What can hurt in a child's stomach?
A child’s abdomen rarely hurts in isolation: the pain comes from hollow organs during stretching or spasm, from the inflamed peritoneum, and from organs beyond it. A small child does not know how to accurately point out the location, so he attributes almost any pain to the navel area. The closer the pain is to the navel and the more intermittent it is, the more often it is functional; The clearer the localization and the more the child spares the stomach, the higher the likelihood of a serious cause. Therefore, the doctor is important not only the words, but also the child’s behavior.
- Spasm and distension of the intestines with gas and constipation
- Inflammation: appendicitis, mesadenitis, gastritis
- Urinary tract infections and renal colic
- Diseases outside the abdomen: pneumonia, sore throat, viral infections
- Functional pain due to anxiety and stress
- Gynecological causes in teenage girls
Common causes by age
In children in the first months of life, painful attacks are more often associated with infant colic: the child cries in the evenings, draws in his legs, but grows well. At an early age, intestinal infections, constipation and intussusception come to the fore, in which attacks of pain alternate with calm intervals. In preschoolers and schoolchildren, mesadenitis due to a viral infection, gastritis, constipation and functional pain become frequent. In adolescents, reasons related to nutrition, stress and gynecological issues are added.
- Up to 6 months - colic, less often an allergy to milk protein
- Up to 3 years - infections, constipation, intussusception
- Preschoolers - mesadenitis, constipation, helminthic infestation
- Schoolchildren - functional pain, gastritis, appendicitis
- Adolescents - peptic ulcer, cholelithiasis, gynecological causes
When is abdominal pain dangerous?
Dangerous conditions usually reveal themselves not by one symptom, but by a combination of signs and dynamics. Pain that does not go away and increases over several hours, pain that wakes the child at night, as well as any combination of pain with repeated vomiting, blood in the stool, or lack of stool and gas are alarming. If appendicitis is suspected, the child usually avoids sudden movements: it hurts him to jump and cough. In such situations, you need to show the child to a doctor as quickly as possible or call an ambulance at 103 and not give food or drink until the examination.
- Constant pain longer than 3–4 hours
- Pain in the right lower abdomen
- Repeated vomiting, especially with bile
- Lack of stool and gas, bloating
- Blood in stool or urine
- Paleness, cold sweat, weakness
- Abdominal injury the day before
What examinations are needed
The first and main stage is the examination: the doctor evaluates the abdomen, temperature, and behavior of the child and, if necessary, looks at the dynamics after a few hours. A general blood test shows inflammation, a urine test excludes a urinary tract infection, which in children often disguises itself as abdominal pain. Ultrasound helps to see the appendix, intussusception, gallstones, kidney changes and enlarged mesenteric lymph nodes. For chronic pain, a coprogram, tests for Helicobacter and celiac disease are added, and if inflammatory bowel disease is suspected, calprotectin is added.
- Examination by a pediatrician and, if necessary, a pediatric surgeon
- Complete blood count with ESR
- General urine test
- Ultrasound of the abdomen and kidneys
- Coprogram and feces for occult blood
- Calprotectin fecal for suspected intestinal inflammation
- Endoscopy as prescribed by a gastroenterologist
What to do at home and how to treat it
If the child is active, plays, the temperature is normal and the pain is mild, it is reasonable to observe: offer a drink, light food, check whether there is stool. A heating pad, an enema and painkillers before examination for acute pain are dangerous - they blur the picture and can cause harm. Treatment depends on the cause: for constipation, stool is adjusted, for intestinal infection, water is taken, for gastritis, nutrition and drugs that reduce acidity are selected, for appendicitis and obstruction, surgery is required. Functional pain is treated with regimen, nutrition and stress management - it is real, although there are no structural changes.
- Observation for mild pain and good health
- Do not give painkillers or a heating pad until the examination.
- Light food and plenty of fluids
- Treatment of constipation, infection or gastritis as prescribed by a doctor
- Emergency surgery for appendicitis and obstruction
- Sleep patterns, physical activity and support for functional pain