06.05.2019

Acute respiratory infections with abdominal syndrome in children: what to do if your stomach hurts during a cold? Abdominal syndrome: causes, symptoms, diagnosis and treatment

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 has no direct connection with any surgical pathology, but is caused either by diseases of the organs located in abdominal cavity, or problems with nervous system the patient, the condition of his lungs and heart. This pain can also be provoked by an inflammatory process in the peritoneum caused by exposure to toxic substances, and its stretching by a diseased organ.

In what cases does abdominal syndrome develop?

Abdominal pain syndrome has quite complex classification. Conventionally, it can be correlated with the diseases against which it manifests itself.

These may be diseases of the digestive system - hepatitis, cirrhosis of the liver, pyloric stenosis duodenum and so on.
The mentioned abdominal pain can also accompany pathologies of the chest organs - pneumonia, myocardial infarction, diverticulosis of the esophagus, etc.
The manifestation of abdominal syndrome has also been observed in infectious or viral diseases - syphilis, herpes zoster, etc.

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

How pain manifests itself under various factors

Abdominal pain syndrome is distinguished depending on the type of pain. It is this sign that often helps specialists diagnose correct diagnosis and establish the cause of the disease. This is done through a thorough examination of the patient, biochemical analysis blood, ultrasound results, as well as x-rays of the chest and abdominal cavity.

There are spastic pains that arise and disappear suddenly, having the character of a painful attack. They often radiate to the back, under the shoulder blade, in the lower back or lower limbs and are accompanied by nausea, vomiting, forced positioning, etc. As a rule, they are provoked by inflammatory processes in the abdominal cavity, poisoning or dysfunction 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 combined common name"acute belly" Such pain appears suddenly, it is diffuse, accompanied by general malaise and severe vomiting. It gets worse when you change position, move or cough.
occur during 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 abdomen. It is usually associated with and against the background of which the described syndrome develops - an increase in temperature (if it is an infection), or in the joints (with ischemic heart disease or rheumatism), etc.
And are not associated with diseases of 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 a reason to consult a doctor, because abdominal syndrome, as you have seen, can be a sign of a condition that requires urgent surgery and threatens the patient’s life.

Features of the manifestation of chronic abdominal pain

Abdominal pain syndrome can manifest itself in short-lived and rapidly developing attacks, or it can also be protracted and chronic.

IN the latter case the pain usually increases gradually and recurs over several weeks or even months. And it should be said that chronic form 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 triggered by a state of latent depression. Such patients, as a rule, complain of a combination of different localizations of pain - for example, they may simultaneously have pain in their head, back, stomach, etc. 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 in the background 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 possible danger If you experience abdominal pain, you should know in what cases it requires urgent medical attention.

if it appears along with pain severe weakness, dizziness and state of apathy;
multiple subcutaneous hematomas appear on the body;
the patient suffers from repeated vomiting;
abdominal muscles are tense;
along with pain, tachycardia occurs and blood pressure decreases;
the patient is worried about a fever, the origin of which is unclear;
the volume of the abdomen increases greatly, accompanied by severe pain;
gases do not escape, and there are no peristaltic sounds;
Women experience heavy discharge or bleeding.

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

Abdominal pain syndrome in children

Children are a special risk group for the development of abdominal syndrome. This is due to the child’s body’s ability to overreact to any damaging factors.

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

Abdominal syndrome in school-age children most often turns out to be a sign of chronic gastroduodenitis or dysfunction of the pancreas. Often the syndrome develops against the background of acute or chronic pathology of the kidneys or bladder. In teenage 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 pain. This is due to the fact that the child is most often unable to accurately characterize his sensations, their localization, strength and presence of irradiation.

By the way, pediatricians say that children quite often describe any ailment or feeling of discomfort as abdominal pain. Doctors encounter this description even in cases where the child is clearly experiencing dizziness, painful sensations in the ears, head or nausea.

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

This means that 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 be safe!

Manifestation of the syndrome in ARVI

Pediatricians often observe ARVI with abdominal syndrome. In children, this is also due to the peculiarity of the body’s reaction to damaging factors.

In such cases, the usual symptoms viral infection- redness of the throat, runny nose, cough, weakness and fever - in little patient The urge to vomit and abdominal pain may occur. But these manifestations may turn out to be both a feature of the child’s body’s response to infection and, for example, a sign of a chronic pathology of the abdominal organs that has worsened against the background of ARVI.

Therefore, the diagnosis of “ARVI with abdominal syndrome” in medical circles is considered inaccurate and streamlined. It does not give a specific explanation of what is happening in the patient’s body at the moment, and a patient with manifestations of signs of the mentioned syndrome requires 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, abdominal syndrome should be dealt with 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 the patient’s perception of pain.

To eliminate the discomfort that appears due to problems with the gastrointestinal tract, myotropic antispasmodics are usually prescribed. The most popular among them is the drug "Drotaverine", which has a high selective effect and does not have negative influence nervous and cardiovascular system. This tool It not only has an antispasmodic effect, but also helps reduce blood viscosity, which makes it possible to use it not only for biliary dyskinesia, gastric or duodenal ulcers, but also for coronary intestinal disease.

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

What is abdominal ischemic syndrome

In medicine, it is customary to distinguish the syndrome of abdominal chronic ischemia from the various abdominal pain described above. It is a lack of blood supply to various parts that develops over a long period of time. abdominal aorta as a result:

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

This condition is fraught with the death (necrotization) of areas of blood vessels or organs that do not receive sufficient oxygen and do not remove decay products.

Interestingly, abdominal ischemic syndrome is most often found in men after 45 years of age. And it manifests itself, as a rule, as a triad of symptoms - pressing, aching, often paroxysmal pain in the abdomen, intestinal dysfunction, as well as a progressive decrease in body weight.

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 food taken.

It can be provoked not only by food, but also by physical stress or fast walking, and the pain is relieved at rest on its own, although sometimes this requires additional nitroglycerin or (in case of increased intensity) analgesics.

When diagnosed with “abdominal ischemic syndrome,” treatment, as in other cases, is aimed at the underlying disease. The patient is prescribed anticoagulants that improve the blood circulation process, and in the case of intestinal dysbiosis, agents that improve its microflora.

Patients are usually recommended fractional nutrition in small portions with the exception of coarse and in severe cases of the disease they may be shown surgical intervention to restore blood circulation in the abdominal branches of the aorta.

Compartment syndrome

If the patient’s intra-abdominal pressure increases as a result of complications caused by injury or surgery, then this condition is diagnosed as abdominal compartment syndrome. It is quite dangerous and is also accompanied by abdominal pain different strengths and localization, which also depend on height pain threshold in the patient, and on his general condition.

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

As already mentioned, compartment syndrome is a dangerous condition. Without special treatment, it can lead not only to serious violations 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- so-called decompression, as a result of which the level of intra-abdominal pressure decreases and blood circulation in the abdominal area is restored.

Abdominal syndrome is one of the most important and frequent clinical manifestations of most diseases of the gastrointestinal tract. But unlike many other pathologies, it is impossible to “get sick” in the usual sense of the word. After all, abdominal syndrome is actually the pain that we feel. It can be different (for details, see the corresponding section): sharp, dull, pulling, cramping, encircling and point-like. Unfortunately, pain cannot be considered an objective criterion. Therefore, the attending physician often faces the need not only to explain the reasons for its occurrence, but also to alleviate the patient’s condition in the absence of a confirmed diagnosis.

However, in addition to the obvious difficulties associated with subjective sensations, abdominal syndrome (AS) differs from other similar conditions due to its confusing and difficult to understand classification. Firstly, the justification of such a diagnosis for any acute conditions (appendicitis, perforation of an ulcer, an attack of cholecystitis) is quite doubtful. Secondly, it should be clearly understood: AS, which we will talk about today, is not at all the same as abdominal ischemic syndrome (AIS, chronic abdominal ischemia syndrome). After all, AIS is a long-term developing chronic failure blood supply in various parts of the abdominal aorta. Thirdly, many domestic doctors treat AS with some prejudice, not considering it an independent nosological unit. The main argument is the interpretation of the patient’s subjective complaints, because many of them (especially if the question concerns children) are unable to explain in words what worries them. And “concerned” mothers, demanding (!) to diagnose their child with “abdominal syndrome” if he has eaten too much candy or unripe apples, are unlikely to cause a surge of positive emotions in the doctor.

The topic “ARVI and abdominal pain syndrome in children” deserves special mention. What could be the connection between an acute respiratory viral infection and pain caused by pathology of the gastrointestinal tract, you ask? To be honest, we ourselves did not immediately understand this. But after digging through specialized forums, we found out that such a diagnosis is very popular in our area. Formally, he has the right to life, but most practicing doctors who take their work responsibly are confident that in this case, district pediatricians are trying to avoid mentioning an acute illness in the medical record. intestinal infection(OKI). It is also possible that such “ARVI” means hidden appendicitis. “Treatment” will, of course, give results. The patient will most likely stop coughing, but will very soon end up on the operating table.

Causes

There are quite a lot of diseases that can trigger the occurrence of AS, because pain can be accompanied by almost any disorder normal operation gastrointestinal tract. But before moving directly to the causes of the syndrome, an important clarification should be made regarding pain receptors located in the abdominal cavity. The fact is that their sensitivity is quite selective, therefore many types of irritating effects may be completely invisible to the patient. But cuts, ruptures, stretching or compression of internal organs lead to a surge in pain.

