The child has a stomach ache: possible causes and how to provide first aid. When you need to urgently call a doctor. Video consultation. Stress and emotional stress. Causes of abdominal pain in children

A child's illness is a test not only for him, but also for his parents. Sometimes a small problem turns into a big problem. If a child for no apparent reason began to complain of pain in the legs, anxiety intensifies. The sooner the causes of the pathology are found and treatment begins, the better. Pain in the legs is sometimes the result of normal physiological processes, but sometimes signal the need for urgent medical intervention.

When a child complains of pain in the legs, it must be shown to an experienced specialist

Possible causes of pain and accompanying symptoms

Table of possible reasons why a child's legs hurt:

growing pains

One of the common factors that cause pain in the legs in children aged 3-9 years is growing pains. At rest, the discomfort disappears. Typical symptoms:

• normal body temperature;
• the absence of any changes in the skin on the arms and legs (edema, redness, etc.);
• during the day there is no pain, or they are insignificant;
• the localization of painful sensations does not change.

If the child is characterized by most of the items from this list, then he is faced with a normal physiological process. Why is this happening? The answer lies in the asynchronous development of muscles and bones. To alleviate unpleasant symptoms, you can use a warm bath or a relaxing massage. Of the medicines, if necessary, Diclofenac (ointment), Nurofen or Ibuprofen will help.

Orthopedic pathologies

The vast majority of orthopedic pathologies accompanied by pain in the legs are various types of flat feet, poor posture, dysplasia or other pathological changes in the hip joints (we recommend reading:). Localization of pain - the lower part of the leg (foot, shin), with loads, the symptoms intensify. No changes in the skin are observed.

Injuries

If the child is distinguished by mobility and a "combat" character, then this is the source of pain in the legs. Injuries, sprains, bruises - all this is the result of an overly active lifestyle. In this case, nothing needs to be done, the consequences of minor injuries go away on their own. If the damage turned out to be serious and led to lameness, contact a traumatologist - instrumental diagnosis of the causes of discomfort is necessary.

Chronic infectious processes

Most common infections:

Lack of trace elements and vitamins

For constant growth and development, the child's body needs "building materials": proteins, fats, carbohydrates, acids, vitamins and trace elements. If any substances are not enough, pathologies arise.

For example, pain in the legs for no apparent reason may be due to a lack of:

• calcium;
• magnesium;
• fluorine;
• vitamins.

Imbalance of trace elements often occurs in children aged 2-7 years. At this time, the rate of development of the child is highly dependent on nutrition. Pain caused by nutritional deficiencies occurs at night (in the form of cramps in the calf area) or when walking (pain in the foot or below the knees). Weak regeneration is also noted: even after the slightest bruise, the legs hurt for a long time, and this causes a lot of inconvenience. To fix the problem, try to adjust the diet yourself or consult a doctor.

Cardiopsychoneurosis

Dystonia - muscle spasms. There are many factors that cause pathology: heredity, stress, past diseases. Neurocirculatory dystonia is characterized by sharp spasms that hinder movement. In this case, the pain goes away on its own. Companions of the disease are disorders of the cardiovascular system: tachycardia, bradycardia. Therapy includes taking sedatives.

Congenital cardiovascular diseases

With malformations of the cardiovascular system, blood circulation is disturbed. As a result, the legs become weak. Congenital pathologies are detected in the first year of a baby's life, but if doctors have not found any violations, then they can be identified independently by the following signs:

• from a very early age, the legs hurt in the morning and at night;
• at rest, the pain disappears, but when walking it appears again;
• Heart rate and respiratory rate are outside the normal range (we recommend reading:);
• the pulse in the legs is weakly palpable;
• painful sensations cover the legs below the knee and feet.

stress

Stress is a person's companion throughout life. It is more difficult for children to cope with it than for adults, so psychosomatic diseases arise. At 3-4 years old, stress is caused by adaptation to the outside world. At the age of 5-6, school years begin, and the baby has to join a new team. Help your child during this time. Listen when he complains. Try to find out about his experiences in time and deal with them together.

Other reasons

The described list of causes of pain is not exhaustive. Any disease affects many internal organs and can affect the condition of the joints. Disruptions in the production of hormones also lead to pain in various parts of the body.

The most common cause of malaise in children is discomfort in the abdomen. They occur at any age and can be caused by various factors, so only a qualified pediatrician can accurately determine the nature of the pain.

Why does my stomach hurt

Before trying to determine the cause of pain, it is necessary to find out how intense they are, where they are localized. With severe pain, babies, as a rule, prefer to lie down, taking not very comfortable positions. They turn and stand up, while the children are very careful, slowly. The symptom may be acute (dagger pain), dull aching or stabbing.

It is important to determine the cause of pain to track where their epicenter is located. So, the left side of the peritoneum may indicate intestinal obstruction / inflammation. In addition, the pancreas is located on the left, which is also capable of giving unpleasant symptoms. With pain on the right, this can also indicate problems with the intestines, but if the symptom is localized in this area, in addition, pathologies of the liver and gallbladder or tracts are possible (for example, dyskinesia, cholecystitis, etc.)

If the child has a fever and a stomach ache, then an intestinal infection or appendicitis is likely. In any case, if such signs occur, parents should immediately call a doctor who can determine the cause of the baby's ailment. If, in addition to the main symptoms, there is blood in the child’s stool or vomit, this is a good reason to urgently call an ambulance.

In the navel

The main causes of pain in the navel are overeating or incomplete / untimely bowel movements. The treatment in this case is simple: it is necessary to reduce the amount of food given to the child, stop snacking between main meals, and remove fatty foods from the diet. If after that the baby still has pain around the navel, give him an enema (even if he often empties his intestines) - this will help to alleviate the patient's condition. An alternative option is to give your son or daughter mild laxatives.

Other diseases sometimes indicated by pain below the navel are:

• intestinal hernia (it is provoked by constipation, diarrhea, dysbacteriosis, malfunctions of the digestive process);
• umbilical hernia (occurs in babies who often cry and thereby strain the tummy);
• intervertebral hernia (sometimes pinched nerves in the spine are given by soreness in the lower abdominal cavity);
• appendicitis (this is possible if the child complains that he has pain in the lower abdomen, which is accompanied by fever);
• gastroduodenitis (with prolonged pain below the navel, inflammation of the gastric mucosa can be assumed, the symptom often manifests itself after eating).

Cramping pains

If, against the background of a normal state of health, a child has bouts of abdominal pain, this may indicate intestinal intussusception (the introduction of one area of ​​\u200b\u200bthe intestine into another due to a violation of the peristalsis of the organ). Sometimes attacks are accompanied by vomiting, an increase in body temperature, while at the beginning of the disease the stool may not differ from normal. Acute cramping pains in the abdomen in children under 12 months of age are expressed by causeless crying / screaming, constant anxiety, poor sleep, tucking the legs to the chest.

With intussusception, the seizures subside as abruptly as they appear: the children calm down, they begin to eat and play normally again. The frequency of pain syndrome is the main symptom of this disease. In the course of the development of pathology, attacks become more frequent, becoming longer, pronounced. As a rule, the disease affects children 6-12 months old, the cause of which is the incorrect introduction of complementary foods containing fruit / vegetable components.

Vomiting and diarrhea in a child

If these symptoms are not accompanied by a temperature, then there can be a huge number of causes that caused them. When a baby has a stomach ache and diarrhea, this does not necessarily indicate the presence of any pathology (only a doctor can accurately diagnose). The most common cause of loose stools and nausea is Escherichia coli, which more often manifests itself in the summer season. The reason for this is insufficient hand hygiene or the consumption of dirty fruits.

