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The Keys Behind Tummy Ache in Children Explained by a Paediatrician


    Tummy pain in children is concerning to families and is common in paediatric emergencies. Dr. Mar Begara, paediatrician and integrative physician, points out that abdominal pain already accounts for 20% of consultations in children over 4 years old.

    Gas accumulation, colic, cramps and diarrhoea, stomach viruses, and nervousness are potential triggers of abdominal pain. However, as the paediatrician explains, we may also be dealing with a Paediatric Functional Digestive Disorder if we are suffering from it:

    1. There are chronic and recurrent gastrointestinal symptoms with no related cause.
    2. and are accompanied by sleep problems.

    Gut-brain axis disruption in Paediatric Functional Digestive Disorder (FDD)

    Why PDD occurs in children depends on many factors (genetics and environmental, social, and psychological factors…) but “there is no doubt that there is a notable alteration of the gut-brain axisand abdominal pain is the most commonly reported symptom. 

    This phenomenon prompted a recent clinical investigation led by Dr. Begara in collaboration with Hifas da Terra. The study findings were unveiled at the SESAP International Congress in Barcelona. 

    According to Mar Begara, Lion’s Mane has been clinically employed for cases of reflux in children. However until now there was no evidence to substantiate the “clinical effectiveness and microbiota improvements” following the utilisation of specific strains of Lion’s Mane and Reishi in conjunction with vitamin D.

    Additionally, while the HIFAS-SIBO study demonstrated gastrointestinal enhancements in adults, including reductions in gas, bloating, constipation, and stress, similar outcomes hadn’t been observed in children, making this a “pioneering study”. Remember that you can receive this study and other articles in your inbox by subscribing to our newsletter here.

    Table of Contents

    Tummy aches in children, constipation and migraines

    Health professionals rely on the Rome IV paediatric criteria to diagnose functional digestive disorders in children. 

    According to Rome IV, symptoms must have been present at least once a week for the past two months, with no evidence of inflammatory, metabolic or anatomical disease to explain them, for an accurate diagnosis.

    According to the child health expert, when addressing Pediatric Functional Digestive Disorders (PDD) in children aged 4 to 18, three main types of disorders emerge: nausea and vomiting, abdominal pain, and functional defecation disorders. Drawing from her clinical expertise, she highlights these as the most prevalent categories.

    • Tummy ache (abdominal pain, dyspepsia, irritable bowel pain, etc.)
    • Functional constipation
    • Migraines with equivalent abdominal pain

    Tummy Pain in Children and Paediatric Functional Digestive Disorder

    Thanks to her years as a healthcare professional, both in primary care and as a specialist at the Hospital de La Paz in MadridDr. Begara knows well the problems derived from functional digestive disorders and as she explains “in reality we are dealing with children who have gone to all the professionals”. 

    Tummy aches in boys and girls do not occur in isolation. They can also suffer from otitis, recurrent rhinitisallergies, atopic dermatitis and vaginitis in the case of girls. All of this is related to a syndrome of inflammation of the mucous membranes where “80% of our immune system is housed”.


    Outcomes of Mycotherapy in Patients with Paediatric Functional Digestive Disorder

    As mentioned above, Dr Begara has led a pioneering study to address PDD in children using natural supplements from Hifas da Terra such as syrup with Reishi and Lion’s Mane (Dr GB) and vitamin D3 (Cocovit D).

    Although abdominal pain was essential to be a participant, the study goes beyond how abdominal pain is improved, as significant analytical changes related to other areas such as microbiota composition and others related to sleep reconciliation have been observed.

    If you are a health practitioner you can register in the Professional Area where you fill resources and training. 


    Abdominal pain is the most prominent symptom and can be described as stabbing, burning or constant discomfort. This pain may be related to meals, physical activity or stress.

    The results of the study showed a significant reduction in the intensity and frequency of belly pain.