What does this mean? Unfortunately, in the case of AS, it is no longer possible to perceive pain as an indicator of the state of the body, since the nature and type of “pleasant” sensations in the general case depend little on the cause that causes them. Because of this, during a superficial, formal examination of many patients (especially children), the doctor can “overlook” a life-threatening condition, limiting himself to prescribing harmless antispasmodics. Which, as you might guess, in the case of appendicitis or intestinal obstruction cannot bring any real benefit. The reasons themselves are divided into two types:

Intra-abdominal (localized in the abdominal cavity)

1. Generalized peritonitis that developed as a result of damage to the membrane (perforation) of a hollow organ or ectopic pregnancy

2. Inflammation of organs caused by:

cholecystitis;
diverticulitis;
pancreatitis;
colitis;
pyelonephritis;
endometriosis;
appendicitis;
peptic ulcer;
gastroenteritis;
pelvic inflammation;
regional enteritis;
hepatitis;
lymphadenitis.

3. Obstruction (obturation) of a hollow organ

intestinal;
biliary;
uterine;
aortic;
urinary tract.

4. Ischemic pathologies

infarctions of the intestines, liver and spleen;
mesenteric ischemia;
organ torsion.

5. Other reasons

retroperitoneal tumors;
IBS - irritable bowel syndrome;
hysteria;
withdrawal symptoms after drug withdrawal;
Munchausen syndrome.

Extra-abdominal (localized in the abdominal cavity)

1.Diseases of the chest organs

myocardial ischemia;
pneumonia;
pathologies of the upper esophagus.

2. Neurogenic diseases

herpes zoster (herpes zoster);
syphilis;
various problems with the spine;
disorders of normal metabolism (porphyria, diabetes mellitus).

Symptoms

The main (and perhaps the only) manifestation of AS is pain. Adults can still more or less clearly describe their feelings, but with regard to children (especially small ones), one cannot count on such “cooperation”. And if a child is brought to the regional clinic by a pediatrician whose only complaint is “a pain somewhere in the tummy,” it can be quite difficult to identify the root cause of the problem. As a result, parents receive a medical card with the entry “abdominal syndrome due to ARVI” (we talked about this just above) and begin to treat the cold.

The nature of pain in AS and possible causes of their occurrence

1. The attack occurs and develops rapidly, the pain is very intense

rupture of a large vessel aneurysm;
myocardial infarction (sometimes it occurs in children);
renal or biliary colic (occurs during the passage of stones).

2. The level of pain reaches its maximum in a few minutes, remaining at its peak for a long time

total intestinal obstruction;
acute pancreatitis;
thrombosis of mesenteric vessels.

3. The attack develops quite slowly, but can last many hours

diverticulitis;
acute cholecystitis or appendicitis.

4. Colicky or intermittent abdominal pain

small intestinal mechanical obstruction;
subacute pancreatitis in the initial stages.

Approximate location of the attack and organs that could provoke it

1. Right hypochondrium

gallbladder;
duodenum;
hepatic angle colon;
ureter and right kidney;
liver;
biliary tract;
head of the pancreas;
abnormally located appendix;
pleura and right lung.

2. Left hypochondrium

tail of the pancreas;
splenic angle of the colon;
ureter and left kidney;
stomach;
spleen;
pleura and left lung.

3. Epigastric region (the area under the xiphoid process)

liver;
stomach;
lower parts of the esophagus;
pancreas;
esophageal opening of the diaphragm;
biliary tract;
stuffing box;
organs located directly in the chest;
celiac plexus.

4. Right iliac region

terminal portion of the ileum;
ureter and right kidney;
appendix;
terminal section of the ascending and cecum colon;
right uterine appendages.

5.Left iliac region

ureter and left kidney;
sigmoid and descending colon;
left uterine appendages.

6. Umbilical zone

transverse colon;
pancreas;
small intestine;
appendix with a medial location;
peritoneal vessels.

7. Pubic and groin areas

pelvic organs;
bladder;
rectum.

Possible types of pain

1. Colic (spastic pain)

occur due to spasm of the smooth muscles of the excretory ducts and hollow organs (stomach, gall bladder, pancreatic duct, esophagus, intestines, biliary tract);
may appear when various pathologies internal organs (colic and spasms of various etiologies), poisoning or functional diseases(IBS - irritable bowel syndrome);
appear and disappear suddenly, the use of antispasmodics significantly reduces the intensity of the attack;
may radiate to the back, lumbar region, shoulder blades or legs;
the patient shows signs of nervous excitement and anxiety;
forced, often unnatural, body position;
the most typical clinical manifestations: vomiting, rumbling in the abdomen, nausea, flatulence, fever, chills, change in the color of feces and urine, constipation, diarrhea;
After passing gas and having a bowel movement, the pain often decreases or disappears.

2. Arising due to tension of the ligamentous apparatus of hollow organs and their stretching

rarely have a clear localization;
characterized by a pulling, aching character.

3. Dependent on various disorders of local circulation (congestive and ischemic pathologies in the vessels of the abdominal cavity)

paroxysmal nature of the pain syndrome with a slow increase in severity;
most probable reasons: spasm, stenotic lesion of the abdominal aorta (most often congenital or atherosclerotic), embolism and thrombosis of intestinal vessels, stagnation of blood in the inferior vena cava and portal veins, microcirculation disorders.

4. Peritoneal pain (the so-called “acute abdomen”: peritonitis, acute pancreatitis)

because of the transience they represent real threat for the life of the patient;
explained by severe structural changes in internal organs (ulcers, inflammation, malignant and benign neoplasms);
the level of pain is extremely high, further intensifying with coughing, palpation and any change in body position;
characteristic symptoms: unsatisfactory general state, muscle tension in the anterior abdominal wall, severe vomiting.

5. Reflected (mirror) pain

the approximate location of an attack cannot be “tied” to any organ;
diseases and pathologies that can provoke referred pain: pneumonia, embolism pulmonary artery, pleurisy, porphyria, poisoning, myocardial ischemia, pneumothorax, insect bites;
in some cases may mean terminal stage development malignant neoplasms(so-called neoplastic syndrome).

6. Psychogenic pain

are not objectively related to any problems in the internal organs;
most often such pain is explained psycho-emotional stress, heavy nervous exhaustion or even chronic fatigue;
the intensity of the attack depends to a greater extent on the psychological state of the patient, and not on individual characteristics his body;
the nature of the pain is long-lasting and monotonous, and often discomfort remain after the elimination of the causes that caused them.

Symptoms requiring emergency hospitalization

Diagnostics

AC - classic example how a formal approach to a patient can lead to big problems. When the only complaint presented is pain (especially for children), the doctor is faced with a difficult task: he is forced to explain to the patient that the prescription of certain painkillers is not a treatment, but only a relief of symptoms. The correct approach will be, as we have already found out, to search for the reasons that caused the pain. But the realities of our life are such that from the clinic the patient most often goes to the pharmacy for analgesics or antispasmodics.

What measures can be taken to make a correct diagnosis?

1. Laboratory research

clinical urine analysis is not the main thing in this case, but, nevertheless, will help to identify pyelonephritis, infection of the genitourinary tract and urolithiasis;
a blood test may indicate possible leukocytosis (a common companion to diverticulitis and appendicitis), but even normal results the analysis is not able to exclude infection or inflammation;
liver tests will give an idea of the condition of the liver, pancreas and gallbladder (the most informative indicators are the level of lipase and amylase).

2. Instrumental methods

Differential diagnosis

AS should be distinguished from acute conditions with similar clinical manifestations:

perforated ulcer of the duodenum or stomach (sudden sharp pain in the epigastrium);
acute cholecystitis (systematic pain attacks in the right hypochondrium);
acute pancreatitis (girdling pain accompanied by uncontrollable vomiting);
renal and hepatic colic (sharp cramping pain);
acute appendicitis (at first there is pain without obvious localization, but after 2-3 hours it migrates to the groin area);
thromboembolism of mesenteric vessels ( sudden attack pain without clear localization);
dissecting aneurysm of the abdominal aorta (sharp pain in the epigastrium against the background of severe atherosclerosis);
pleurisy and lower lobe pneumonia (signs acute inflammation lungs).

Treatment

Treatment of abdominal syndrome is a rather complex task. If the underlying cause of AS cannot be identified (this sometimes happens), doctors have to look for ways to relieve the pain attack. It should be borne in mind that the use of traditional analgesics is generally not recommended due to high probability blurring the clinical picture of the disease. Because most effective means Treatments currently considered include the following groups of drugs:

When abdominal pain occurs, many rush to take a No-shpa or Phthalazole tablet, believing that they have a problem with the digestive organs. However, the stomach can hurt due to a dozen reasons that have absolutely nothing to do with the stomach or intestines. This phenomenon even has medical term- abdominal syndrome. What it is? The name comes from the Latin “abdomen”, which translates as “belly”. That is, everything related to this area human body, is abdominal. For example, the stomach, intestines, bladder, spleen, kidneys are abdominal organs, and gastritis, pancreatitis, cholecystitis, colitis and other gastrointestinal problems are abdominal diseases. By analogy, abdominal syndrome is all the troubles in the abdominal area (heaviness, pain, tingling, spasms and other bad sensations). With such patient complaints, the doctor’s task is to correctly differentiate the symptoms so as not to make a mistake with the diagnosis. Let's figure out how this is done in practice and what the characteristics of pain are for each disease.