In addition to diarrhea and vomiting, the child sometimes has a fever, dehydration of the body begins, an admixture of blood or mucus is sometimes observed in the feces, and the general condition will be lethargic. When infected with Escherichia coli, each meal ends with a bowel movement. The cause of these symptoms can be poisoning with stale food, poisons or medicines (antibiotics). In this case, the symptoms appear within a couple of hours after the toxins enter the body.

Sharp pain

As a rule, colic or cramps in the stomach in children occur due to intestinal obstruction. The first pathology often occurs in children 6-12 months old and is accompanied by nausea / vomiting, the second, as a rule, is diagnosed in infants under one year old. If 2 hours after the appearance of pain, the child's condition has not improved and the tummy continues to hurt, the baby should be taken to the doctor for examination.

In the morning

If a child complains of abdominal pain that occurs in the morning, there may be several reasons for this. The most common among them are:

• allergy;
• intestinal infection;
• upset stomach;
• appendicitis;
• helminthic invasion.

Sometimes children have a stomach ache in the morning due to nervousness associated with unwillingness to attend kindergarten / school. The reasons for this are problems with teachers, peers, so parents should talk with the child and try to find out the causes, intensity, localization of pain. If it is very strong, while the baby lying down takes unnatural positions, slowly, carefully rises and turns over, you need to show it to the pediatrician. In some cases, these signs indicate appendicitis or peritonitis.

Persistent abdominal pain

The reasons that the baby often has a stomach ache can be both serious pathologies and mild violations of the digestive process. The most common factors that cause a symptom are:

In small children, the stomach often hurts, while the symptom quickly disappears on its own, without bringing serious consequences. Even an unwashed apple can cause pain. However, if a child has a fever and a stomach ache, this indicates the presence of a chronic or acute illness. At the same time, children's activity decreases, constipation or diarrhea begins, vomiting, nausea, weakness occurs, the skin turns pale. With such symptoms, parents, as a rule, go to the doctor, they are typical for:

• appendicitis;
• pneumococcal or streptococcal peritonitis (inflammation of the abdominal mucosa);
• acute diverticulitis (protrusion of the wall of the large intestine due to abnormal development of the organ);
• acute cholecystitis (inflammation of the gallbladder, in which the abdomen hurts in the right upper quadrant);
• acute pancreatitis (inflammation of the pancreas, which is characterized by girdle pain and a slight fever);
• intestinal infection (severe diarrhea or constipation begins, the stomach hurts without ceasing, the temperature rises);
• various infectious diseases such as acute respiratory infections, tonsillitis, measles, whooping cough (with mesadenitis, the abdominal lymph nodes become inflamed and the tummy starts to hurt).

When walking

After excessive physical education, with vomiting, coughing, sometimes there is a stretching of the abdominal muscles, as a result of which there is pain in the abdomen when walking and running. In this case, the child's appetite remains normal and general well-being does not deviate from the norm. If the stomach starts to hurt after eating fatty / fried foods, the doctor suggests dysfunction of the biliary tract, in which children complain of pain in the right hypochondrium, which manifests itself while running or walking.

At night

If in the evening abdominal pain begins in a child, many pathologies can be assumed. Along with diseases of the digestive tract, pain syndrome can cause such factors:

It is not uncommon for a child to have a stomach ache at night in adolescence and preschool age due to neuroses that arise due to difficult relationships with peers. Conflicts with classmates or teachers serve as a strong stress factor of a neurotic nature, which provokes serious consequences such as acute pain at night or in the early morning (before the start of the school day).

After meal

In children, such pains sometimes indicate the presence of an infection or inflammatory processes in the digestive tract. In addition, the characteristic symptoms for this is a complete lack of appetite, a state of anxiety. If a child has a stomach ache after eating, it is necessary to show it to the doctor, since the disease itself will not go away. With an acute abdomen, this should be done immediately (the symptom is manifested by a constant, severe pain syndrome). This symptom is typical for appendicitis, pancreatitis, cholecystitis, and other dangerous pathologies.

Newborn

In infants, such phenomena are not uncommon and, as a rule, there is no reason to panic. If a newborn has a tummy ache, he tightens his legs and cries loudly. Often, babies are particularly uncomfortable with gases that are formed from breast milk carbohydrates (especially a lot of them in the initial portions). During breastfeeding, mothers need to be especially careful when compiling their menu in order to prevent the development of colic or food allergies in the child. In addition, a woman must:

• reduce to a minimum the consumption of sweets, potatoes, pasta;
• give up coffee, chocolate, hot spices, cocoa;
• fill the menu with fresh fruits, herbs, while citrus fruits should be consumed to a minimum;
• carefully you should eat all red berries, vegetables, fruits;
• it is better to refuse for a while from beans, eggplants, bread, sauerkraut, grapes, sausages.

What to do if your stomach hurts

As a rule, parents are able to eliminate the pain syndrome on their own, but this is acceptable only in cases where the symptom is not accompanied by fever or incessant vomiting. Often, the child's tummy hurts with increased gas formation and the symptom disappears within a couple of hours after going to the toilet. At the same time, there is no need to call a doctor, you just need to feed the baby with liquid food and reassure.

What to do with abdominal pain to alleviate the condition of the child? It is impossible to give any pills to the baby without doctor's prescriptions. It is better to give a boy or girl an enema (this does not apply to babies - they should not perform the procedure without the permission of a doctor). If constipation has become the cause of the pain syndrome, supplement the child's menu with raw vegetables, apricots, and apples.

If you have diarrhea, give your baby more fluids in small amounts and often. Neurotic pains are perfectly removed with infusion of motherwort and valerian. In addition, the child before going to bed should be given a glass of warm milk with honey. To neutralize stress, walk with your baby in the fresh air more often, give him a contrast shower, reduce the time for watching TV, and forbid playing on the computer before bedtime.

What to give a child with stomach pain

The medicine for abdominal pain for children should definitely be in the first-aid kit of parents. Treatment of colic and bloating involves taking light medications for the baby. Their use must be agreed with the doctor. What helps with stomach pain:

• Disflatil;
• Espumizan;
• Festal;
• Enterosgel;
• Mezim;
• Laktovit;
• Linex;
• Activated carbon;
• No-shpa;
• Furazolidone.

First aid

If a child has a stomach ache against the background of impaired digestion, parents need to carefully monitor the diet of their child: exclude all gas-producing foods (milk, pickles, beans, bread, kvass, mushrooms) from the menu, supplement it with fiber. What to do with the onset of an acute abdomen? First aid for pain in the stomach is to call an ambulance. Only a doctor is able to determine the cause of acute pain and choose the appropriate treatment. Until the ambulance arrives, it is only allowed to apply an ice pack to the baby's stomach to alleviate his condition.

What can you eat when your stomach hurts

Each pathology provides for a specific diet, which is selected by the gastroenterologist. If the cause of pain in a child was a digestive disorder or mild poisoning, it is not necessary to contact a specialist. What can you eat when your stomach hurts:

• vegetable soups;
• liquid cereals (semolina, oatmeal, rice, buckwheat);
• boiled, steam vegetables, except cabbage;
• some crackers;
• lean fish;
• scrambled eggs, boiled soft-boiled eggs;
• lean meat (a week after poisoning);
• herbal decoctions, teas;
• honey, jelly;
• baked fruit.

