stretching of its diseased organ.

When can abdominal syndrome develop?

There is no general classification of this pathology. Its conditional division is based on the diseases in which it manifests itself. Abdominal syndrome (AS) is inherent in many diseases of the digestive organs: hepatitis, cirrhosis, pylorus stenosis of the duodenum and many others. Pain in the abdomen is also noted in diseases of the chest: with pneumonia, myocardial infarction, diverticulosis of the esophagus. Even infectious and viral diseases can lead to the formation of abdominal syndrome (herpes zoster, syphilis). A special group of diseases in which the formation of AS is noted are diseases caused by metabolic disorders or pathology of the immune system, namely, porphyria, diabetes mellitus and rheumatism.

The main clinical sign of abdominal syndrome is abdominal pain. The location of pain can be any, it is often not associated with the anatomical position of the diseased organ. Pain leads to tension in the abdominal muscles. Pain may be accompanied by nausea, bloating, flatulence, diarrhea, or constipation. In addition to this symptom complex, the symptoms of the underlying disease are added - fever with infection, pain in the heart with myocardial ischemia, arthralgia with rheumatism.

Children are a special risk group for the development of abdominal syndrome, which is associated with the ability of the child's body to overreact to any damaging factor.

What should be done for abdominal pain?

For any pain in the abdomen, you need to urgently consult a doctor - only he can determine the true cause of the abdominal syndrome. Self-medication is fraught with formidable complications. Abdominal syndrome may be one of the manifestations of an acute abdomen that accompanies peritonitis and requires surgical treatment. In the abdominal form of myocardial infarction, acute cardiovascular failure may develop. To determine the cause of AS, the doctor is helped by a general and biochemical blood test, ultrasound results, and x-rays of the abdominal and thoracic organs. The patient himself also provides assistance in making a diagnosis to the doctor, answering all questions in detail.

Principles of AS treatment

In the treatment of AS, priority is given to the treatment of the underlying pathology - bringing the metabolism back to normal, antibiotic therapy for infectious diseases. Painkillers are prescribed only after the exclusion of acute surgical pathology. With vomiting, antiemetics are prescribed, with constipation - a laxative, with flatulence, the digestive processes are normalized with a diet and enzymatic preparations. Abdominal syndrome in myocardial infarction is stopped by the introduction of narcotic analgesics that eliminate pain, but can cause vomiting.

Prognosis for abdominal syndrome

The prognosis for abdominal syndrome is favorable. Adequate therapy of the underlying disease leads to the rapid disappearance of pain and other symptoms. However, the relief of symptoms is not a reason to refuse a visit to the doctor. Finding the right treatment can take a long time, and failure to treat leads to a recurrence of the abdominal syndrome.

Can AS be prevented?

There are no specific methods for the prevention of AS, however, the correct maintenance therapy of the underlying disease can significantly reduce the likelihood of its development.

In medicine, it is customary to refer to a complex of symptoms, the main criterion for which is abdominal pain. It should be noted right away that it often does not have a direct connection with any surgical pathology, but is caused either by diseases of the organs located in the abdominal cavity, or problems with the patient's nervous system, the state of his lungs and heart. The inflammatory process in the peritoneum, caused by exposure to toxic substances, and its stretching by the diseased organ can also provoke the named pain.

In what cases does abdominal syndrome develop?

Abdominal pain syndrome has a rather complicated classification. Conventionally, it can be correlated with the diseases against which it manifests itself.

These can be diseases of the digestive system - hepatitis, cirrhosis of the liver, stenosis of the pylorus of the duodenum, etc.
These abdominal pains can also accompany pathologies of the chest organs - pneumonia, myocardial infarction, esophageal diverticulosis, etc.
The manifestation of abdominal syndrome was also observed in infectious or viral diseases - syphilis, herpes zoster, etc.

In a special group of pathological conditions that form the development of the described pathology, it is necessary to include diseases caused by metabolic or immune system disorders - diabetes mellitus, rheumatism and porphyria.

How pain manifests itself with various factors

Abdominal pain syndrome is also distinguished depending on the type of pain. It is this symptom that often helps specialists to make the correct diagnosis and establish the cause of the disease. This is done with the help of a thorough examination of the patient, a biochemical blood test, ultrasound results, as well as x-rays of the chest and abdominal organs.