Human abdomen

To make it easier to understand the question: “Abdominal syndrome - what is it?” and to understand where it comes from, you need to clearly understand how our stomach works, what organs it contains, how they interact with each other. In anatomical pictures you can see a schematic tube of the esophagus, a baggy stomach, an intestine wriggling like a snake, the liver on the right under the ribs, the spleen on the left, and at the very bottom the bladder with ureters extending from the kidneys. That, it seems, is all. In reality, our abdominal cavity has a more complex structure. Conventionally, it is divided into three segments. The border of the upper one is - on the one hand - a dome-shaped muscle called the diaphragm. Above it is the chest cavity with the lungs. On the other hand, the upper segment is separated from the middle by the so-called mesentery of the colon. This is a two-layer fold, with the help of which all organs of the gastrointestinal tract are attached to the posterior plane of the abdomen. In the upper segment there are three sections - hepatic, pancreas and omental. The middle segment extends from the mesentery to the beginning of the pelvis. It is in this part of the abdomen that the umbilical zone is located. And finally, the lower segment is the pelvic area, in which the organs of the genitourinary and reproductive systems find their place.

Any disturbances (inflammation, infection, mechanical and chemical influences, pathologies of formation and development) in the activity of each organ located in the above three segments cause abdominal syndrome. In addition, the peritoneum contains blood and lymphatic vessels, and among them the most famous are the aorta and solar plexus. The slightest problem with them also provokes abdominal pain.

To summarize: abdominal syndrome can be caused by any currently known gastrointestinal disease and genitourinary system, problems with blood vessels and nerve plexuses peritoneum, chemical exposure (poisoning, drugs), mechanical compression (squeezing) by neighboring organs of everything located in the peritoneum.

The pain is acute

Differential diagnosis abdominal pain syndrome, as a rule, begins with determining the location and nature of the pain. The most life-threatening and difficult to tolerate by humans is, of course, sharp pain. It occurs suddenly, sharply, often without any visible reasons that provoked it, and manifests itself in attacks lasting from several minutes to an hour.

Acute pain may be accompanied by vomiting, diarrhea, fever, chills, cold sweat, and loss of consciousness. Most often they have a precise localization (right, left, bottom, top), which helps to establish a preliminary diagnosis.

Diseases that cause this abdominal syndrome are:

1. Inflammatory processes in the peritoneum - acute and recurrent appendicitis, Meckel's diverticulitis, peritonitis, acute cholecystitis or pancreatitis.

2. or strangulated hernia.

3. Perforation (perforation, hole) of the peritoneal organs, which occurs with a stomach and/or duodenal ulcer and diverticulum. This also includes ruptures of the liver, aorta, spleen, ovary, and tumors.

In cases with perforation, as well as appendicitis and peritonitis, the patient’s life depends 100% on correct setting diagnosis and emergency surgery.

Additional research:

blood test (makes it possible to assess the activity inflammatory process, determine blood type);
X-ray (shows the presence or absence of perforation, obstruction, hernia);
if there is a suspicion of bleeding in the gastrointestinal tract, an esophagogastroduodenoscopy is performed.

Chronic pain

They grow gradually and last long months. In this case, the sensations seem to be dull, pulling, aching, often “spread” over the entire periphery of the peritoneum, without a specific localization. Chronic pain may subside and return again, for example, after eating something. In almost all cases, such abdominal syndrome indicates chronic conditions. These may be:

1) gastritis (pain in the upper segment, nausea, heaviness in the stomach, belching, heartburn, problems with bowel movements);

2) stomach and/or duodenal ulcer on early stages(pain in the pit of the stomach on an empty stomach, at night or shortly after eating, heartburn, sour belching, bloating, flatulence, nausea);

3) urolithiasis disease(pain in the side or lower abdomen, blood and/or sand in the urine, pain when urinating, nausea, vomiting);

4) chronic cholecystitis (pain in the upper segment on the right, general weakness, bitterness in the mouth, low temperature, persistent nausea, vomiting - sometimes with bile, belching);

5) chronic cholangitis (pain in the liver area, fatigue, yellowness of the skin, low temperature, with acute form pain can radiate to the heart and under the shoulder blade);

6) oncology of the gastrointestinal tract in the initial stage.

Recurrent pain in children

Recurrent pain is pain that recurs over a period of time. They can occur in children of any age and in adults.

In newborns common cause pain in the tummy becomes intestinal colic (can be identified by sharp, high-pitched crying, restless behavior, bloating, refusal to eat, arching of the back, chaotic rapid movements of the arms and legs, regurgitation). An important sign Intestinal colic is that when they are eliminated, the baby becomes calm, smiles, and eats well. Heat, tummy massage, and dill water. As the baby grows up, all these troubles go away on their own.

A much more serious problem is abdominal syndrome in somatic pathology in children. "Soma" means "body" in Greek. That is, the concept of “somatic pathology” means any disease of the body organs and any congenital or acquired defect. In newborns the following are most often observed:

1) infectious diseases Gastrointestinal tract (temperature up to critical levels, refusal to eat, lethargy, diarrhea, regurgitation, vomiting, crying, in some cases, change in skin color);

2) pathologies of the gastrointestinal tract (hernia, cyst and others).

Making a diagnosis in this case is complicated by the fact that the baby is not able to show where it hurts and explain his feelings. Differential diagnosis of abdominal pain syndrome in newborns is carried out using additional examinations, such as:

coprogram;
blood analysis;
esophagogastroduodenoscopy;
abdominal cavity;
daily pH-metry.

Recurrent pain in adults

In older children (mostly school age) and adults, there are so many causes of recurring abdominal pain that they have been divided into five categories:

What are infectious and inflammatory pain, more or less clear. What do functional mean? If they are indicated in the diagnosis, how then should we understand the term “abdominal syndrome in children”? What it is? The concept of functional pain can be explained as follows: patients are bothered by discomfort in the abdomen for no apparent reason and without diseases of the peritoneal organs. Some adults even believe that the child is lying about his pain, since no violations are found in him. However, such a phenomenon exists in medicine, and it is usually observed in children over 8 years of age. Functional pain can be caused by:

1) abdominal migraine (abdominal pain turns into headache accompanied by vomiting, nausea, refusal to eat);

2) (completely healthy child pain appears in the upper abdominal segment and disappears after defecation);

3) intestinal irritation.

Another controversial diagnosis is “ARVI with abdominal syndrome” in children. Treatment in this case has some specificity, since children experience symptoms of both a cold and an intestinal infection. Doctors often make this diagnosis for children who have the slightest signs of acute respiratory viral infections (for example, a runny nose), but confirmation of diseases of the gastrointestinal tract is not found. The frequency of such cases, as well as the epidemic nature of the disease, deserve more detailed coverage.

ARI with abdominal syndrome

This pathology is more often observed in preschool children and junior schoolchildren. It occurs extremely rarely in adults. In medicine, acute respiratory infections and acute respiratory viral infections are classified as a single type of illness, since acute respiratory infections ( respiratory diseases) are most often caused by viruses, and they automatically become classified as RVI. It’s easiest to “catch them” in children’s groups - school, kindergarten, nursery. In addition to the well-known respiratory flu, the so-called “ stomach flu", or rotavirus. It is also diagnosed as ARVI with abdominal syndrome. Symptoms in children of this disease appear 1-5 days after infection. The clinical picture is as follows:

complaints of abdominal pain;
vomit;
nausea;
temperature;
diarrhea;
runny nose;
cough;
red throat;
painful to swallow;
lethargy, weakness.

As can be seen from the list, there are symptoms of both a cold and an intestinal infection. In rare cases, the child may actually have common cold plus gastrointestinal disease, which doctors must clearly distinguish between. Diagnostics rotavirus infection extremely complex. It includes electron microscopy, diffuse precipitation, and a variety of reactions. Pediatricians often make a diagnosis without such complex tests, only by clinical manifestation diseases and based on anamnesis. With rotavirus infection, although cold symptoms are present, it is not the ENT organs that are infected, but the gastrointestinal tract, mainly the colon. The source of infection is a sick person. Rotaviruses enter the body of a new host with food, through dirty hands, and household items (for example, toys) used by the patient.

Treatment of ARVI with abdominal syndrome should be based on the diagnosis. So, if abdominal pain in a child is caused by pathological waste products respiratory viruses, treatment of the underlying disease is carried out, plus rehydration of the body by taking sorbents. If rotavirus infection is confirmed, there is no point in prescribing antibiotics to the child, since they have no effect on the pathogen. Treatment consists of taking activated carbon, sorbents, diet, drinking plenty of fluids. If a child has diarrhea, probiotics are prescribed. Prevention of this disease is vaccination.

Paroxysmal pain without bowel disease

To make it easier to determine what causes abdominal syndrome, pain is divided into categories according to the location in the abdominal area where it is felt most strongly.

Paroxysmal pain without symptoms of dyspepsia occurs in the middle segment (mesogastrium) and lower segment (hypogastrium). Possible reasons:

infection with worms;
Payr's syndrome;
pyelonephritis;
hydronephrosis;
problems with the genitals;
intestinal obstruction (incomplete);
stenosis (compression) of the celiac trunk;

If the patient has just such an abdominal syndrome, treatment is prescribed based on additional examinations:

extended blood test;
sowing stool for worm eggs and intestinal infections;
Analysis of urine;
irrigography (irrigoscopy with barium beam method);
Dopplerography of abdominal vessels.