Video

Children are family members, for whom you always worry more than for yourself. That is why, when your child begins to complain of discomfort in the abdomen, we wake up with serious anxiety and fear for his health. In this material, we will tell you why a child has a stomach ache, how to get rid of pain, and whether it is worth resorting to self-treatment.

You need to understand that the “belly” is a rather extensive area. This word can refer to the entire part of the body extending from:

• lower chest;
• to the human groin.

Unfortunately, the problem of pain in the abdomen in children occurs quite often, since their body is not yet a well-formed stable system, but is just beginning to develop. As a result, external influences, as well as internal factors that do not have a great impact on an adult, can cause serious harm to a child.

The reasons for the occurrence of pain in the abdomen in children may vary, and be:

• insignificant, easily eliminated on their own;
• serious, requiring medical attention.

Parents without fail need to be attentive to the child's complaints of pain, since sometimes the cause of their occurrence turns out to be much more dangerous than you originally thought.

What is abdominal pain

Pain in the abdomen in a child can be accompanied by completely different manifestations, however, most often it has the following characteristics:

• widespread distribution;
• point localization;
• colicky sensations;
• spastic manifestations.

The duration of pain in the abdomen may also vary, coinciding with the same parameter for the disease that caused it:

• they can be chronic (long-lasting pain syndrome);
• and can be acute (momentary pain, often occurring unexpectedly).

It is important to understand that if acute pain suddenly subsided, or completely disappeared, this does not mean that the same thing happened with the disease. Perhaps acute processes have become chronic, and continue to negatively affect your body, undermining your health.

According to its duration, abdominal pain is divided into:

• acute;
• chronic.

Luckily, most stomach pains go away quickly and don't have a serious cause. But it must be remembered that some diseases with similar pain are life-threatening.

• diseases that bother him;
• type of painful manifestations;
• reaction to pain.

So, for example, recently born babies, crying and worrying, most often signal colic in the tummy, the cause of which could be:

• nipple feeding and air swallowing;
• mother eating unsuitable foods, and after breastfeeding, etc.

However, unfortunately, babies react to internal stimuli in the same way due to age. The only signal they have is to cry. He cannot become even louder and more desperate even if the baby experiences more serious pain.

But the pain in the abdomen of a child whose age is, for example, 6 years old, will no longer need to be guessed, since at this age the baby is already independent enough to talk about what worries him. At the same time, he also develops resistance to painful sensations. Now he can tolerate them.

Video - The child has a stomachache

Why does a child have a stomach ache: types of sensations and their causes

Consider the most common causes of abdominal pain in children.

Colic

This problem is typical primarily for newborns and children of slightly older age. Moreover, abdominal colic is a classic picture of “malfunctions” with health in the first life periods of a child.

At the same time, this uncomfortable sensation may occur in a baby who eats:

• mixtures;
• breast milk;
• "adult" food.

At its core, colic is flatulence - an accumulation of gases in the intestines resulting from a combination of various circumstances, for example:

• when a mother feeds or bottles a baby, air can enter his digestive system, which subsequently leads to flatulence;
• a breastfeeding mother may incorrectly make up a diet and use a product that will subsequently affect the baby’s digestive system, provoking all the same gas formation, and with it bloating, colic, etc .;
• overfeeding with the so-called "forward" mother's milk, rich in a large amount of carbohydrates, while the "hind" milk does not flow to the baby due to various reasons;
• a sharp transfer of the baby from one mixture for feeding to another, which gave a negative reaction;
• transfer of a baby from breastfeeding to a mixture;
• incorrect position of the baby when feeding;
• other reasons related to food.

At the same time, colic can be justified not only by the above non-serious external factors, but also by diseases of various body systems of the baby:

• thus, the imperfection of the nervous system can lead to the occurrence of spastic phenomena of a nervous nature in the intestines;
• infectious diseases caused by a pathogen that has entered the body from the outside can also lead to colic, but will not be limited to this, and will lead to more dangerous consequences;
• another common cause is an allergy to a formula for feeding that is incorrectly selected and not suitable for your child;
• disorders associated with the production of digestive enzymes, as a result of which food is not digested to the end;
• predisposition to flatulence due to irritable bowel syndrome, etc.

Colic is a debilitating phenomenon that occurs with equal frequency at night and daytime, exhausting not only the children themselves, but also their parents. To identify the specific cause of this discomfort, it is best to consult a doctor.

Symptoms of colic that parents can track are as follows:

• the baby cries for a long time, on average from one to four hours;
• the child's face is red;
• legs are drawn to the body;
• the limbs of the child have a cool temperature;
• palms are gathered into fists.

Pain while traveling

It often happens that a child complains of abdominal pain during trips somewhere, while this discomfort may well be accompanied by nausea, and even vomiting.

Despite the fact that many parents do not always guess the relationship between the offspring's poor health and movement in transport, it is. The condition of the child in this case can be described by the familiar term "seasickness".

The fact is that motion sickness leads to the consequences listed above in almost 60% of cases among children. At the same time, such a reaction occurs not only in maritime transport, but also:

• in airplane;
• car;
• train
• bus, etc.

It's all about the intensity of the sway that the child feels. The receptors of the vestibular apparatus react to them, and as a result they cause:

• dizziness;
• feeling of instability;
• nausea;
• stomach ache;
• vomiting.

As a rule, the sensitivity of a child to transport increases with age, however, many people suffer from it for the rest of their lives. Methods of dealing in this case with the disease, and specifically abdominal pain, will be as follows:

• frequent stops during the trip so that the child can breathe;
• drinking water in small sips;
• mint gum sometimes helps with nausea, but it does not eliminate the pain in the abdomen.

Bacterial dysentery

Bacterial dysentery or shigellosis is a dangerous disease caused by a bacterium representative of the genus Shigella. For children, the desired pathology can be fatal, so you, as a parent, should take a closer look at the following symptoms:

• abdominal pain in the offspring, which he will either tell you himself, or will cry and scream, pointing to the stomach, while the discomfort will either increase or decrease;
• simultaneously with pain in the abdomen, a dyspeptic disorder occurs, consisting in a pathological increase in the frequency of stools, which will not necessarily be liquid;
• there is blood or mucus in the stool;
• the stool may stop flowing altogether, however, blood will continue to be released from the intestine through the anus, and with it mucus.

• nausea;
• vomit;
• loose stools, etc.

Infection with pathogens of dysentery occurs as follows:

• the child comes into contact with an already ill person;
• the baby drinks water contaminated with bacteria;
• the offspring eats food in which shigella develops for one reason or another.

Only a doctor can treat dysentery, since in each case an individual approach is necessary. However, the most commonly used treatment regimen is:

• soldering with water, or a specialized solution (for example, rehydron);
• use of antibiotics;
• drinking sweet tea;
• therapeutic diet, served in a hospital, under numbers 4, 2;
• in severe cases of the disease, bed rest is recommended;
• with a mild form, it is necessary to do physiotherapy exercises.

We want to reassure mothers of young children: contrary to popular belief, babies recover from dysentery much easier than older children, in addition, they also tolerate this pathology more stably and get sick less often.

To avoid this disease, it is necessary to follow preventive measures, for example:

• wash hands before eating;
• wash hands after using the toilet;
• feed the child with food cooked at the proper temperature, or well-washed foods;
• when breastfeeding, clean the nipple and surrounding areas, etc.

