Pain in the abdomen of a child in 4 years

  • Features of digestion in children
  • The causes of abdominal pain
  • Diseases that cause pain syndrome
  • What to do if the baby has a stomachache
  • Related Videos

Children in four years often complain of abdominal pain, and they can not pinpoint exactly where it hurts, as a rule, they point to the area near the navel or to the entire abdomen, which makes diagnosis much more difficult. Also, small children can not differentiate the pain and sensations that arise when it is necessary to empty the intestine.

Most of the discomfort arises from the use of "wrong" food, overeating, against the background of emotional experience. And although in rare cases the abdomen of a child has a severe pain in 4 years due to organic lesions, they are still possible, so do not leave a complaint of crumbs without attention.

Features of digestion in children

The digestive function is affected by the amount and activity of enzymes produced in the digestive canal. In children, the digestive system does not work as an adult, because there are structural and functional differences.

In the first months of life, the secretory apparatus of the tract can only process breast milk or its artificial substitutes. The number of cells that produce secret is not so much, and the activity of enzymes is negligible. During the transition to lure, the digestive glands develop further and their adaptation to the type and composition of the food.

The more varied the diet of a child, the faster the adaptation of the gastrointestinal tract. The activity of gastric enzymes increases to 14-15 years of age. By three years, the activity of proteases (enzymes that break down proteins) has reached a maximum, and lipases that digest fats and amylases that convert carbohydrates into simple sugar have been increasing their activity for 6 more years.

Thus, the process of digestion of food takes more time, which leads to a delay in food in the intestine. In the process of fermentation and putrefaction, gas is released, which causes pain and discomfort in the abdominal cavity.

Abdominal pain
The composition of the gastric secret in children is similar to that of an adult, but its acidity and enzyme activity is significantly lower, which affects the protective function and digestion

In young children, the digestive system is not yet ripe, which makes it difficult to digest food. If the food consumed does not correspond to the development of digestion, then the barrier function of the digestive tract decreases, which leads to frequent illnesses and forms prerequisites for allergic reactions.

The process of splitting food begins in the oral cavity under the action of enzymes that are secreted by the salivary glands. In the saliva of a child, the activity of amylase (an enzyme that breaks down starch to oligosaccharides) is five times lower than that of an adult, correspondingly, complex carbohydrates are less absorbed in the intestine.

The amount of saliva influences digestion processes. The more it is, the better the food is moistened, it dissolves faster and faster. In a four-year-old man, about 1.82 ml of saliva is released in 10 minutes, while in a six-year-old man, 1.5 times more (3.14 ml). Only by the age of seven the child has the same amount of saliva as an adult.

Saliva performs digestive, protective, remineralizing, trophic and buffer function.

The causes of abdominal pain

In children of four years, the stomach may suffer from the digestive system, but sometimes discomfort occurs as a result of morphological changes, functional disorders or changes in the bacterial flora of the intestine. The pains that are associated with functional impairment, as a rule, do not increase and pass quickly. Often they arise against a background of emotional tension.

If the pain in the abdomen becomes stronger, symptoms such as vomiting, diarrhea, feces with an admixture, an increase in temperature, it can be triggered by a surgical, organic disorder or intestinal infection. In this case, hospitalization is required.

On surgical pathology indicates:

Pain in the child's stomach
  • severe pain in the abdomen;
  • refusal to eat;
  • forced position of the body;
  • muscle tension of the abdominal wall;
  • altered behavior (anxiety or lack of mobility);
  • awakening from pain;
  • because of pain, vomiting begins, there is a stool retention or, conversely, diarrhea;
  • the appearance of the child changes;
  • heartbeat does not correspond to body temperature.

In preschool children, abdominal pains appear against the background of a urinary tract infection, respiratory diseases, if there is helminthic invasion. Often, discomfort is caused by constipation or malnutrition. Urinary tract infection is impaired urination, it becomes frequent, painful.