Abdominal pain with bowel dysfunction

All five categories of recurrent pain can be observed in the lower and middle segments of the peritoneum with intestinal problems. There are many reasons why this abdominal syndrome occurs. Here are just a few of them:

helminthiasis;
allergies to any products;
nonspecific ulcerative colitis (additionally, diarrhea is observed, and the stool may contain pus or blood, flatulence, loss of appetite, general weakness, dizziness, weight loss);
celiac disease (more often observed in young children when they begin to feed them with infant formula containing cereals);
infectious diseases (salmonellosis, campylobacteriosis);
pathologies in the large intestine, for example, dolichosigma (elongated sigmoid colon), with prolonged constipation added to the pain;
disaccharidase deficiency;
hemorrhagic vasculitis.

The latter disease appears when the blood vessels in the intestine become inflamed and, as a result, swell and thrombose. The reasons are disturbances in blood circulation processes and a shift in hemostasis. This condition is also known as hemorrhagic abdominal syndrome. It is differentiated in three degrees of activity:

I (mild) - symptoms are mild, determined ESR indicators in blood.

II (moderate) - mild pain in the peritoneum is observed, the temperature rises, weakness and headache appear.

III (severe) - high temperature, severe headaches and abdominal pain, weakness, nausea, vomiting with blood, urine and feces with blood, bleeding in the stomach and intestines, perforation may occur.

If pain occurs in the middle and lower parts of the peritoneum with suspicion of any problems with the intestines, diagnosis includes:

extended blood test (biochemical and general);
coprogram;
fibrocolonoscopy;
irrigography;
stool culture;
blood test for antibodies;
hydrogen test;
Endoscopy and tissue biopsy of the small intestine;
immunological tests;
sugar curve.

Pain in the upper segment of the peritoneum (epigastric)

Most often, abdominal syndrome in the upper segment of the peritoneum is a consequence of food intake and can manifest itself in two forms:

dyspepsia, that is, with disruption of the stomach (“hunger pains” that go away after eating);
dyskinetic (bursting pain, feeling of overeating, regardless of the amount of food taken, belching, vomiting, nausea).

The causes of such conditions can be gastroduodenitis, hypersecretion of hydrochloric acid in the stomach, infections, worms, diseases of the pancreas and/or biliary tract, and impaired gastroduodenal motility. In addition, pain in the epigastrium can be caused by Dunbar's syndrome (pathology of the celiac trunk of the aorta when it is compressed by the diaphragm). This disease can be congenital, hereditary (often) or acquired when a person develops neurofibrous tissue.

The celiac trunk (a large short branch of the aorta of the peritoneum) during compression turns out to be pressed against the aorta, strongly narrowed at its mouth. This causes abdominal ischemic syndrome, which is diagnosed using contrast X-rays (angiography). The celiac trunk, together with other blood vessels of the abdominal cavity, supplies blood to all organs of the gastrointestinal tract. When compressed, the delivery of blood, and therefore the supply of organs with necessary substances, does not occur in full, which leads to their oxygen starvation(hypoxia) and ischemia. The symptoms of this disease are similar to those observed with gastritis, duodenitis, and stomach ulcers.

If the intestines experience a lack of blood supply, ischemic colitis and enteritis develop. If insufficient blood flows to the liver, hepatitis develops, and the pancreas responds to disruptions in the blood supply with pancreatitis.

To avoid misdiagnosis, additional examinations of patients with suspected abdominal ischemic syndrome should be carried out. Endovascular diagnosis is an advanced method that involves examining blood vessels by inserting a catheter with x-ray properties. That is, the method will allow you to see problems in the vessels without surgical intervention. Endovascular diagnostics is used for any vascular diseases of the abdominal cavity. If there are indications, endovascular operations are also performed. Abdominal ischemic syndrome can be suspected based on the following patient complaints:

constant abdominal pain, especially after eating, when performing any physical work or emotional stress;
sensations of fullness and heaviness in the upper segment of the peritoneum;
belching;
heartburn;
feeling of bitterness in the mouth;
diarrhea or, conversely, constipation;
frequent headaches;
dyspnea;
throbbing in the abdomen;
weight loss;
general fatigue and weakness.

Only an external examination of the patient, as well as standard methods diagnostics (blood tests, urine tests, ultrasound) are not decisive in detecting this disease.

Vertebral abdominal syndrome

This type of pathology is one of the most difficult to detect. It lies in the fact that patients have obvious signs problems with the gastrointestinal tract (abdominal pain, vomiting, belching, heartburn, diarrhea or constipation), but they are caused by diseases of the spine or other parts musculoskeletal system. Often doctors do not immediately correctly determine the cause, so they carry out treatment that does not bring results. So, according to statistics, about 40% of patients with osteochondrosis thoracic, are being treated for intestinal and stomach diseases that do not exist. The picture with spinal diseases is even sadder. The pain in such cases is most often aching, dull, absolutely unrelated to food intake, and if patients have constipation or diarrhea, they are not treated classical methods. The following diseases can cause vertebral abdominal syndrome:

spondylosis;
scoliosis;
spinal tuberculosis;
syndromes associated with tumor changes in the spinal column;
visceral syndromes (Gutzeit).

The saddest thing is that patients who complain of abdominal pain and do not have gastrointestinal pathologies are often perceived as malingerers. To find out the cause of unexplained abdominal pain, it is necessary to use additional diagnostic methods, such as spondylography, X-ray, MRI, X-ray tomography, echospondylography and others.

Colds in young children are a common cause of concern for parents. Often they simply do not know how to behave and what to do, how ARVI differs from the flu. Let's consider the disorder, name its features, signs and possible complications that are observed in children who have had a viral infection, list the means of treatment and prevention of the disease.

Incubation period of ARVI in children

Common causes of ARVI in children are parainfluenza viruses, sentential infection, adenovirus and rhinovirus. They are transmitted exclusively by airborne droplets. People often combine these diseases with one term – cold. According to statistical observations of ARVI, the symptoms and treatment of which in children are described below, up to 3 years of age are recorded 6-8 times per year. This is due to the instability of the immune system.

The incubation period of ARVI, for which there are no symptoms and therefore is not treated in children, lasts from 1 to 10 days. On average, its duration is 3-5 days. In this case, the period of contagiousness (the time when infection of others is possible) is 3-7 days. It is worth noting that with a respiratory-sentential pathogen, the release of the pathogen is recorded even after a few weeks, when the first clinical manifestations appear.

Symptoms of ARVI in children

This disease has an acute onset. At the same time, doctors note 2 syndromes in its manifestations: catarrhal and intoxication. The first is characterized by the appearance external signs, among which:

runny nose;
sneezing;
lacrimation;
cough;
sore throat;
pain when swallowing.

These signs of ARVI in children become an indication to start therapeutic effects. In its absence, or incorrectly prescribed and further development of the process, signs of intoxication appear, as the pathogen begins to release its metabolic products into the blood. At this stage the following are recorded:

Nervous system disorders:

weakness apathy;
fatigue;
headache;
Pain in the eyes;
muscle pain.

From the gastrointestinal tract:

decreased appetite;
nausea;
vomit;
loose stool.

Damage to the immune system—enlargement of regional lymph nodes.

How to distinguish influenza from ARVI in a child?

Due to the fact that these 2 diseases are viral in nature, they have similar external manifestations. Parents themselves often cannot correctly identify what the child is sick with. Among the main differences it is necessary to note:

Flu always has an acute onset. Almost within a few hours after the pathogen enters the body, there is a deterioration in general health, aches and fatigue appear. ARVI has a gradual course with increasing symptoms - runny nose, sore throat, then cough.
The flu is characterized by headaches with a rise in temperature to 39, chills, and increased sweating. A respiratory viral infection is characterized by nasal congestion and sneezing.
During a cold, intoxication is less severe. Influenza is characterized by a severe course, with frequent complications. In the absence of timely treatment, progression to bronchitis and pneumonia is possible.
A long recovery period is typical for influenza. It takes about 1 month. Noted asthenic syndrome, which is characterized by increased fatigue, mood swings, and decreased appetite.

In some cases, parents notice that their child’s legs hurt due to ARVI. This phenomenon indicates high degree intoxication of the body, and is often observed when a bacterial factor is added. Often, an undetected cold in time without treatment develops into pneumonia. It is characterized by defeat respiratory system, severe cough, requires antibacterial therapy and hospitalization.

Many mothers, turning to a pediatrician, complain that their child has a stomach ache due to ARVI. This phenomenon is recorded 1-2 days after the start. In this case, vomiting and frequent bowel movements are observed, but irritation of the peritoneum is not noted. In such cases, a preliminary diagnosis of “appendicitis” is erroneously made. To be properly diagnosed, you need to see a doctor.

It is worth noting that abdominal syndrome during ARVI, the symptoms and treatment of which in children differ from the treatment in adults, lasts for 2 days. The reason for this phenomenon may be damage to the autonomic nervous system by toxins released by pathogens. The patient is recorded:

increased sweating;
deterioration in general health;
skin rash that fades quickly.

Diarrhea due to ARVI in a child

Diarrhea during ARVI is observed when the disorder is provoked by rotavirus. This pathogen affects the intestines and stomach. The virus is relatively resistant to current therapy. Nausea, vomiting, general loss of strength, and apathy are often observed. The child does not show interest in games and often lies down. Similar symptoms are observed for 1-3 days, after which a period of relief begins.