Infectious diseases of viral etiology

When we talk about abdominal pain in children, it is necessary to remember one of the most common causes of its occurrence - a viral type infection. The most common infection in children is rotavirus. It is she who causes terrible pain in the abdomen, accompanied by many other unpleasant symptoms.

Rotaviruses enter the child's body through the fecal-oral route. In other words, the release of the virus occurs with the feces of an infected person, who transfers them to the external environment by touching various objects:

• cell phones;
• of money;
• door handles;
• toothbrushes;
• table surfaces;
• even food.

This is due to insufficient observance of elementary hygiene rules. If you are sick and not in the habit of washing your hands after going to the toilet, there is a high chance of infecting people living with you.

In order for a healthy adult, and even more so a child, to become ill with a rotavirus infection, just two units of measurement of the virus are enough.

If one member of a large family is infected, it is almost impossible to prevent the rest of its members from getting sick, despite the observance of all precautions.

At the same time, not only relatives and friends of the patient fall into the risk group, but also:

• visitors to public eating places (if the patient is an employee of such a place);
• buyers, if sellers selling absolutely any product are sick;
• students whose teacher, while checking notebooks, left viruses on each of them.

That is why infection can be completely unexpected for you. As for the incubation period necessary for the virus to induce the first symptoms of the disease, it is only two days. As soon as this time comes to an end, the disease will become stronger, and will manifest itself as a sharp pain in the abdomen, especially painful for young children.

The onset of an infectious disease implies the onset of symptoms characteristic of a cold:

• cough;
• temperature rise;
• snot, etc.

Rotavirus leads to serious intoxication of the body - a serious condition in which it is, as it were, poisoned. The disease is accompanied by extensive symptoms, which are shown in the following table.

Table 1. Symptoms of rotavirus

The cause of symptoms that are taken for signs of an intestinal disorder may not be poisoning, but rotavirus. How to distinguish one from the other? We will talk about this in

Abdominal tuberculosis

Abdominal tuberculosis refers to the defeat of:

• segments of the digestive system;
• lymph nodes;
• peritoneum (thin layer covering the organs of the abdominal cavity);
• spaces behind the peritoneum.

Very often, this disease is detected in the later stages of development, as it mimics other diseases of the gastrointestinal tract.

Symptoms of this disease will be as follows:

• weight loss due to disruption of digestive processes and absorption of nutrients;
• stomach ache;
• weakness;
• temperature caused by intoxication;
• lethargy;
• pain in the head;
• Bad mood;
• night sweats;
• insomnia;
• loss of appetite (sometimes complete);
• pain in the area of ​​the heart muscle;
• pulse disorders;
• intestinal obstruction;
• drop in blood pressure in the arteries, etc.

With abdominal tuberculosis, the child begins to experience severe pain in the abdomen, as well as to feel its increase, which is not always noticeable from the outside.

The disease is often transmitted after close contact with a sick person.

Constipation

Constipation itself is not a disease, however, it is he who most often causes pain in the abdomen, caused, as you can already understand, by stagnation of feces in the intestines.

Constipation is the accumulation of feces inside the intestines, for some reason not having the opportunity to pass naturally

The causes of constipation may be as follows:

• the prevalence in the daily menu of products of animal origin, saturated with fats, to the detriment of vegetable coarse fiber;
• a sedentary lifestyle, for example, if a child prefers a computer to active games;
• peptic ulcer of the intestine;
• cancerous processes in the gastrointestinal tract;
• mechanical damage to the intestines;
• adhesions;
• diseases of a neurological type;
• disruption of the endocrine system;
• taking various medicines.

All of the above reasons are relevant for children as well as for adults. In the presence of any of them, bouts of constipation will occur frequently. Due to the fact that hardened feces from the inside will damage the intestines, the child will feel pain. In addition, hardened feces provoke increased gas formation, and inflammatory processes at the site of prolonged contact with the intestines, thereby increasing the pain syndrome.

Symptoms in this case will be as follows:

• the child will point to his stomach, or say that he has pain in the navel;
• abdominal pain will be serious, most likely, it will cause a serious tantrum in the baby;
• the child will not be able to go to the toilet;
• the stool that will come out of the intestine will be characterized by high density and hardness;
• a visit to the toilet may take place once every few days, or not take place at all;
• the baby's stomach will be swollen due to the formation of a large amount of gas in the intestines.

Dairy intolerance

Another common cause of pain in the abdomen is intolerance to dairy products. In other words, the child's body has a special attitude to the products of this category, or rather to the lactose contained in them.

This condition occurs when the child's body does not produce the enzymes needed to process milk sugar (lactose). Or, it produces them in small quantities.

In addition, allergic reactions to milk proteins may also develop. This is typical for children with allergies, whose parents also show a sensitive reaction to various foods, smells, etc.

Symptoms of intolerance and allergy to dairy products are as follows:

• abdominal pain;
• bloating;
• flatulence;
• colic in the intestines;
• distribution of pain throughout the abdomen.

Peptic ulcer and gastritis

Peptic ulcer and gastritis are diseases that are very similar to each other. Most often, they cause abdominal pain in children and adults, contrary to popular belief that children do not suffer from this disease.

Gastritis is a deformation of the mucous walls of the stomach and their inflammation, while peptic ulcer is actually the same, only with its development, the walls of the intestine and stomach cover wounds that bleed and gradually become deeper, up to the organ.

Children who already know how to express themselves talk about the pain of a peptic ulcer or gastritis, as an unpleasant burning sensation, corroding the flesh. In some cases, it is so strong that urgent anesthesia is required.

Most often, with these diseases, pain is felt in:

• left side of the abdomen;
• in the region of the stomach;
• at the chest.

The diseases sought will be accompanied by:

• weight loss
• pain associated with eating (with peptic ulcer it will hurt in between meals, with gastritis while eating);
• vomiting;
• frequent nausea;
• constipation;
• diarrhea
• weight loss
• there is fear, etc.

Helminths

The colonization of helminths is another reason why children of different ages can have stomach ache. Malicious organisms get inside our body, as a rule, as follows:

• in case of non-compliance with food hygiene;
• when personal hygiene is not observed.

Getting inside the gastrointestinal tract, helminths can also move to other organs, developing there, and emitting waste products that are harmful to us, actually acting like a poison. As a result, not only the manifestation of unpleasant symptoms occurs, but also the destruction of the walls of the organs in which the worms live, which causes irreparable damage to our body.

In addition, helminths provoke:

• spastic phenomena in the intestine;
• diarrhea;
• gas formation;
• flatulence, etc.

You can fight these symptoms only by destroying the worms. For this, the attending physician (and only he, self-medication is not effective) prescribes:

• enterosorbents;
• anthelmintics;
• antihistamines;
• diet
• plentiful drink.

We will tell you which modern antihelminthic drugs for children are most effective, and what are the principles for their use.

Appendicitis

Appendicitis is an inflammatory process that has taken possession of the process of our intestines, which looks like a worm. It's called the appendix. In a healthy state, it looks like a small oblong tube of the following sizes:

• diameter from 7 to 10 millimeters;
• up to 150 mm long.

The branch of this organ comes from the caecum, it is a dead end. In fact, to date, the real function of the appendix has not been clarified. After its removal, people still lead a quality life that is no different from the previous one, according to at least, externally.

With inflammation of this process, a person feels severe pain. The child cannot bear them long time therefore urgent hospitalization is required. Simultaneously with abdominal pain:

• the temperature rises;
• sweating increases;
• vomiting opens;
• sometimes loose stools occur;
• pain from the center of the abdomen radiates down;
• palpation is extremely painful.