    Stool Disturbances

    Disturbances in bowel movements, such as constipation or diarrhoea, are common symptoms. These may be due to impaired motor function of the bowel or imbalances in the gut microbiota.

    The experimental group in this study showed a significant reduction in diarrhoea after supplementation.

    Dermatitis and the link to tummy ache

    The connection between gut health and skin health, known as the gut-skin axis, can manifest itself in the form of dermatitis or skin rashes in children with functional digestive disorders. This highlights the importance of a healthy microbiota for the prevention of skin inflammation.

    40% of the participants in this study (5-18 years) had dermatitis and the improvement after 12 weeks of study participation was significant.

    Difficulty Sleeping

    Affected children may have difficulty falling asleep or staying asleep during the night. This may be directly related to the tummy ache or be a consequence of the stress associated with their condition.

    At the beginning of the study, 30% of the participants had difficulty sleeping and at the end of the study, they reported a significant reduction in the time needed to fall asleep, which means an improvement in the children’s tiredness, but also in the quality of life for the whole family


    The Importance of Gut Health

    Maintaining a healthy gut microbiota is essential to prevent and manage functional digestive disorders. This can be achieved through a diet rich in fibre, prebiotics and probiotics (Reishi and Lion’s Mane contain prebiotics), which encourage the growth of beneficial bacteria in the gut. In addition, it is important to address stress and anxiety factors in children, as these can negatively affect gut health.

    The first 1000 days of life

    It has been shown that the first 1000 days of life, from conception to age 2 years, are critical for physical, cognitive and emotional development. This period is also essential for the configuration of a healthy and balanced microbiota in which other factors such as breastfeeding and even the mother’s microbiota play a role.

    Children's Gut Microbiota

    The gut microbiota consists of trillions of organisms that reside in the digestive tract. These microbes play a crucial role in digestion, nutrient absorption and protection against pathogens. A balanced microbiota is important for gut health, especially in children, whose immune and digestive systems are still developing.

    The study also analysed the composition of the microbiota and found an increase in the microbiota numbers of:

    • Akkermansia muciniphila. This bacterium is related to intestinal and immune health. It helps maintain the intestinal barrier through its ability to regenerate the mucus layer that lines the intestine.
    • A significant increase in Veillonella spp., Bacteroides spp. and Oxalobacter, species associated with the regulatory microbiota, was also found.


    Tummy pain in children, when recurrent and not isolated, may be due to Functional Digestive Disorder in children and is a complex condition that requires a special approach to management. Families and caregivers should be alert to symptoms such as abdominal pain, altered bowel movements, dermatitis and difficulty sleeping.

    Adoption of the paediatric Rome IV criteria facilitates accurate diagnosis and maintaining healthy gut microbiota is key to the treatment and prevention of these disorders. Collaboration between families, caregivers and healthcare professionals is essential to ensure the well-being of children affected by functional digestive disorders.

    Although further evidence is still needed, the study Outcomes of Mycotherapy in Patients with Paediatric Functional Digestive Disorder may help improve not only abdominal discomfort but also gut microbiota and sleep quality.

    In addition, the professional’s clinical experience and knowledge of laboratory composition and quality standards are two key tools for managing children’s health problems and particular situations that undermine their quality of life.

    At Hifas da Terra we research and develop supplements that follow strict pharmaceutical quality and safety controls and we analyse the active biomolecules contained in our formulas. Our commitment to transparency extends throughout the entire manufacturing process, from selecting premium strains to organic cultivation and packaging. We opt for glass and other recyclable materials for packaging to ensure optimal preservation of our products. With over 20 years of expertise in formulating and researching, our products have gained the trust and recommendation of an increasing number of professionals each day.

    • Vernon-Roberts, Angharad, India Alexander, and Andrew S. Day. “Systematic review of pediatric functional gastrointestinal disorders (Rome IV criteria).” Journal of clinical medicine 10.21 (2021): 5087.




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