Enterovirus and adenovirus can also cause diarrhea. In this case, their transmission is carried out through contact and household means. Infection is accompanied by the appearance of the following symptoms:

cough;
soreness in the ear area (rare);
nasal congestion;
redness of the tongue and palatine arches (occasionally).

Vomiting due to ARVI in a child

Vomiting during ARVI may be the result of the body's reaction to a sharp rise in temperature. It is worth noting that in such a situation the phenomenon is one-time in nature. If the child feels sick throughout the whole day and at the end of the day the health does not improve, 2 or more acts of vomiting are recorded, it is necessary to consult a doctor. Such symptoms are characteristic of rotavirus infection, as described above.

Temperature during ARVI in children

Considering ARVI, the symptoms and treatment of which in children are described in the article, we note that an increase in temperature values is the first sign of a cold. This is how the body strives to kill the virus, reduce its activity, prevent reproduction, further development diseases. But with a simple cold, the value of this parameter does not exceed 38 degrees. With ARVI, a child may have a temperature of 39 if it is the flu. Appear accompanying symptoms: headache, aches, restless child, refuses to play.

It is worth noting that antipyretics are taken when the values have crossed 39 degrees. Until this time, doctors do not recommend using medicines. Such recommendations are due to the need to activate the immune system and form antibodies to the pathogen.

How long does the fever last for ARVI in children?

It is worth noting that antipyretics are taken when the values have crossed 39 degrees. Until this time, doctors do not recommend using medications. Such recommendations are due to the need to activate the immune system and form antibodies to the pathogen. When talking about how many days the temperature lasts for ARVI in children, doctors talk about an average value of 3-5 days.

At the same time, they note that how long the temperature lasts during ARVI in a child depends on:

baby's age
state of the immune system.
type of pathogen.

How to treat ARVI in children?

It is necessary to begin treatment for ARVI in children as soon as the first signs appear. The basis of therapy is symptomatic treatment - combating symptoms: nasal rinsing, gargling, inhalation. But in order to exclude the cause, it is necessary to determine the type of pathogen. Due to the fact that such a diagnosis takes time, doctors resort to prescribing antiviral drugs that have a wide spectrum. The complex of therapy for ARVI includes:

antipyretic drugs;
use of antiviral agents;
symptomatic treatment: cough and runny nose remedies.

Treatment of ARVI in children - drugs

To begin with, it must be said that antibiotics for ARVI in children, as well as in adult patients, are not used. They are not effective for this type of disorder - they affect microorganisms, and respiratory infections are viral in nature. The justification for using this group of drugs may be due to the addition of diseases of bacterial origin.

Antiviral drugs for ARVI, the symptoms and treatment of which in children are sometimes determined by the child’s condition, should be prescribed in the first 1-1.5 days. Among the drugs used for ARVI, it is necessary to mention:

Antiviral:

Remantadine is effective against all strains of influenza virus type A; also able to suppress the development of parainfluenza viruses; the drug is used for a course of 5 days; The estimated dosage of the drug is 1.5 mg/kg per day, this amount is taken 2 times (for children 3-7 years old), children 7-10 years old - 50 mg 2 times a day, over 10 - 3 times in the same dosage .
Arbidol is an active interferon reducer that quickly activates the immune system; reception can be started from 2 years; Children 2-6 years old are prescribed 50 mg at a time, 6-12 years old - 100 mg.

For local symptomatic treatment:

Oxolinic ointment;
Florenal 0.5%;
Bonafton.

Antipyretics:

Paracetamol is used at the rate of 15 mg/kg, per day it is permissible to take 60 mg/kg;
Ibuprofen is prescribed at 5-10 mg/kg of the child’s body weight; it reduces the severity of pain (arthralgia, muscle pain).

How long does ARVI last in a child?

The duration of ARVI is an exclusively individual parameter. Pediatricians cannot give a definite answer to this question. According to statistical observations, the average duration of a cold from the first appearance of its symptoms until the disappearance of clinical manifestations is 1-1.5 weeks. But this does not mean that the mother should prepare herself for such a long-term treatment. Factors determining this parameter are:

state of immunity;
intensity of treatment;
form of the disease.

It is worth considering that any virus is capable of mutation. This fact determines the individual treatment algorithm for ARVI, the symptoms and treatment of which in children are described above. This phenomenon completely changes the structure of the virus - new symptoms appear, which can mislead doctors and complicate the diagnostic process. As a result, there is a need long-term treatment, the use of new methods and drugs.

Complications after ARVI in children

The most common type of complication of ARVI in children is damage to the sinuses - ethmoiditis, sinusitis. The main symptom of such disorders is constant nasal congestion. The child himself complains about:

Constant headaches. Visually, parents can identify swelling in the lower jaw. It is worth noting that the greatest likelihood of developing such a disorder is observed in children with a curved nasal septum, carious teeth.
Inflammation of the upper respiratory tract is also considered as a consequence of acute respiratory viral infection, the symptoms and treatment of which in children are similar to what is carried out in adults. With laryngitis, children complain of soreness, a feeling of a lump in the throat, and tickling.
Acute tonsillitis is regarded by doctors as a consequence of a cold. It becomes painful for the child to swallow, and a sore throat appears. Such a violation is dangerous because it can cause complications on the kidneys and cardiovascular system.
Defeat hearing aid– not uncommon after ARVI. Doctors often register otitis media, eustachitis. Guys complain of shooting pains in the ear, which leads to hearing loss.

Cough after ARVI in a child

Residual cough in a child after ARVI is observed for 1-2 days. At the same time, it is of low intensity, does not bother, and mild coughing is periodically noted. If the cough persists for 3-5 days and its intensity does not decrease, you should consult a pediatrician. A visit to the doctor will allow you to accurately determine the disorder, methods and algorithm for its treatment. Similar symptoms are typical for diseases of the upper respiratory tract:

bronchitis;
laryngitis;
pharyngitis.

A child's legs hurt after ARVI

Often mothers note that their child’s calves hurt after an acute respiratory viral infection. The main reason Such painful phenomena are recognized as intoxication of the body. This explains the phenomenon in which a child, after an acute respiratory viral infection, has a temperature of 37. In such cases, in order to reduce suffering, a warming ointment is used (the temperature normalizes itself). This remedy helps to expand local blood vessels and increase blood flow to them. To exclude this consequence of ARVI, the symptoms and treatment of which in adolescents and children are mentioned above, therapy is prescribed from the first manifestations.

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In what cases does abdominal syndrome develop?

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

These may be diseases of the digestive system - hepatitis, cirrhosis of the liver, stenosis of the duodenal pylorus, etc.
The mentioned abdominal pain can also accompany pathologies of the chest organs - pneumonia, myocardial infarction, diverticulosis of the esophagus, etc.
The manifestation of abdominal syndrome has also been observed in infectious or viral diseases - syphilis, herpes zoster, etc.

A special group of pathological conditions that shape the development of the described pathology includes diseases caused by metabolic or immune system disorders - diabetes mellitus, rheumatism and porphyria.

How pain manifests itself under various factors

Abdominal pain syndrome is distinguished depending on the type of pain. It is this sign that often helps specialists make the correct diagnosis and establish the cause of the disease. This is done through 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, having the character of a painful 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 collectively called “acute abdomen”. Such pain appears suddenly, it is diffuse, accompanied by general malaise and severe vomiting. It gets worse when you change position, move or cough.
Referred pain occurs during pneumonia, heart attack, pleurisy, etc. During such attacks, pain caused by a disease of an organ located outside the abdominal cavity is reflected into the abdomen. It is usually accompanied by symptoms of the disease against which the described syndrome develops - fever (if it is an infection), pain in the heart or in the joints (with ischemic heart disease or rheumatism), etc.
And psychogenic pain is not associated with diseases of the internal organs. They are neurotic and are most often caused by stress, shock and depression of the patient.

Features of the manifestation of chronic abdominal pain

Abdominal pain syndrome can manifest itself in short-lived and rapidly developing attacks, or it can also be protracted and chronic.

In the latter case, the pain, as a rule, increases gradually and recurs over several weeks or 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.

True, not all chronic abdominal pain is caused by mental disorders - they can also appear against the background of cancer, joint diseases, and 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 suffers from repeated vomiting;
abdominal muscles are tense;
along with pain, tachycardia occurs and blood pressure decreases;
the patient is worried about a fever, the origin of which is unclear;
the volume of the abdomen increases greatly, accompanied by severe pain;
gases do not escape, and there are no peristaltic sounds;
Women experience heavy discharge or bleeding.

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

Abdominal pain syndrome in children

Children are a special risk group for the development of abdominal syndrome. This is due to the child’s body’s ability to overreact to any damaging factors.

Difficulties in diagnosing abdominal syndrome in children

By the way, pediatricians say that children quite often describe any ailment or feeling of discomfort as abdominal pain. Doctors encounter this description even in cases where the child clearly experiences dizziness, pain in the ears, head, or nausea.

This means that 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 be safe!

Manifestation of the syndrome in ARVI

Pediatricians often observe ARVI with abdominal syndrome. In children, this is also due to 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 may turn out to be both a feature of the child’s body’s response to infection and, for example, a sign of a chronic pathology of the abdominal organs that has worsened against the background of ARVI.

How is abdominal syndrome treated?

To eliminate the discomfort that appears due to problems with the gastrointestinal tract, myotropic antispasmodics are usually prescribed. The most popular among them is the drug "Drotaverine", which has a highly selective effect and does not have a negative effect on the nervous and cardiovascular systems. This remedy not only has an antispasmodic effect, but also helps reduce blood viscosity, which makes it possible to use it not only for biliary dyskinesia, gastric or duodenal ulcers, but also for ischemic intestinal disease.