Menstruation

The occurrence of this cause will be typical for teenage girls. When they first encounter their period, which can be very painful, they experience fear and terrible discomfort. The task of the mother or father (if there is no mother in the family), as well as another parent, is to explain to the child the physiological nature of this process, and to establish the moral side of the issue.

As for pain, during menstruation, it occurs due to the fact that every month inside the woman's body occurs:

• egg maturation;
• preparation of the inner surface of the uterus for the attachment of the fetal egg.

When pregnancy does not occur, the body has to renew this layer, in fact, removing it, rejecting the cells. That is why there is irritation and pain characteristic of menstruation. Its manifestation will be individual, but many girls even find it difficult to do ordinary things in "these days."

In addition, the uterus irritates the intestines located next to it, leading to:

• swelling;
• flatulence;
• frequent bowel movements.

For this condition, these manifestations are absolutely normal, however, terribly unpleasant.

An antispasmodic tablet will help soothe the irritated organ. To also reduce the general irritability of the girl, also characteristic of this time, you can brew her tea with herbs such as:

• motherwort;
• hop;
• valerian, etc.

Summing up

Pain in the abdomen is always a test for a child. Adults get used to enduring pain in their lifetime, so they treat it easier than a small person who has not yet mastered this valuable skill. In addition, an adult understands exactly what hurts, and can thus explain to another adult about this and get help. However, at the same time, the child sometimes still does not know how to speak, how, in fact, to gesticulate, so it becomes unrealistically difficult to guess the true cause of his condition.

In this article, we do not suggest that you familiarize yourself with the “treatment” section, it is simply not included in the material presented. And there is a reason for this: the pathological conditions described above are far from all the reasons why a child can feel pain in the abdomen. In addition, even those listed here require an individual approach to treatment, which should be charted by a specialist in the field of medicine, and not necessarily a gastroenterologist.

It is dangerous to self-treat a baby without a medical education, since taking even one medicine can worsen his condition, and, depending on the age and severity of the disease, even lead to death.

Smirnova Olga Leonidovna

Neurologist, education: First Moscow State Medical University named after I.M. Sechenov. Work experience 20 years.

Articles written

Children's health is a priority for all adults. And if a child has a headache, then some parents panic, and some simply do not pay attention to it. And both sides are wrong: headaches in children can be very different, but even in a serious situation, panic is not needed, as well as indifference. Healthy children also complain about them. And it will not be superfluous to show them to the doctor, especially if the baby has a constant headache.

Sources of headaches in children can be very different. A conscious complaint of pain in the head may be in a child of 5-6 years old, but not earlier. After all, it is from the age of five that they can describe their feelings. In children up to a year old and a little older, pain syndrome can be detected by a number of signs.

Interesting! Headache in preschool children occurs in almost 4-7%, and in adolescence - already in 60-80%.

Almost all structural components of the human head from the venous sinus to large vessels are equipped with pain receptors, which can provoke pain by reacting with certain substances. People of all ages may experience what doctors call headaches. It doesn’t matter who is faced with cephalalgia: a baby of three or four years old or an elderly person is always unpleasant, and sometimes dangerous. And all because a headache in children or adults is not a specific sign of some kind of pathology, but a symptom of many diseases.

Cephalgia is usually divided into 2 main types:

Primary when the child has only a headache, and there are no other accompanying symptoms. This suggests that cephalalgia is not caused by a virus, bacterium or other pathogenic flora. Its varieties are:

• migraine;
• bunch pains;
• from .

Secondary when this is not the main symptom, but a concomitant of some kind of disease or pathology. Often, secondary cephalgia occurs during infection, an increase in temperature. There are more than 300 officially registered reasons why a child has a severe headache, but the most common of them are:

• post-traumatic condition;
• the influence of external factors that provoke a special condition - from the onset of an allergy to a reaction to the weather;
• inflammatory process such as sinusitis;
• overdose of drugs for headaches.

Reason: migraine

Migraine most often occurs in a child 10 years of age and older, sometimes lowering the age threshold is possible, and most often in cases where parents suffer from such pain. Migraine occurs due to a sharp narrowing and / or expansion of cerebral vessels. At the same time, the child complains of a headache in only one part of the head, calling it. In addition, the baby may feel sick and vomit, he will react negatively to light and noise.

Important! A migraine attack in children can last from 4 hours to three days.

To provoke a migraine attack in a child of 3-16 years old can:

• strong emotional experience;
• hunger;
• abuse of certain foods that provoke pain (chocolate, canned food, nuts, cheese, etc.);
• very cold water;
• alcohol and smoking;
• phase of the menstrual cycle for girls;
• sleep mode failure;
• a long trip in one transport or spending a lot of time at the computer;
• diseases of a general type.

Reason: stress

More than 90% of headaches are a reaction of the baby's body to prolonged or severe stress. Such a headache in a child is the result of mental overstrain, which provoked a spasm of the muscles of the head and its vessels. Usually such an attack lasts from several minutes to several days, but not more than a week.

At the same time, not only the frontal part hurts, the pain encircles the entire head of the child, like a helmet. Feels tight and tight. All this does not affect the normal activity of the baby, but school performance can seriously decrease. The peak of the attack may be accompanied by nausea and lack of appetite, a negative attitude towards light and noise.

Interesting! To the main reasons for such pain, doctors began to attribute chronic inflammatory processes in the meninges, which provoked streptococcus. As evidenced by notes in medical journals.

Causes of bundle pain

Interesting! Bundle pains are more common in boys than in girls.

Acute and chronicforms

Often, parents, figuring out the problem, completely forget to determine whether this pain is acute or chronic. And in vain, because this is what can give the main clue to identify the reason why the child has a headache.

Causes of acute headache

Headaches in children 3-10 years of age and older are often acute and paroxysmal. And there are many reasons for this:

Infections of the intracranial type, which can provoke:

• specific childhood infections like measles or rubella;
• common infectious diseases from tonsillitis to malaria;
• inflammation in the ear, teeth or paranasal sinuses;
• salmonellosis or cholera;
• purulent foci in the brain;
• encephalitis;

1. When a part of the head was injured or it was all, as well as with a bruise of the brain.
2. Mental overstrain or diseases such as neurosis, depression.
3. Vascular problems extracranial (high blood pressure or kidney disease) and intracranial (primary migraine or vascular anomaly).
4. Hemorrhage in the brain or its membrane.
5. An increase in intracranial pressure due to a tumor or, then the child has a headache in the frontal part.
6. Reaction to prescription or withdrawal of caffeine-, amphetamine- or vasoconstrictor-based medications.
7. Reaction to inhalation of toxic chemicals such as nitrates, lead fumes, dichlorvos, etc.

Often for acute pain in a child of 8 years or another age, there may be an atypical cause:

• performing a lumbar puncture;
• excess physical activity;
• problems with visual function, including glaucoma;
• inflammatory processes in the nerves located inside the skull.

Causes of Chronic Headache in Children

Frequent headaches in children often become chronic. They can last for weeks or even months. In the forehead area, a child may get sick due to migraine, bundle or tension pain, which means that all their causes can be considered causes of chronic pain.

But if the child has no reasons related to the state of health, then you should pay attention to:

• his cap, headband or goggles, which may be tight and cause pain if used for a long time. This is true for children who are 5 years old or younger, because they rarely pay attention to such things;
• cold and its effect on the baby, because even a child of 8 years old can have such a reaction not only to a long stay in the cold, but also to cold food and, especially, to ice cream. The effect of cold on children of the first year of life is very dangerous.