There are spastic pains that arise and disappear suddenly, bearing the character of a pain attack. They often radiate to the back, under the shoulder blade, to the lower back or lower extremities and are accompanied by nausea, vomiting, forced positioning, etc. As a rule, they are provoked by inflammatory processes in the abdominal cavity, poisoning or disruption of the gastrointestinal tract.
If the syndrome is caused by stretching of hollow organs, then the pain becomes aching and pulling.
And with structural changes or damage to organs, peritoneal pain appears. In medicine, they are considered the most dangerous and are united by the common name "acute abdomen". Such pain appears suddenly, it is diffuse, accompanied by general malaise and severe vomiting. When you change position, move or cough - it gets worse.
occur with pneumonia, heart attack, pleurisy, etc. During such attacks, pain caused by a disease of an organ located outside the abdominal cavity is reflected in the stomach. They usually join it and against the background of which the described syndrome develops - fever (if it is an infection), or in the joints (with coronary heart disease or rheumatism), etc.
And not associated with a disease of the internal organs. They are neurotic and are most often caused by stress, shock and depression of the patient.

I would like to emphasize that any pain in the abdomen should be the reason for going to the doctor, because the abdominal syndrome, as you have seen, can be a sign of a condition that requires urgent surgery and threatens the life of the patient.

Features of the manifestation of chronic abdominal pain

The syndrome of abdominal pain can be manifested by short-lived and rapidly developing attacks, and can also be of a protracted chronic nature.

In the latter case, the pain, as a rule, increases gradually and recurs within a few weeks and even months. And it should be said that the chronic form of the syndrome is mainly formed depending on psychological factors, and not on the degree of damaging effects. That is, this pathology to some extent ceases to reflect the degree of the underlying disease and begins to develop according to its own laws.

Researchers believe that chronic abdominal syndrome is often provoked by a state of latent depression. Such patients, as a rule, complain of a combination of different localizations of pain sensations - for example, they can have a headache, back, stomach, etc. at the same time. Therefore, they often characterize their condition as follows: "My whole body hurts."

True, not all chronic abdominal pain is caused by mental disorders - they can also appear against the background of oncological diseases, joint diseases, coronary heart disease. But in this case, the syndrome has a clear limited localization.

Manifestations of abdominal syndrome that require urgent hospitalization

As mentioned earlier, acute abdominal syndrome in some cases may be a sign of serious dysfunction of some organs in the abdominal cavity or outside it. Therefore, in order not to expose yourself to possible danger when abdominal pain occurs, you should know in which cases it requires urgent medical attention.

if, along with pain, severe weakness, dizziness and a state of apathy appear;
multiple subcutaneous hematomas appear on the body;
the patient is tormented by repeated vomiting;
abdominal muscles tense;
along with pain, tachycardia occurs and blood pressure decreases;
the patient is worried about fever, the origin of which is unclear;
the volume of the abdomen increases greatly, accompanied by severe pain;
gases do not depart, and there are no peristaltic noises;
women have profuse discharge or bleeding.

Each of these signs (and even more so their combination) requires a mandatory consultation of a specialist, as it may be a manifestation of a life-threatening condition.

Abdominal pain syndrome in children

According to the development of abdominal syndrome, children represent a special risk group. This is due to the ability of the child's body to overreact to any damaging factors.

So, at an early age, the named syndrome may be provoked by excessive gas formation, causing intestinal colic in a baby. And occasionally, intussusception (a type of obstruction) of the intestine, requiring immediate hospitalization, or congenital anomalies of the abdominal organs can also act as a cause.

Abdominal syndrome in schoolchildren is most often a sign of chronic gastroduodenitis or pancreatic dysfunction. Often, the syndrome develops against the background of acute or chronic pathology of the kidneys or bladder. In adolescent girls, it can manifest itself during the formation of the menstrual cycle. By the way, in this case, the appearance of pain may be a sign of the presence of ovarian cysts.

Difficulties in diagnosing abdominal syndrome in children

Abdominal syndrome in children causes certain difficulties in diagnosing the pathology that caused the onset of pain. This is due to the fact that the child most often is not able to accurately characterize his feelings, their localization, strength and the presence of irradiation.

By the way, pediatricians say that babies quite often describe any malaise and discomfort as pain in the abdomen. Doctors encounter this description even in cases where the child is clearly experiencing dizziness, pain in the ears, head, or nausea.

Ways to deal with abdominal syndrome in children, as well as in adults, directly depend on the underlying disease that caused it, therefore, experts strongly recommend that parents do not make independent decisions and do not try to stop the pain in the baby’s abdomen without the help of a specialist with antispasmodics or painkillers drugs. The fact is that such actions can blur the picture of what is happening with the child, make even more difficult an already difficult diagnosis, and thereby cause serious consequences.