What is abdominal ischemic syndrome

In medicine, it is customary to distinguish the syndrome of abdominal chronic ischemia from the various abdominal pain described above. It is a long-term insufficiency of blood supply to various parts of the abdominal aorta as a result of:

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

This condition is fraught with the death (necrotization) of areas of blood vessels or organs that do not receive sufficient oxygen and do not remove decay products.

How to deal with abdominal ischemic syndrome

When diagnosed with “abdominal ischemic syndrome,” treatment, as in other cases, is aimed at the underlying disease. The patient is prescribed antispasmodics, drugs that improve blood circulation, anticoagulants, and in the case of intestinal dysbiosis, drugs that improve its microflora.

Patients are usually recommended to eat fractional meals in small portions with the exception of coarse and gas-forming foods. And in severe cases of the disease, they may be indicated for surgical intervention to restore blood circulation in the abdominal branches of the aorta.

Compartment syndrome

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

By the way, there are no specific symptoms indicating intra-abdominal hypertension, therefore, to make this diagnosis, a physical method of examining the abdomen or studying the general clinical picture of the disease is not enough. 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 prescribing urgent, adequate treatment.

As already mentioned, compartment syndrome is a dangerous condition. Without special treatment, it can lead not only to serious dysfunction 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 is reduced and blood circulation in the abdominal area is restored.

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Symptoms

The symptoms of acute respiratory viral infections and acute respiratory infections are actually the same. It is quite difficult to establish the symptoms of ARVI in children. At the initial stage of development of the disease, it is almost impossible, even knowing the signs of ARVI in children. For this reason, the doctor can indicate the diagnosis of acute respiratory infections in the medical history, and this will not be his mistake.

To establish a diagnosis of ARVI in children, it will be necessary to go through several stages of research, donate the child’s blood for analysis to determine the presence or absence of the virus. The doctor does not refer the child for tests, but is based on visually detected symptoms. The diagnosis of ARVI in children is made by a doctor in the case when the disease has signs of mass spread, the cause of which can only be a virus transmitted by airborne droplets.

Acute respiratory infections and acute respiratory viral infections in children have common symptoms:

pain in the child’s oropharynx;
presence of a runny nose, difficulty breathing through the nose;
at the beginning of the disease, pain in the eyes and lacrimation appear;
have headaches;
there is a cough;
the child experiences lethargy and general malaise.

To determine acute respiratory infections or acute respiratory viral infections in children, you need to understand what is going on. With a cold, the disease develops slowly, unlike the flu. The child begins to have a sore throat, and after a while a runny nose appears. With the appearance of a runny nose, the child begins to sneeze, and after a couple of days, cough. In this case there may be slight fever, from 37 and a half to 38 degrees Celsius.

In some cases, ARVI may be accompanied by abdominal syndrome. Gastrointestinal diseases are often associated with this syndrome. Abdominal syndrome is abdominal pain in a child. Under no circumstances should pain be ignored, and vice versa, it is important to understand whether it is related to ARVI or is another disease. To accurately determine the cause of pain, it is better to show your baby to a doctor. If necessary, the doctor will write out a referral for an ultrasound to examine the internal organs.

The flu differs from the cold in its rate of development. Moreover, it is not so easy to distinguish which type of virus a child has in each individual case. This is determined by the symptoms that appear in the presence of a certain type of virus. Basically, there are three types of viruses in mind. They are parainfluenza, adenovirus and rhinovirus.

Symptoms of different types of influenza viruses:

parainfluenza distorts the child's voice. Hoarseness is observed, in which the sonority of the voice is lost and hoarseness appears. Complete loss of voice may occur;
adenoviral infection affects the child’s tonsils. At first, there is an increase in the palatine tonsils, which creates difficulties when trying to make swallowing movements. On the second or third day, a burning sensation appears in the eyes. After the same amount of time, a grayish or whitish film appears on the tonsils, in the throat area, under the eyelids and in the corners of the eyes. In addition to this, pain in the abdominal area may appear and increase The lymph nodes in the patient;
Rhinovirus infection is expressed in the patient’s sensation of dryness in the nasopharynx, incessant sneezing, and a sore throat. The temperature remains at 37 degrees Celsius, and after a couple of days, clear mucus continuously discharges from the nose.

Influenza epidemics occur every year, affecting people regardless of gender and age. Treating the disease or doing anything on your own is not recommended. This can lead to all sorts of complications. Possible complications are due to the fact that the influenza virus tends to mutate. No one knows how the virus will behave in this disease. Moreover, the influenza virus affects both people and animals, which creates additional conditions for the spread of the disease.

How long does the illness last?

Usually the illness lasts about ten days, but only in cases where:

no complications;
adequate treatment is being carried out.

In case of illness in children aged from one to 10 years, it is recommended to consult a doctor for recommendations. Treating children from one to 6 years of age on your own, especially if it concerns medications, is extremely dangerous for the child’s health.

Treatment

Treatment of ARVI in children is mainly symptomatic, aimed at eliminating symptoms and viruses. acute respiratory infections infants treated with extreme caution.

For colds, in case of pronounced symptoms, apply antiviral drugs. Most of these drugs are available without a prescription. It is necessary to take immunostimulating drugs to boost immunity, which in children aged from one to 4-5 years is always weak and vulnerable. The disease occurs more often in the cold season. Usually in winter, children's immunity is weakened due to a lack of vitamins and increased growth. No matter how many vitamins a child is given, they are still in winter time missing due to increased activity with the growth of the body. For this reason, children aged 1 to 4 years are at risk, as are older people.

To make breathing easier, vasoconstrictor medications are taken in the form of nasal drops or sprays. Nasal medications should be taken with caution to avoid addiction and possible complications. Along with this, it is necessary to take cough suppressants. Periodically it is necessary to carry out inhalations to soften the cough and remove sputum. It is recommended to periodically rinse your nose using weak saline solutions.

For inhalation, pairs of tinctures and decoctions of calendula, chamomile and sage are suitable. You can prepare a mixture of soda and salt for inhalation. To make breathing easier, you can warm up your baby's nose using a boiled warm egg. Another way to warm up the spout is to use a small bag of heated salt.

If you have a sore throat, you should gargle periodically. Rinsing is also carried out using herbs or weak salt solutions. You can add a couple of drops of iodine to the saline solution.

In addition to this, during the illness the child should wear warm woolen socks and scarves during the winter season. It is important to keep your body warm and comfortable.

If the child is between one and 4 years old, call a doctor at the first symptoms. If a child has this age category frequent acute respiratory viral infections are observed, it is necessary to identify the cause.

Features of treatment of infants

Acute respiratory infections are caused by over 200 types of viruses that have been identified to date. The disease can infect both an adult and an infant aged 3 months to a year. If this happens, do not rush to do anything yourself, it is better to immediately call a doctor.

The main rule for acute respiratory infections in an infant under one year old is drinking. It is necessary to give your baby water more often than usual. Ideally, the water should be equal to the body temperature of a healthy child. This temperature of water, when it enters the baby’s stomach, is quickly absorbed by the body. The fluid entering the body helps to dilute mucus and quickly remove it from the body. If a baby’s sputum with acute respiratory infections is viscous, this will indicate a lack of fluid in the body.

In case of fever, the temperature is brought down by various antipyretic suppositories. This can be done if the baby’s temperature rises from 38 degrees Celsius. If the temperature is below this indicator, then there is no need to bring it down. Rectal suppositories are contraindicated for diarrhea and stomach upsets in a baby. The presence of temperature during acute respiratory infections is quite normal phenomenon, indicating that the immune system is independently fighting the virus. The goal is to help the immune system fight the virus and recover. If the baby has a fever, there is no need to bathe him in hot water. It's better to wait until the temperature drops.

The best way to help a baby is mother's milk. Breast milk contains a lot of useful substances necessary for the development of the growing baby's body, including immunoglobulins. Immunoglobulins are substances that help the infant’s developing immune system fight viruses and infections. Babies aged six months and above can be given chamomile or rosehip infusions as drinks.

During illness, the baby may lose appetite. There is no need to force him to eat; it is better to feed the child in such cases when he himself asks for it. Loss of appetite is a peculiar reaction of the body fighting the virus.

The temperature in the room where the patient is located should be approximately 20-22 degrees. The baby’s room must be ventilated regularly so that the viruses in the sick baby’s room die and do not spread. During your baby's illness, monitor the humidity in the room to avoid drying out the mucous membranes of the nose and oropharynx.

Complications

Like many diseases, inadequate treatment or no treatment at all can lead to complications. If a child, having a cold, does not comply with bed rest, then such an attitude towards the illness can lead to complications in the form of otitis media or sinusitis. Parainfluenza can cause complications in the form of sinusitis.

This can also happen if the disease is not completely cured. Complications rarely occur with colds in people with strong immunity.

Prevention

For prevention purposes, it is necessary to isolate the patient as much as possible. It is necessary to provide the patient with separate dishes, towels and other utensils. When washing dishes, it is advisable to scald them with boiling water. The patient's room must be regularly ventilated.

Viruses with this disease spread very quickly. You can become infected by being at a distance of seven meters from the patient. This is due to the fact that in the first days of the disease the patient is most contagious, and viruses are transmitted by airborne droplets. At the same time, influenza viruses can live perfectly well while outside the body in the air. They feel great indoors, warm rooms. Ventilation of the room and cool air eliminate airborne viruses. Approach the patient at medical mask. Complete the treatment, use as many medications as the doctor prescribes.