Symptoms and diagnosis

So, in a child of 7 years old, the doctor can ask about his pain, because at this age it will not be a problem for him to describe it. But to make a diagnosis, a 4-year-old baby will need careful testimony from the parents. In order for the diagnosis to be complete, many questions will need to be answered. Not only about how the baby reacted to pain, but also about the duration and frequency of attacks. Sometimes children, even at the age of 12, cannot remember if they feel sick during an attack, but for a doctor this is very important.

Therefore, you need to be ready to give such answers. Often, 7-year-old children suffer from a school load that is new to them, and the doctor will need information not only about the duration of classes, but also a complete list of them.

Important! A headache in the forehead, which happened for the first time and is acute, with increasing intensity, is a reason to urgently take the child to the hospital, because it is often the result of a dangerous disease that can lead to death.

It doesn’t matter if your child is 11 years old or a year old, but if there is at least one of the following dangerous symptoms, then a doctor’s call is mandatory:

• sharp and very severe pain in the head;
• her character is unusual;
• pain is affected by a change in the position of the head;
• if she fell ill in the morning after a night's sleep;
• there was a sharp change in the nature and frequency of seizures;
• it is difficult for the child to remain conscious, it becomes confused;
• Before that, the kid hit his head.

If a child of 7 years old can learn about his pain, then from small children you will not get a clear description. Parents of infants can identify the problem by the following symptoms:

• a state of extreme excitement;
• incessant crying;
• sleep is disturbed;
• vomiting fountain;
• repeated and profuse regurgitation;
• a large fontanel stands out above the general level of the skull.

Babies of the third year of life will already be able to show where the discomfort is and talk about it. At seven years old, most often the problem is closely related to the common cold and other colds. Children 9 years of age and older may suffer from ill-fitting glasses or lenses.

Emergency help

No matter how old your child is - six, eight or three, he will need first aid for a headache. Depending on the situation, it may include:

1. Providing the child with a comfortable rest in a quiet and peaceful environment, preferably in bed. And make sure he sleeps.
2. Applying a cool wet washcloth to the head.
3. Removing nervousness with a dose of lemongrass and eleutherococcus.
4. Raising the tone with warm tea with lemon.
5. Taking a decoction of soothing herbs, such as motherwort and valerian.
6. Exclusion from the child's diet of all foods that provoke migraine attacks.
7. Taking medication.

The last point should be carried out only when all the previous ones have failed. It is important to remember that only a small part of adult drugs are approved for children, and only for older people. In other cases, such attacks are treated with special children's drugs, which were prescribed by a doctor, and not advised by a pharmacist in a pharmacy.

Important! Without a doctor's prescription, you can treat headaches in children with Ibuprofen and Nurofen . Do not exceed the dose indicated in the instructions for them, which is strictly tied to the weight and age of the child.

Prevention

Prevention is always easier than cure. Therefore, it is useful to take the following preventive measures into service:

• regular and proper nutrition;
• strict sleep schedule;
• often walk in the fresh air;
• sleep only in well-ventilated rooms;
• monitor a favorable psychological climate in the family;
• often communicate with the baby;
• exercise or engage in other beneficial physical activity.

Some children have occasional abdominal pain. What is causing the discomfort? Overeating, intestinal gas, constipation, intolerance to certain foods, intestinal infections, food poisoning, urinary tract infections, appendicitis - this is not a complete list of possible causes. In some cases, abdominal pain does not have a clearly defined physiological cause.

As a rule, abdominal pain disappears after two to three hours. In some cases, however, pain may persist for much longer.

In what cases should you contact your doctor? If your child is in severe pain, contact your pediatrician immediately. Also look out for the following symptoms:

• pain continues in the child for more than two hours;
• pains are cramping in nature and last more than 12 hours;
• abdominal pain occurs regularly in a child;
• the child has vomiting with blood or bile;
• heat;
• blood in stools.

In all these cases, you should contact your pediatrician immediately.

If your child has abdominal pain, have him lie down for 10-15 minutes. After a short rest, he will surely feel better. Sometimes a warm heating pad helps to relieve unpleasant symptoms. Give your child plenty of fluids, avoid coarse, hard foods. Laxatives or enemas can only be prescribed to the child by the attending physician.

Abdominal pain can be indicated by the child himself or pain can be inferred from gestures, facial expressions and verbal expressions, as well as, for example, with pronounced anxiety, screaming, pulling up the legs, bending the torso, sensitivity of the abdomen to touch. The younger the child, the less specific the manifestations and localization of pain.

Causes of pain in a child

Acute abdominal pain:

• inflammatory causes:
  • gastroenteritis;
  • appendicitis;
  • mesenteric lymphadenitis;
  • peritonitis;
  • hepatitis;
  • pancreatitis;
• mechanical reasons:
  • invagination, inversion;
  • strangulated hernia;
  • adhesive intestinal obstruction (mechanical intestinal obstruction due to the formation of connective tissue adhesions);
• acute constipation;
• urinary tract infections, kidney stones;
• adnexitis, torsion of the legs of the ovarian cyst, dysmenorrhea;
• vascular diseases, such as Schönlein-Genoch purpura, thrombosis and embolism of the vessels of the mesentery, kidneys and spleen;
• metabolic disorders, such as diabetic ketoacidosis ("diabetic pseudoperitonitis");
• pneumonia, pleurisy.

Chronic abdominal pain:

When the cause of pain is acute appendicitis (inflammation of the appendix), the pain is usually localized in the navel. Sometimes the pain extends to the lower abdomen (the abdomen may be soft to the touch). As a rule, in such cases, the child has a fever, vomiting begins. If your child has symptoms of appendicitis, contact your pediatrician immediately. In such a situation, delay can result in serious complications.

Sometimes the cause of abdominal pain can be emotional stress associated with an unfavorable psychological climate at home or at school. For a child of school age, such stresses are a common occurrence. The cause of stress can be a divorce or other family troubles, problems in relationships with peers, with teachers. Some children experience abdominal pain in the morning, and this is most often associated with nervous tension before the start of the school day. Such pains, as a rule, disappear within a day; if necessary, let the child stay at home. Try to identify the root cause of emotional stress and address the problem as soon as possible.

Symptoms and signs of pain in a child

In young children the equivalent of pain in the abdomen are crying, crying, anxiety, refusal of food, crouched posture with the legs brought to the stomach, impulsive leg movements (“kicking legs”).

In preschool and primary school age pains in the abdomen often do not have a clear localization, most often, regardless of punktum fiksum, the child localizes pain in the umbilical region.

Abdominal pain in children can be caused by both diseases of the abdominal organs and diseases of other organs and systems. Allocate abdominal pain, acute and recurrent.

When a child develops acute pain, first of all, it is necessary to exclude a number of diseases united by the concept "sharp kivot". Such diseases include acute pathology of the abdominal organs, in which emergency surgical care is vital: acute appendicitis, perforated stomach or intestinal ulcer, peritonitis etc. Along with intense pain for an "acute abdomen" is characterized by a sharp deterioration in health, dry mouth, tachycardia, possibly an increase in body temperature.

On examination, you should check the symptoms of peritoneal irritation: tension of the anterior abdominal wall, symptoms of Shchetkin-Blyumerg, Rovsing, etc. In case of doubtful results, an urgent consultation of the surgeon is necessary, with positive symptoms, hospitalization in a surgical hospital.