So, if your child complains of abdominal pain and other signs of abdominal syndrome, you should immediately consult a doctor. In this case, it is better to play it safe!

The manifestation of the syndrome in ARVI

Often, pediatricians also observe SARS with abdominal syndrome. In children, this is also associated with the peculiarity of the body's reaction to damaging factors.

In such cases, the usual symptoms of a viral infection - redness of the throat, runny nose, cough, weakness and fever - in a small patient may be accompanied by vomiting and abdominal pain. But these manifestations can turn out to be both a feature of the reaction of the child's body to an infection, and, for example, a sign of a chronic pathology of the abdominal organs that has worsened against the background of SARS.

Therefore, the diagnosis of "SARS with abdominal syndrome" in medical circles is considered inaccurate and streamlined. He does not give a specific explanation of what is happening in the patient's body at the moment, and a patient with manifestations of the symptoms of the mentioned syndrome requires a mandatory additional examination to exclude surgical causes of abdominal pain.

How is abdominal syndrome treated?

Due to the fact that the described condition is not a separate disease, but only a complex of symptoms, it is necessary to deal with the abdominal syndrome by eliminating, first of all, the cause that caused the disease. A significant role in this is also played by the elimination of motor disorders in the gastrointestinal tract and the normalization of pain perception in the patient.

To eliminate the discomfort that appeared against the background of problems with the gastrointestinal tract, as a rule, myotropic antispasmodics are prescribed. The most popular among them is the drug "Drotaverine", which has a high selective effect and does not have a negative effect on the nervous and cardiovascular systems. This remedy has not only an antispasmodic effect, but also helps to reduce blood viscosity, which allows it to be used not only for biliary dyskinesia, peptic ulcer of the stomach or duodenum, but also for coronary bowel disease.

No less effective are drugs related to muscarinic receptor blockers (they create conditions for muscle relaxation and relieving spasms) or selective and non-selective anticholinergics (Gastrocepin, Platifillin, Metacin, etc.).

What is abdominal ischemic syndrome

From the various abdominal pains described above in medicine, it is customary to distinguish the syndrome of abdominal chronic ischemia. It is a developing for a long time insufficiency of blood supply to various parts of the abdominal aorta as a result of:

severe cardiovascular disorders;
arteritis;
vasculitis;
anomalies in the development and compression of blood vessels;
as well as the appearance of cicatricial stenosis after injuries and operations.

Such a state is fraught with the death (necrosis) of sections of vessels or organs into which oxygen is not supplied sufficiently and decay products are not removed.

Interestingly, abdominal ischemic syndrome is most often found in men over 45 years of age. And it is manifested, as a rule, by a triad of signs - pressing, aching, often paroxysmal pain in the abdomen, intestinal dysfunction, as well as progressive weight loss.

How to deal with abdominal ischemic syndrome

The pain usually appears about half an hour to an hour after eating and can last up to four hours. Sometimes it radiates to the back or to the left side of the chest and is accompanied by flatulence, belching, nausea, vomiting, regardless of the quality of the food taken.

It can be provoked not only by food, but also by physical exertion or brisk walking, and pain is stopped at rest on its own, however, sometimes for this you need to additionally take nitroglycerin or (in case of increased intensity) analgesics.

With the diagnosis of "abdominal ischemic syndrome", treatment, as in other cases, is directed to the underlying disease. The patient is prescribed anticoagulants that improve the blood circulation process, and in the case of intestinal dysbacteriosis - means that improve its microflora.

Patients are usually recommended fractional meals in small portions with the exception of gross and in severe cases of the disease, they may be shown surgery to restore blood circulation in the abdominal branches of the aorta.

compartment syndrome

If the patient has increased intra-abdominal pressure as a result of complications caused by trauma or surgery, then this condition is diagnosed as abdominal compartment syndrome. It is quite dangerous and is also accompanied by pain in the abdomen of varying strength and localization, which depend both on the height of the patient's pain threshold and on his general condition.

By the way, there are no specific symptoms that speak of intra-abdominal hypertension, therefore, a physical method of examining the abdomen or studying the general clinical picture of the disease is not enough to make the above diagnosis. The most accurate way to determine hypertension in this case, according to experts, is to measure the pressure in the bladder, which can serve as a starting point for the appointment of urgent adequate treatment.

As already mentioned, compartment syndrome is a dangerous condition. Without special treatment, it can lead not only to serious violations of the functions of the abdominal organs, but even to death. As a rule, the most effective way to combat the mentioned abdominal syndrome is surgical intervention - the so-called decompression, as a result of which the level of intra-abdominal pressure decreases and blood circulation in the abdominal region is restored.