There is no panacea for this disease. This is due to the mutation of viruses. To somehow limit the possibility of infection, you can get an annual vaccination. The best prevention of this disease is a strong immune system. Regular hardening of the body is suitable for this. At strong immunity, even if infected, the body itself can easily cope with the virus and receive antibodies.

It is important to understand that acute respiratory diseases are diseases that you will have to face one way or another, no matter how hard you try to protect your first-born. A child between 4 and 10 years old can get this disease up to 12 times a year and this is not a reason for concern. Between the ages of 4 and 6, children usually attend kindergartens, and from the age of 7 they attend schools. For this reason, frequent illnesses acute respiratory diseases in children of this age category, especially in winter, are associated with being in the same room.

The main rule is never give a child under 10 years of age medicine every time he has a runny nose. Let your body cope with the illness on its own and frequent acute respiratory infections will stop over time. Moreover, by using this or that medication without consulting a doctor, you risk complicating the situation.

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ARVI with abdominal syndrome

is a complex of symptoms that primarily manifests itself as abdominal pain. The main reasons for the development of the syndrome are spasms of certain parts of the gastrointestinal tract or overstretching of the biliary tract. Abdominal syndrome also causes bloating.

Causes of abdominal syndrome

The appearance of unpleasant symptoms is provoked by:

passive lifestyle;
stress;
poor nutrition;
taking antibiotics;
intestinal disease and others.

Quite often the appearance of pain is provoked by spasms resulting from allergic reaction, irritation of the phrenic nerves, irradiation of pain from the pleura or pericardium.

If the cause of abdominal ischemic pain syndrome is vasculitis and periarteritis, then such unpleasant symptom, like blood in the stool, the cause of this is hemorrhage into the intestinal wall.

In addition, the syndrome itself can become a sign of a disease. Thus, ARVI with abdominal syndrome indicates that the disease is progressing to a more complex stage and can lead to febrile seizures, hemorrhagic phenomena or chronic diseases.

Symptoms of abdominal syndrome

Abdominal pain syndrome is characterized by intermittent pain, the localization of which is difficult to determine.

The disease is also accompanied by:

vomiting;
tension in the muscles of the anterior abdominal wall;
changes in the cellular composition of the blood, that is, leukocytosis.

Experts distinguish two types of pain:

Acute abdominal syndrome. It has a short duration and most often develops quickly.
Chronic abdominal pain syndrome. It is characterized by a gradual increase in pain that can recur over months.

The syndrome is also divided into:

visceral;
parental;
reflected;
psychogenic.

Visceral pain occurs as a result of increased pressure in the hollow organ or stretching of its wall; also factors in the development of pain are:

mesenteric tension;
vascular disorders;
stretching of the capsule of parenchymal organs.

Somatic pain results from the presence pathological processes in the parietal peritoneum and tissues.

Abdominal reflected mechanism syndrome is localized in various anatomical areas, which can be significantly distant from the pathological focus. This pain occurs when a stone passes or an organ is damaged.

The cause of psychogenic pain is often depression, which in the first stages may not be noticed even by the patient himself. Stress and prolonged depression trigger a biochemical process that provokes the development of psychogenic pain.

Often one form of pain flows into another. Thus, with increased pressure in the intestines, visceral pain occurs, which subsequently flows into reflected pain in the back.

Thus, abdominal syndrome has a fairly extensive list of manifestations that signal the presence of pathologies in the body.

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What is abdominal syndrome called? Treatment of abdominal syndrome

Abdominal syndrome in medicine is usually called a complex of symptoms, the main criterion for which is abdominal pain. It should be immediately noted 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 by problems with the patient’s nervous system, the condition of his lungs and heart. This pain can also be provoked by an inflammatory process in the peritoneum caused by exposure to toxic substances, and its stretching by a diseased organ.

In what cases does abdominal syndrome develop?

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

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

How pain manifests itself under various factors

There are spastic pains that arise and disappear suddenly, having the character of a painful 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 collectively called “acute abdomen”. Such pain appears suddenly, it is diffuse, accompanied by general malaise and severe vomiting. It gets worse when you change position, move or cough.
Referred pain occurs during pneumonia, heart attack, pleurisy, etc. During such attacks, pain caused by a disease of an organ located outside the abdominal cavity is reflected into the abdomen. It is usually accompanied by symptoms of the disease against which the described syndrome develops - fever (if it is an infection), pain in the heart or in the joints (with coronary heart disease or rheumatism), etc.
And psychogenic pain is not associated with diseases of the internal organs. They are neurotic and are most often caused by stress, shock and depression of the patient.

Features of the manifestation of chronic abdominal pain

Abdominal pain syndrome can manifest itself in short-lived and rapidly developing attacks, or it can also be protracted and chronic.

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 suffers from repeated vomiting;
abdominal muscles are tense;
along with pain, tachycardia occurs and blood pressure decreases;
the patient is worried about a fever, the origin of which is unclear;
the volume of the abdomen increases greatly, accompanied by severe pain;
gases do not escape, and there are no peristaltic sounds;
Women experience heavy discharge or bleeding.

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

Abdominal pain syndrome in children

Children are a special risk group for the development of abdominal syndrome. This is due to the child’s body’s ability to overreact to any damaging factors.

Difficulties in diagnosing abdominal syndrome in children

By the way, pediatricians say that children quite often describe any ailment or feeling of discomfort as abdominal pain. Doctors encounter this description even in cases where the child clearly experiences dizziness, pain in the ears, head, or nausea.

This means that 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 be safe!

Manifestation of the syndrome in ARVI

Pediatricians often observe ARVI with abdominal syndrome. In children, this is also due to the peculiarity of the body’s reaction to damaging factors.

How is abdominal syndrome treated?

To eliminate the discomfort that appears due to problems with the gastrointestinal tract, myotropic antispasmodics are usually prescribed. The most popular among them is the drug "Drotaverine", which has a highly selective effect and does not have a negative effect on the nervous and cardiovascular systems. This remedy not only has an antispasmodic effect, but also helps reduce blood viscosity, which makes it possible to use it not only for biliary dyskinesia, gastric or duodenal ulcers, but also for ischemic intestinal disease.

What is abdominal ischemic syndrome

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

This condition is fraught with the death (necrotization) of areas of blood vessels or organs that do not receive sufficient oxygen and do not remove decay products.

Interestingly, abdominal ischemic syndrome is most often found in men after 45 years of age. And it manifests itself, as a rule, as a triad of symptoms - pressing and aching, often paroxysmal pain in the abdomen, intestinal dysfunction, as well as a progressive decrease in body weight.

How to deal with abdominal ischemic syndrome

Compartment syndrome

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

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Differential diagnosis of abdominal pain syndrome. Abdominal syndrome - what is it?

When abdominal pain occurs, many rush to take a No-shpa or Phthalazole tablet, believing that they have a problem with the digestive organs. However, the stomach can hurt due to a dozen reasons that have absolutely nothing to do with the stomach or intestines. This phenomenon even has a medical term - abdominal syndrome. What it is? The name comes from the Latin “abdomen”, which translates as “belly”. That is, everything connected with this area of the human body is abdominal. For example, the stomach, intestines, bladder, spleen, kidneys are abdominal organs, and gastritis, pancreatitis, cholecystitis, colitis and other gastrointestinal problems are abdominal diseases. By analogy, abdominal syndrome is all the troubles in the abdomen (heaviness, pain, tingling, spasms and other bad sensations). With such patient complaints, the doctor’s task is to correctly differentiate the symptoms so as not to make a mistake with the diagnosis. Let's figure out how this is done in practice and what the characteristics of pain are for each disease.

Human abdomen

To summarize: abdominal syndrome can be caused by any currently known disease of the gastrointestinal tract and genitourinary system, problems with blood vessels and nerve plexuses of the peritoneum, chemical exposure (poisoning, drugs), mechanical compression (squeezing) by neighboring organs of everything located in the peritoneum.

The pain is acute

Differential diagnosis of abdominal pain syndrome, as a rule, begins with determining the location and nature of the pain. The most life-threatening and difficult for a person to endure is, of course, acute pain. It occurs suddenly, sharply, often without any visible reasons that provoked it, and manifests itself in attacks lasting from several minutes to an hour.

Diseases that cause this abdominal syndrome are:

1. Inflammatory processes in the peritoneum - acute and recurrent appendicitis, Meckel's diverticulitis, peritonitis, acute cholecystitis or pancreatitis.

2. Intestinal obstruction or strangulated hernia.

In cases with perforation, as well as appendicitis and peritonitis, the patient’s life depends 100% on the correct diagnosis and urgent surgical intervention.

Additional research:

blood test (makes it possible to assess the activity of the inflammatory process and determine the blood group);
X-ray (shows the presence or absence of perforation, obstruction, hernia);
if there is a suspicion of bleeding in the gastrointestinal tract, an esophagogastroduodenoscopy is performed.