Sudden onset of paroxysmal pain in the abdomen, alternating with periods of relative well-being, gradually weakening against the background of a deteriorating state of health of the child, suggest acute intestinal obstruction. It is necessary to find out whether any food error preceded the appearance of pain. When examining a child, attention should be paid to the presence of asymmetry of the abdomen, sometimes it is possible to palpate a painful cylindrical formation in the abdominal cavity, it is advisable to conduct a digital rectal examination. Detection after this blood test on the glove allows you to diagnose intestinal intussusception. The child should be urgently hospitalized in a surgical hospital.

The appearance in a child of intense paroxysmal pain in the abdomen, combined with symptoms of acute intestinal obstruction and the detection of a painful, tense protrusion in the groin area or, in boys, in the scrotum, during examination, makes it possible to establish a diagnosis infringement of inguinal hernia. The child must be urgently placed in the surgical department.

If a child develops acute pain in the abdomen against the background of diarrhea, regurgitation, vomiting, fever and, often, the appearance of signs of dehydration, one can think about the development acute intestinal infection(acute enterocolitis or gastroenterocolitis). It is necessary to conduct a coprological and bacteriological examination of feces, if oral rehydration is impossible or if the degree of dehydration is II-III, the child should be hospitalized in an infectious diseases hospital.

If a child develops acute pain in the abdomen, along with fever, vomiting, upset stool, skin rashes, pain in the joints, it can be assumed yersiniosis or pseudotuberculosis. A bacteriological examination of feces, vomit, as well as a serological examination of blood serum at the 1st and 3rd week of the disease is necessary.

In children of the first months of life, there are often bouts of anxiety, manifested by screaming, straining, redness of the face. During an attack, regurgitation, bloating and tension of the abdominal muscles are noted. Attacks continue from several minutes to 6-8 hours. After excluding the diagnosis of "acute abdomen", infectious pathology of the digestive tract, otitis, hypertensive-hydroceal syndrome, the diagnosis of the so-called infantile colic.

The causes of colic are spasms of different parts of the stomach and intestines against the background of perinatal encephalopathy, hyperexcitability syndrome, alimentary errors, food allergies, and inadequate child care. It is necessary to analyze with parents the features of feeding and raising a child, to perform a coprogram and sowing feces for dysbacteriosis, to consult a child with a neuropathologist and gastroenterologist.

Acute abdominal pain is sometimes found in children who are ill influenza. It is necessary to take into account the epidemiological situation - to find out from parents the presence of patients in the children's team and the child's home environment. When examining a child, attention should be paid to the moderate severity of catarrhal phenomena in the nasopharynx, high body temperature, intoxication, sometimes arthralgia and hemorrhage. A child with this form of influenza must be observed in dynamics, and sometimes hospitalized.

In case of acute pain in the abdomen, combined with a high rise in body temperature, chills, sore throat when swallowing, signs of atypical angina, swollen lymph nodes, difficulty in nasal breathing, on the 3rd-4th day of the disease, an increase in the liver and spleen, one should think about infectious mononucleosis.

A blood test can help in verifying the diagnosis - an increase in the number of monocytes, plasma cells, the appearance of atypical monosclerosis is characteristic; immunochemical (ELISA) and molecular biological (PCR, RT-PCR) diagnostic methods. Hospitalization is advisable in severe cases of the disease.

With pain in the right hypochondrium, combined with nausea, vomiting, it is necessary to exclude viral hepatitis. Parents should clarify the epidemiological history and find out the color of the child's stool and urine - light stools and dark urine are characteristic. On examination, pay attention to the color of the skin and mucous membranes, the presence of enlargement and tenderness of the liver. If a child has icterus of the sclera and skin, or a significant (2 or more times) increase in the activity of transaminases in the blood serum (ALT, ACT) is found during the examination, the child must be sent to the infectious diseases department.

Abdominal pain in combination with high body temperature and dysuric phenomena (frequent urination, restlessness during urination) may indicate urinary tract infection, pyelonephritis, or interstitial nephritis. It is necessary to prescribe a general urinalysis and urine culture for flora, ultrasound of the kidneys and bladder. In case of pronounced changes in the urinary syndrome, significant intoxication, hospitalization is possible.
With acute pain in the abdomen, combined with the appearance of edema, slow urination, cloudy urine, it can be assumed glomerulonephritis or lipoid nephrosis. It is necessary to do a general urine test, organize a record of the fluid drunk and excreted by the child, daily weighing, monitoring blood pressure, and in case of oliguria, severe edema, high proteinuria or hematuria, hospitalize the child in the somatic (preferably nephrological) department of the hospital.

The presence of cough, rapid breathing, elevated body temperature in a child with abdominal pain suggests acute pleuropneumonia. A thorough physical examination of the lungs, complete blood count, and chest X-ray are needed. In the presence of severe respiratory failure or pleurisy, the child must be hospitalized.

Acute abdominal pain in a febrile child who, during examination, reveals tachycardia, arrhythmia, widening of the boundaries of cardiac dullness, deafness of heart tones, murmur in the heart area, may be a symptom acute pericarditis. It is necessary to make the child an ECG, X-ray, echocardiography, a complete blood count, determine C-reactive protein, sialic acids in the blood, consult a cardiologist, and if the diagnosis is confirmed, hospitalize him in the somatic (cardiology) department.

Acute abdominal pain in a child in combination with symmetrical papulo-hemorrhagic rashes On the skin (more often on the shins and feet), fever, sometimes with arthritis, let us think about hemorrhagic vasculitis. With a differential diagnostic purpose, it is advisable to check endothelial tests in a child (“pinch”, “tourniquet”, etc.), do a blood test to determine platelets, bleeding time and coagulability. With a high activity of the process, the child should be sent to a somatic hospital.

The appearance in a patient with acute pain in the abdomen of a sharp smell of acetone from the mouth, progressive weakness, thirst, frequent urination (prliuria) gives reason to suspect a debut diabetes. It is necessary to examine the sugar content in urine and blood. In case of hyperglycemia and glucosuria, the child should be urgently hospitalized in the endocrinology department.

Repeated episodes of abdominal pain and vomiting in a child with gradually increasing muscle weakness, thirst, polyuria, anorexia may occur with chronic adrenal insufficiency. On examination, attention should be paid to the presence of hyperpigmentation of the skin, especially in the folds and places of friction of clothing. It is advisable to analyze the pedigree. The detection of hyperkalemia and hyponatremia, a decrease in the excretion of 17-OKS and 17-KS in daily urine, and ultrasound of the adrenal glands are of diagnostic importance. You need to consult an endocrinologist.

In a child with recurrent abdominal pain, the presence of increased excitability, accelerated intellectual development, episodic arthralgias, periodic bouts of vomiting gives reason to think about neuroarthritic diathesis. It is advisable to clarify the family history (urolithiasis, radiculitis, gout), assess the level of uric acid in the blood serum and urates in the urine, and during the period of vomiting, examine urine for acetone and conduct a bacteriological examination of vomit and feces.

If a child with recurrent abdominal pain has pallor of the skin and mucous membranes, swollen lymph nodes, bone tenderness, hemorrhagic manifestations, it should be excluded leukemia or Hodgkin's disease. It is necessary to do a blood test, including the determination of the number of platelets and reticulocytes. It is advisable to conduct an ultrasound scan of the liver, spleen, para-aortic lymph nodes, chest x-ray (mediastinum). It may be necessary to study the myelogram or the morphology of the biopsy of the lymph node - a consultation with a hematologist is necessary, and with a probable diagnosis, hospitalization in the hematology department.
Recurrent abdominal pain in combination with heartburn, belching suggests gastroesophageal reflux disease or acute esophagitis. Necessary esophagogastroscopy, prolonged pH-metry or impedancemetry of the esophagus, consultation of a gastroenterologist.