Constipation in the child
If the cause of pain in constipation, the discomfort after a defecation

Diseases that cause pain syndrome

Often, periodic abdominal pains in a small child arise because of such pathologies as dysbacteriosis, helminthic invasion, hernia, intolerance of some products. It is impossible to establish the cause of discomfort without a doctor, because the diseases of the digestive system have similar signs.

But if the parents know what precedes pain, what additional symptoms arise, how long the stomach aches, then this will speed up the establishment of the correct diagnosis and will save the child from unnecessary medical tests and examinations.


Intestinal microflora is involved in digestion. Microbes colonizing the large intestine have the following positive effects on the body:

  • splits vegetative fiber;
  • isolate lactic acid having antiseptic properties;
  • decrease the activity of trypsin, amylase, enterokinase in the large intestine;
  • increase immunity, suppressing the development of pathogenic microorganisms;
  • synthesize some vitamins;
  • participate in metabolic processes.

The microflora is affected by many factors: the arrival of microbes with food, the features of the diet (the predominance of carbohydrates over animal proteins), motor function of the intestine, drug therapy, the activity of digestive enzymes. The composition of the intestinal microflora is affected by chronic foci of infection, for example, bottle caries or adenoids.

In children, enzymes are not yet active enough and can not protect the body from pathogenic flora, so the risk of dysbiosis and intestinal infections increases.

With dysbacteriosis of the intestine, the number of bifidobacteria and lactobacilli decreases, and the number of pathogenic microorganisms increases. There is a disorder of stool, flatulence, eructation, rumbling in the abdomen, intestinal colic, an unpleasant odor from the mouth.

In addition, there are signs of hypovitaminosis, anemia, a change in the ionic composition of the plasma, a lack of calcium. Often, children develop allergic reactions, which can manifest as itching, hives, foaming stools, intense, sudden abdominal pain and other intestinal disorders.

Treatment of a dysbacteriosis assumes elimination of the reason of disease, symptomatic therapy, strengthening of the general and local immunity, restoration of a microflora of an intestine.

Lactase insufficiency

The disease occurs because the body lacks an enzyme that breaks down the milk sugar (lactose). Since the substance enters the intestines in an unchanged form, it begins to ferment, which leads to a decrease in pH and increased gas production.

Lactase deficiency can be congenital, that is, genetically determined, constitutional, when the activity of lactase gradually decreases, beginning at the age of 3-5 years. Probable and secondary insufficiency, which arises from the infectious disease of the small intestine and is eliminated when it is stopped.

Children have a stomach ache after eating foods that contain lactose (especially whole milk). The sign of the disease is a frequent, liquid, foamy stool with a sour smell, which appears up to 12 times a day. Due to diarrhea in young children, there are symptoms of dehydration and low weight gain.

There are also changes in the work of the central nervous system: children become irritable, hyperexcitable, crying, there is a delay in psychomotor development. To confirm lactase deficiency, a fecal biochemical test is performed. Also, with the exception of the milk menu, the clinical manifestations of the disease (bloating, diarrhea) disappear.

Treatment consists in dietotherapy, in which milk is excluded in any form, as well as some medicines (probiotics). If hypolactasia is negligible, then the use of fermented milk products and butter is allowed.

Herniated abdomen

The hernia is formed as a result of the displacement of the internal organs into the neighboring parts of the abdominal cavity through ruptures of the muscular aponeurotic layer. A defect can be seen when the patient is standing (it looks like protrusion). Allocate diaphragmatic, umbilical, inguinal, femoral hernia and others. The most common disease occurs in preschool children and in people older than 45 years.

A hernia arises because of the inherent weakness of the ligamentous apparatus and the acquired changes that contribute to the formation of weak points. Migrates the hernia with increasing vnutriibryushnogo pressure (strong cough, constipation, bloating). Isolate the external hernia (protrusion goes under the skin) and internal, when the organs move inside the abdominal cavity.

As a rule, the umbilical hernia is diagnosed in children, in which the intestine or a large omentum falls through the enlarged umbilical ring. This disease occurs in 20% of full-term and 30% of premature babies. After the umbilical cord dries, the ring closes, which takes some time.