Chronic pain

They grow gradually and last for many months. In this case, the sensations seem to be dull, pulling, aching, often “spread” over the entire periphery of the peritoneum, without a specific localization. Chronic pain may subside and return again, for example, after eating something. In almost all cases, such abdominal syndrome indicates chronic diseases of the abdominal organs. It can be:

1) gastritis (pain in the upper segment, nausea, heaviness in the stomach, belching, heartburn, problems with bowel movements);

2) stomach and/or duodenal ulcer in the early stages (pain in the pit of the stomach on an empty stomach, at night or shortly after eating, heartburn, sour belching, bloating, flatulence, nausea);

3) urolithiasis (pain in the side or lower abdomen, blood and/or sand in the urine, pain when urinating, nausea, vomiting);

4) chronic cholecystitis (pain in the upper segment on the right, general weakness, bitterness in the mouth, low temperature, persistent nausea, vomiting - sometimes with bile, belching);

5) chronic cholangitis (pain in the liver, fatigue, yellowness of the skin, low temperature; in the acute form, pain can radiate to the heart and under the shoulder blade);

6) oncology of the gastrointestinal tract in the initial stage.

Recurrent pain in children

Recurrent pain is pain that recurs over a period of time. They can occur in children of any age and in adults.

In newborns, intestinal colic is a common cause of abdominal pain (can be identified by sharp, high-pitched crying, restless behavior, bloating, refusal to eat, arching of the back, chaotic rapid movements of arms and legs, regurgitation). An important sign of intestinal colic is that when it is eliminated, the baby becomes calm, smiles, and eats well. Heat, tummy massage, and dill water help to cope with the disease. As the baby grows up, all these troubles go away on their own.

1) infectious diseases of the gastrointestinal tract (temperature up to critical levels, refusal to eat, lethargy, diarrhea, regurgitation, vomiting, crying, in some cases, change in skin color);

2) pathologies of the gastrointestinal tract (hernia, cyst and others).

coprogram;
blood analysis;
esophagogastroduodenoscopy;
barium x-ray of the abdominal cavity;
daily pH-metry.

Recurrent pain in adults

In older children (mostly school age) and adults, there are so many causes of recurring abdominal pain that they have been divided into five categories:

What infectious and inflammatory pain is is more or less clear. What do functional mean? If they are indicated in the diagnosis, how then should we understand the term “abdominal syndrome in children”? What it is? The concept of functional pain can be explained as follows: patients are bothered by discomfort in the abdomen for no apparent reason and without diseases of the peritoneal organs. Some adults even believe that the child is lying about his pain, since no violations are found in him. However, such a phenomenon exists in medicine, and it is usually observed in children over 8 years of age. Functional pain can be caused by:

1) abdominal migraine (abdominal pain turns into headache, accompanied by vomiting, nausea, refusal to eat);

2) functional dyspepsia (in a completely healthy child, pain appears in the upper segment of the abdomen and disappears after defecation);

3) intestinal irritation.

ARI with abdominal syndrome

This pathology is more often observed in preschoolers and primary schoolchildren. It occurs extremely rarely in adults. In medicine, acute respiratory infections and acute respiratory viral infections are classified as a single type of illness, since respiratory diseases (respiratory diseases) are most often caused by viruses, and they automatically become classified as acute respiratory viral infections. It’s easiest to “pick up” them in children’s groups – school, kindergarten, nursery. In addition to the well-known respiratory flu, the so-called “stomach flu”, or rotavirus, also poses a great danger. It is also diagnosed as ARVI with abdominal syndrome. In children, symptoms of this disease appear 1-5 days after infection. The clinical picture is as follows:

complaints of abdominal pain;
vomit;
nausea;
temperature;
diarrhea;
runny nose;
cough;
red throat;
painful to swallow;
lethargy, weakness.

As can be seen from the list, there are symptoms of both a cold and an intestinal infection. In rare cases, a child may actually have a common cold plus a gastrointestinal disease, which doctors must clearly distinguish between. Diagnosis of rotavirus infection is extremely difficult. It includes linked immunosorbent assay, electron microscopy, diffuse precipitation, carrying out many reactions. Pediatricians often make a diagnosis without such complex tests, only based on the clinical manifestations of the disease and based on anamnesis. With rotavirus infection, although cold symptoms are present, it is not the ENT organs that are infected, but the gastrointestinal tract, mainly the colon. The source of infection is a sick person. Rotaviruses enter the body of a new host with food, through dirty hands, and household items (for example, toys) used by the patient.

Treatment of ARVI with abdominal syndrome should be based on the diagnosis. So, if abdominal pain in a child is caused by pathological waste products of respiratory viruses, the underlying disease is treated, plus rehydration of the body by taking sorbents. If rotavirus infection is confirmed, there is no point in prescribing antibiotics to the child, since they have no effect on the pathogen. Treatment consists of taking activated carbon, sorbents, following a diet, and drinking plenty of fluids. If a child has diarrhea, probiotics are prescribed. Prevention of this disease is vaccination.

Paroxysmal pain without bowel disease

To make it easier to determine what causes abdominal syndrome, pain is divided into categories according to the location in the abdominal area where it is felt most strongly.

Paroxysmal pain without symptoms of dyspepsia occurs in the middle segment (mesogastrium) and lower segment (hypogastrium). Possible reasons:

infection with worms;
Payr's syndrome;
pyelonephritis;
hydronephrosis;
problems with the genitals;
intestinal obstruction (incomplete);
stenosis (compression) of the celiac trunk;

If the patient has just such an abdominal syndrome, treatment is prescribed based on additional examinations:

extended blood test;
sowing stool for worm eggs and intestinal infections;
Analysis of urine;
Ultrasound of the gastrointestinal tract;
irrigography (irrigoscopy with barium beam method);
Dopplerography of abdominal vessels.

Abdominal pain with bowel dysfunction

helminthiasis;
allergies to any products;
nonspecific ulcerative colitis (additionally, diarrhea is observed, and the stool may contain pus or blood, flatulence, loss of appetite, general weakness, dizziness, weight loss);
celiac disease (more often observed in young children when they begin to feed them with infant formula containing cereals);
infectious diseases (salmonellosis, campylobacteriosis);
pathologies in the large intestine, for example, dolichosigma (elongated sigmoid colon), with prolonged constipation added to the pain;
disaccharidase deficiency;
hemorrhagic vasculitis.

I (mild) – symptoms are mild, determined by ESR levels in the blood.

II (moderate) – mild pain in the peritoneum is observed, the temperature rises, weakness and headache appear.

III (severe) - high temperature, severe headaches and abdominal pain, weakness, nausea, vomiting with blood, urine and feces with blood, bleeding in the stomach and intestines, perforation may occur.

If pain occurs in the middle and lower parts of the peritoneum with suspicion of any problems with the intestines, diagnosis includes:

extended blood test (biochemical and general);
coprogram;
fibrocolonoscopy;
irrigography;
stool culture;
blood test for antibodies;
hydrogen test;
Endoscopy and tissue biopsy of the small intestine;
immunological tests;
sugar curve.

Pain in the upper segment of the peritoneum (epigastric)

Most often, abdominal syndrome in the upper segment of the peritoneum is a consequence of food intake and can manifest itself in two forms:

dyspepsia, that is, with disruption of the stomach (“hunger pains” that go away after eating);
dyskinetic (bursting pain, feeling of overeating, regardless of the amount of food taken, belching, vomiting, nausea).

The celiac trunk (a large short branch of the aorta of the peritoneum) during compression turns out to be pressed against the aorta, strongly narrowed at its mouth. This causes abdominal ischemic syndrome, which is diagnosed using contrast X-rays (angiography). The celiac trunk, together with other blood vessels of the abdominal cavity, supplies blood to all organs of the gastrointestinal tract. When compressed, the delivery of blood, and therefore the supply of organs with necessary substances, does not occur in full, which leads to their oxygen starvation (hypoxia) and ischemia. The symptoms of this disease are similar to those observed with gastritis, duodenitis, and stomach ulcers.

To avoid misdiagnosis, additional examinations of patients with suspected abdominal ischemic syndrome should be carried out. Endovascular diagnostics is an advanced method in which blood vessels are examined by inserting a catheter with X-ray properties into them. That is, the method will allow you to see problems in the vessels without surgical intervention. Endovascular diagnostics is used for any vascular diseases of the abdominal cavity. If there are indications, endovascular operations are also performed. Abdominal ischemic syndrome can be suspected based on the following patient complaints:

constant abdominal pain, especially after eating, when performing any physical work or emotional stress;
sensations of fullness and heaviness in the upper segment of the peritoneum;
belching;
heartburn;
feeling of bitterness in the mouth;
diarrhea or, conversely, constipation;
frequent headaches;
dyspnea;
throbbing in the abdomen;
weight loss;
general fatigue and weakness.

Only an external examination of the patient, as well as standard diagnostic methods (blood tests, urine tests, ultrasound) are not decisive in detecting this disease.

Vertebral abdominal syndrome

This type of pathology is one of the most difficult to detect. It lies in the fact that patients have obvious signs of problems with the gastrointestinal tract (abdominal pain, vomiting, belching, heartburn, diarrhea or constipation), but they are caused by diseases of the spine or other parts of the musculoskeletal system. Often doctors do not immediately correctly determine the cause, so they carry out treatment that does not bring results. Thus, according to statistical data, about 40% of patients with thoracic osteochondrosis are treated for intestinal and stomach diseases that do not exist. The picture with spinal diseases is even sadder. The pain in such cases is most often aching, dull, absolutely unrelated to eating, and if patients have constipation or diarrhea, they are not treated with classical methods. The following diseases can cause vertebral abdominal syndrome:

spondylosis;
scoliosis;
spinal tuberculosis;
syndromes associated with tumor changes in the spinal column;
visceral syndromes (Gutzeit).

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