The presence of episodic non-stereotypical recurrent pain in the upper abdomen, provoked by a variety of triggers, in a child with symptoms of autonomic dysfunction suggests functional dyspepsia. With the connection of abdominal pain with food intake, the presence of periods of exacerbations, aggravated heredity and concomitant dyspeptic symptoms, one can assume gastritis, gastroduodenitis,stomach ulcer and duodenum. FGDS is required with a study of the morphology of the mucous membrane of the stomach and duodenum, with the definition of Helicobacter pylori, a study of the secretory and motor functions of the stomach (prolonged pH-metry, impedancemetry). It is advisable to consult a gastroenterologist, in complicated cases - hospitalization.

Episodes of abdominal pain that occur along with nausea, rumbling in the abdomen, and loose stools after eating dairy products make it possible to think about lactase deficiency. To confirm the diagnosis, a fecal pH study, an elimination-provocation test, and a lactose tolerance test are used.

With recurrent pain in the right hypochondrium associated with the intake of fried, fatty foods, sometimes accompanied by episodically discolored stools, one can assume dysfunction of the biliary tract, and in the presence of periods of exacerbations and the persistent nature of pain - chronic cholecystitis. It is necessary to clarify the presence of family burden, during examination, pay attention to the color of the skin and sclera, the size and features of the liver, bladder symptoms. It is necessary to prescribe an ultrasound examination of the liver and gallbladder, evaluate the coprogram and signs of the activity of the inflammatory process, conduct a study of the composition of bile, exclude giardiasis. If a child has icteric integument, “liver signs” on the skin, an enlarged and compacted liver, one should think about chronic hepatitis or liver cirrhosis. It is necessary to additionally determine the activity of transaminases, bilirubin, protein fractions, alkaline phosphatase, markers of hepatitis viruses in the blood serum and consult the child with an infectious disease specialist and a gastroenterologist.

With girdle or left hypochondrium pain, combined with an unstable "fatty" stool, repeated vomiting, bloating, you can think about sharp or exacerbation of chronic pancreatitis, reactive pancreatitis. The diagnosis can be confirmed by coprogram (type I steatorrhea), ultrasound of the pancreas, and by detecting an increase in amylase in the urine or amylase, lipase and trypsin in the blood serum. It is necessary to consult a gastroenterologist and, depending on the activity of the disease, hospitalization.

Recurrent abdominal pain in a child with growth retardation, underweight, polyfecal evidence suggests malabsorption. It is necessary to evaluate the coprogram, a general blood test. The study of sweat electrolytes will allow to exclude cystic fibrosis. Determination of anti-gluten, anti-endomysial antibodies and antibodies to tissue transglutaminase will resolve the issue of the presence celiac disease preliminary, and the study of biopsy of the mucous membrane of the small intestine - finally.

The cause of recurrent abdominal pain may be a food allergy. At the same time, a burdened family history, the presence of other manifestations of atopy, and the association of pain with certain foods are diagnostically significant. In terms of confirming the diagnosis - a complete blood count (eosinophilia), a study of general and specific immunoglobulins E, scarification tests. It is possible to conduct an alimination-provocative test. It is advisable to consult an allergist.

Repeated abdominal pains, often of a spastic nature, combined with defecation disorder, induced mainly by psycho-emotional factors, make it possible to think about irritable bowel syndrome. Verification of the diagnosis provides, along with the identification of autonomic dysfunction and psycho-emotional instability, the exclusion of organic pathology of the gastrointestinal tract.

My child often complains that his stomach hurts. It hurts and it goes away. The pain is not very strong. What to do?

If the pain is not severe, does not increase and does not prevent the child from living a normal life, then you have time to assess the situation. The pediatrician may ask some questions, so it's helpful to look at the child beforehand to help determine what's causing the pain.

• When did the pains start? A few days, weeks or months ago?
• Is the pain severe? Does the child cry in pain?
• Where does it hurt? In the navel or lower right?
• How long does it hurt? Is there anything that makes the child get better or worse?
• Does the temperature rise, is there vomiting or diarrhea?
• Does the pain interfere with sleep at night or play during the day?
• Does it happen only on days when you have to go to kindergarten, or at certain times of the day?
• What is the child's appetite?
• Is it related to some particular food or drink, such as dairy products? Or maybe after eating the pain softens or becomes stronger?
• Is the child potty trained? Maybe the pains start when he needs to poop?
• Does the child poop daily? Is the stool hard or liquid? Many or few? Is there any blood?
• Did the child have any strong experiences at home or in kindergarten or a change of scenery?
• Has there been a history of stomach or intestinal problems in the family?
• Maybe you recently took your child on a trip or did he deal with pets?

These are just a few of the many questions your pediatrician may ask you. It is often helpful to keep a diary a few days before your visit (or even earlier) and bring it with you. The diary should record what the child ate and drank when his stomach hurt, what he did at that time, how long his stomach hurt and, most importantly, how often he pooped and how it looked. Explain exactly why you are here (for example, abdominal pain at times for three months) so that he can schedule additional time if necessary.

My child has severe stomach pain. When to start sounding the alarm?

Infants, and often one-year-old or two-year-old children, cannot tell that they have a stomachache, and to determine that the child needs to see a doctor, you will have to work as a detective. The signs and symptoms below should be taken seriously and may indicate that your child needs medical attention.

Call your doctor or make an appointment immediately if you have any of the following.

• The child looks unhealthy.
• His stomach hurts a lot (especially on the lower right).
• The pain intensifies.
• The pain does not stop for more than two hours.
• The abdomen is swollen or painful to touch.
• The child does not want to eat his favorite food.
• Incessant vomiting.
• Persistent diarrhea.
• The stool is bloody, dark or looks like grape jelly.
• It hurts the baby when he jumps up (this applies to older children, of course, not babies).
• Cannot walk or walks bent over (also applies to older children).

How to determine that abdominal pain is a sign of appendicitis?

Appendicitis can be difficult to diagnose, even for doctors, especially in young children, and this is one of the reasons why if a child has a stomachache and even one of these symptoms, you need to immediately find out what the matter is. Typical signs and symptoms of appendicitis: Pain begins in the navel and moves to the right lower abdomen after a few hours. If you press this area, the child cries or complains that he is in pain. In addition, the child may have a fever, vomiting, he may refuse his favorite food. If you ask a child to jump, another symptom may come up: with appendicitis, most children (and adults, too) find it painful to jump.

In young children, the expected signs and symptoms may not always be detected, especially if they are under two years of age. Call the doctor if your child has any of the symptoms listed in the answer to question 45 on the previous page, or if you think it's appendicitis. The doctor will examine the child and may order some tests, including an ultrasound or a CT scan, to look at the appendix.

Patient monitoring

• stake and co-shaped or permanent;
• Times of Day;
• pain interrupting sleep;
• connection with food intake;
• duration, localization.

General condition: satisfactory - unsatisfactory - severe, lethargic, the child cannot be distracted. Nausea, vomiting, diarrhea; last stool time. Abdomen: protruding, swollen; visible peristalsis. Fever, cardiovascular symptoms (pallor, tachycardia, cold sweats).

Gait (eg, limping with appendicitis) and posture (eg, relaxed, bent over). Weight loss?