If during this period there was an increase in intra-abdominal pressure, then it can provoke the loss of the peritoneum, the loops of the intestine or the omentum into the cavernous space.

Usually, the umbilical hernia does not lead to discomfort, but if the defect is large, the children complain of abdominal pain near the navel, nausea, constipation. Infringement in children is rare, but it can cause serious consequences, for example, intestinal obstruction or necrosis of intestinal tissues.

In most cases, if the diameter of the umbilical hernia is not more than 1.5 cm, the protrusion disappears to 5-7 years of age. If there is no spontaneous cure and the size of the defect is large, and if there is a digestive disorder or a hernia is infringed, then surgical treatment is indicated.


Children are most susceptible to helminth diseases, as they have insufficient hygienic skills. According to WHO statistics, every person carries a parasitic disease at least once in a lifetime. Parasites can cause symptoms characteristic of both infectious diseases and non-infectious diseases, often they aggravate the course of existing pathologies and lead to their chronic course.

It is also interesting that in children antibodies for vaccinations are produced less by 2-3 times. If they are infected with parasites, accordingly, a sufficient level of immunity is not formed and the risk of contracting infectious diseases is high.

Infected with parasites through contaminated food, water, unwashed hands. The disease can be acute (14-60 days) and chronic phase. For an acute period, allergic reactions that occur in response to foreign antigens of the parasite are characteristic.

A child can be bothered by a skin rash, fever, inflammation of the lymph nodes, joint pain, dry cough, shortness of breath, chest pain. Typical for helminthiasis abdominal syndrome (stool, flatulence, nausea, eructation). Pain can be short-term or strong, similar to a clinic of an acute abdomen.

In the chronic course of the disease, there are symptoms of intoxication (due to toxic products of vital activity), trauma to organs, metabolic disorders, secondary immunodeficiencies. Children are sluggish, eat poorly, lose weight.

Dirty hands
Among all the infected 80-85% are children under 14 years old

Dermal diseases, diseases of the respiratory tract or genital organs may appear. With ascariasis may develop intestinal obstruction, jaundice, pancreatitis, and with trichinosis may occur perforation of the intestinal wall. Opisthorchiasis is sometimes complicated by inflammation of the stomach and intestines.

The presence of helminths can be found in the study of blood, feces, bile, sputum. Most often, a study of feces for eggs of worms and coprogram is carried out. Eggs of pinworm ripen on perianal folds. To confirm their presence, a scraping is done.

To destroy parasites, the doctor must choose a drug that affects the larvae, eggs and adults. After the drug course, control tests are performed. It is recommended to take the pill not only for the patient, but for all members of the family and the team.

What to do if the baby has a stomachache

Before deciding what to do in case of problems in a child with the tummy, you should establish the cause of discomfort. To do this, you need to see a doctor and get tested. If organic pathologies are not identified, you need to pay more attention to the baby's diet and its emotional state. It is possible that the pain around the navel is caused by negative experiences.

If the baby has a stomach ache due to a delay in stools or increased gas production, while the general condition is normal, then it is necessary to give folk remedies that accelerate peristalsis (boiled beets, prunes). It is also necessary to monitor the amount of fluid used and adjust the diet.

If the child has severe diarrhea, it is necessary to give absorbents (Smecta, activated charcoal, white coal) and means for restoring the water-salt balance (Regidron, Oralit).

Palpation of the abdomen of the child
It is forbidden to give a small child without consulting a doctor enzyme preparations, antibiotics, laxatives

If there are signs of an acute abdomen, then you need to call an ambulance. Before her arrival, you should not give painkillers, do an enema, apply heat to your stomach. When the temperature increases to febrile it is necessary to give an antipyretic (Efferalgan, Panadol, Ibuprofen).

To understand why the tummy hurts in the crumb, it is required to conduct a study. The doctor will order blood tests, urine, feces, and ultrasound, CT, endoscopy. If organic lesions are found, the doctor will prescribe medication or surgical treatment.