🌿 Folk Prescriptions

Abdominal pain is one of the most common symptoms in pediatric clinical practice. Any pain occurring below the sternum, on either side of the navel, or above the pubic bone is termed abdominal pain. One survey found that over one-third of children from infancy to elementary school graduation have experienced abdominal pain. Abdominal pain involves many diseases; both internal and surgical conditions may present with this symptom. The condition discussed here refers to recurrent abdominal pain localized around the umbilicus, excluding organic lesions. It is most common in children aged 3–14, with a prevalence rate of 10%–20% among school-aged children. In TCM, this condition is known as "intestinal gas disease," "intestinal pain," or "twisting intestinal gas." It is believed to result from factors such as worm infestation, improper diet, cold stimulation, spleen-stomach weakness, qi stagnation and blood stasis, or liver qi invading the stomach. Based on different clinical presentations, it can be classified and treated as follows:
1. Worm Infestation Abdominal Pain: Commonly presents with periumbilical pain that comes and goes, severe cases may involve vomiting worms, pain worsens with eating, and the child appears emaciated. Treatment focuses on expelling worms, eliminating food stagnation, and promoting bowel movements. Formula: Wu Mei Wan (Apricot Kernel Pill) with modifications, decocted and administered orally.
2. Food Injury Abdominal Pain: Caused by irregular diet, overconsumption of greasy or fried foods damaging the spleen and stomach. Symptoms include chest and epigastric fullness, poor appetite, belching with sour odor, distension and pain in the upper abdomen, halitosis, thick tongue coating. Infants may vomit undigested milk clumps or food, or display crying and irritability. Treatment aims to eliminate food stagnation and promote digestion. Formula: Bao He Wan (Preserve Harmony Pill) with modifications, or use Jiao San Xian (Fried Three Herbs).
3. Cold Constriction Abdominal Pain: Common in children with weak constitution; cold pathogen easily invades the abdomen when temperatures drop, causing cold constriction and qi stagnation. Symptoms include paroxysmal abdominal pain, loose stools, clear urine, pale complexion, acid regurgitation, cold limbs, warmth alleviates pain. Treatment: Warm the center, dispel cold. Formula: Xiao Jian Zhong Tang (Minor Build-the-Middle Decoction), or Wu Zhu Yu Tang (Evodia Decoction) with modifications.
4. Cold Drink Abdominal Pain: Caused by excessive consumption of raw, cold foods or fruits, damaging the spleen and stomach. Most likely to occur after consuming cold drinks in summer. Symptoms include paroxysmal abdominal pain, commonly around the umbilicus, nausea, vomiting with sour smell and food residue, intestinal rumbling, diarrhea, normal stool examination. Treatment: Warm the center, dispel cold, move qi, relieve pain. Use Si Ni Tang (Four Reversal Decoction) with modifications. When vomiting and diarrhea coexist, Huo Xiang Zheng Qi Water (Huo Xiang Correcting Qi Water) proves effective.
5. Spleen Deficiency Abdominal Pain: Chronic abdominal pain due to inherent spleen-stomach weakness in children. Symptoms include general weakness, fatigue, shortness of breath, incomplete digestion, vomiting or diarrhea, dull abdominal pain. Treatment: Strengthen spleen, tonify qi, harmonize stomach, resolve dampness. Formula: Shen Ling Bai Zhu San (Ginseng and Poria Powder) with modifications.
6. Liver Qi Invading the Stomach Abdominal Pain: Presents with epigastric distension, severe periumbilical pain, intermittent pain, frequent sighing. Pain eases after passing gas, recurrent episodes often triggered by emotional changes. Treatment: Soothe liver, regulate qi, harmonize stomach, relieve pain. Formula: Chai Hu Shu Gan San (Bupleurum Liver-Soothing Powder) with modifications.
7. Qi Stagnation and Blood Stasis Abdominal Pain: Presents with periumbilical distension and discomfort, pain that resists pressure, sharp pain localized (around the umbilicus), palpable mass that doesn’t shift, severe pain upon pressing, dull complexion, dark red tongue or ecchymotic spots, fine or wiry-thready pulse. Treatment: Regulate qi, resolve stasis, dissipate nodules, relieve pain. Commonly use Shao Fu Zhu Yu Tang (Lower Abdominal Stasis-Removing Decoction) with modifications. If qi stagnation is prominent, add Cha Chuan Zi (Toosendan Fruit) and Wu Yao (Lindera Root) to relieve pain. If a mass is present, cautiously add San Leng (Rhizome of Sparganium), E Zhu (Rhizome of Curcuma), or Chuan Shan Jia (Carp's Claw Rhizome) to break up stasis and relieve pain.
In conclusion, the causes of pediatric abdominal pain are diverse. Careful differential diagnosis based on clinical presentation is essential. Alongside syndrome differentiation and medication, acupuncture, massage, and physical therapy may be used as adjunctive treatments. Additionally, preventive measures and daily care are important: maintain regular meal schedules, avoid overeating or indulging in raw, fried, greasy foods; observe dietary hygiene—wash vegetables thoroughly and cook them properly, peel fruits, avoid drinking unboiled water, wash hands before meals and after defecation, and keep the abdomen warm.