Stomach pains – where do they come from and what causes them? Treatment of abdominal pain

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Most cases of abdominal pain are mild and have many common causes, such as indigestion or muscle tightness. Often, symptoms resolve quickly on their own or with basic treatment. Abdominal pain, especially with severe or chronic symptoms, can also be a sign of more serious underlying medical conditions such as cancer or organ failure. Sudden and severe or prolonged abdominal pain may require urgent treatment.

A short episode of pain is called acute, while abdominal pain lasting three months or more is considered chronic or continuous, although the duration is not exact. For example, acute appendicitis is almost always an acute condition, unlike irritable bowel syndrome, which can result in chronic cramps that can last for years or longer. Abdominal pains come in many forms and can range from cramps that come and go, to sudden, stabbing pains, to constant, dull abdominal pain. Even mild pain can be an early sign of a serious condition, and healthcare professionals often monitor these patients for changes in their condition.

Keep in mind that abdominal pain is a subjective symptom that medical professionals cannot measure reliably. The intensity of the pain is just as you say.

When we have stomach aches, we may have other symptoms such as fever, vomiting or diarrhea. Doctors will examine us closely if pain is localized or present throughout the abdomen. They will ask what makes the pain more intense and what seems to calm it down. Does pain change by eating or changing position? Do stomach aches wake us up from sleep? Does pain migrate to another part of the body? The answers can provide important diagnostic clues.

See also: Stomach pain after eating and on an empty stomach – causes

Abdominal wall pain is common and easy to overlook as doctors may direct their attention to internal organs as the cause of the pain. When the abdominal wall is judged suspicious, it is generally easy to make this diagnosis. If you flex your abdominal wall muscles while exercising, tell your doctor that you are experiencing pain on the right side of your stomach. Apparently, the pain is not caused by a diseased internal organ such as the gallbladder or stomach.

Doctors can often determine where pain is coming from by knowing the patient’s detailed history. Depending on the doctor’s approach, the patient may simply be asked to tell their medical history in their own words. Other doctors may want to ask a number of specific questions. Others may use both techniques. Medical history is most important, even more important than the physical examination. After an interview and physical examination, certain diagnostic tests may be recommended to make an accurate diagnosis.

Throat, gut and blood infections can let bacteria enter the digestive tract, causing stomach pain. These infections can also cause digestive changes such as diarrhea or constipation. The cramps associated with menstruation are also a potential source of pain in the lower abdomen, but they are more known for their pelvic pain.

Other common causes of abdominal pain include:

1. constipation;
2. diarrhea;
3. gastroenteritis (gastric flu);
4. acid reflux (when stomach contents return to the esophagus causing heartburn and other symptoms);
5. vomiting;
6. stress.

Diseases affecting the digestive system can also cause chronic abdominal pain. The most common of them are:

1. gastroesophageal reflux disease (GERD);
2. irritable bowel syndrome or spastic colon (a disorder that causes abdominal pain, cramps, and changes in your bowel movements);
3. Crohn’s disease (inflammatory bowel disease);
4. lactose intolerance (the inability to digest lactose, the sugar found in milk and milk products).

The causes of severe abdominal pain include:

1. organ rupture (e.g. appendicitis rupture or appendicitis);
2. gallstone disease;
3. kidney stones;
4. kidney infections.

The location of pain in the abdomen may be a clue to its cause.

Pains that are generalized throughout the abdomen (not in one particular area) may indicate:

1. appendicitis;
2. Crohn’s disease;
3. traumatic injury;
4. irritable bowel syndrome;
5. urinary tract infection;
6. flu.

Pains concentrated in the lower abdomen may indicate:

1. appendicitis;
2. bowel obstruction;
3. ectopic pregnancy (ectopic pregnancy).

In women, pains in the genital organs of the lower abdomen may be caused by:

1. severe menstrual pain (so-called dysmenorrhea);
2. ovarian cysts;
3. miscarriage;
4. myomas;
5. endometriosis;
6. inflammation of the pelvic organs (Adnexitis);
7. Ectopic pregnancy.

Pains in the upper abdomen may be caused by:

1. gallstones;
2. heart attack;
3. hepatitis;
4. pneumonia.

Pains in the center of the abdomen may come from:

1. appendicitis;
2. gastroenteritis;
3. injuries;
4. uremia (build-up of waste products in the blood).

Pains in the lower left abdomen may be caused by:

1. Crohn’s disease;
2. cancer;
3. kidney infection;
4. ovarian cysts;
5. appendicitis.

Pains in the upper left corner of the abdomen are sometimes caused by:

1. enlarged spleen;
2. stool wedging (a hardened stool that cannot be eliminated)
3. injuries;
4. kidney infection;
5. heart attack;
6. cancer.

The causes of pain in the lower right corner of the abdomen include:

1. appendicitis;
2. hernia (when the organ protrudes through a weak spot in the abdominal muscles);
3. kidney infections;
4. tumor;
5. flu.

Pains in the upper right corner of the abdomen may result from:

1. hepatitis;
2. injuries;
3. pneumonia;
4. appendicitis.

If the pains are so severe that we cannot sit still, or we need to curl up in a ball to make ourselves comfortable, we should seek immediate medical attention, or if we have any of the following symptoms:

1. blood in the stool;
2. fever higher than 38,33 ° C;
3. vomiting blood (called blood in vomiting);
4. persistent nausea or vomiting;
5. yellowing of the skin or eyes;
6. swelling or severe tenderness in the abdomen;
7. breathing difficulties.

See a doctor if you have any of the following symptoms:

1. stomach pain that lasts more than 24 hours;
2. prolonged constipation;
3. vomiting;
4. burning sensation when urinating;
5. fever;
6. loss of appetite;
7. unexplained weight loss.

It is also recommended to contact a doctor quickly if we are pregnant or breastfeeding and experience abdominal pain.

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Abdominal pain – diagnosis

Abdominal pain is one of the most common symptoms observed by GPs (doctors working in general practice).

Information about the symptoms and location of abdominal pain can help your doctor diagnose the cause of the pain. Doctors want to know how long a patient has been in pain and may want to do a physical examination. Your doctor may suggest that you get certain blood tests or other diagnostic procedures, especially if your symptoms have been around for a while.

Tests and procedures that can help diagnose the cause of abdominal pain include:

Abdominal pain – physical examination

A physical examination will include a careful examination of your abdomen to locate the source of the pain.

1. The doctor will touch different parts of the abdomen to check for tenderness or other signs that indicate the source of the pain.
2. Your doctor may perform a rectal examination (digital rectal examination) to check for small amounts of blood in your stools or for other problems such as hemorrhoids.
3. If the patient is male, the doctor may examine the penis and testicles.
4. If the patient is a woman, your doctor may perform a pelvic exam to check for problems with the uterus, fallopian tubes and ovaries.
5. The doctor may also look in the patient’s eyes for yellow discoloration (jaundice) and into the mouth to make sure the patient is not dehydrated.

Abdominal pain – laboratory tests

Laboratory tests may or may not help determine the cause of abdominal pain. In combination with information obtained from the questions the patient was asked and the physical examination by the doctor, some blood or urine tests may be ordered and can help make a diagnosis.

1. One of the most important tests is to find out if a woman is pregnant.
2. An elevated white blood cell count could mean an infection or simply be a reaction to the stress of pain and vomiting.
3. A low red blood cell (hemoglobin) count may mean that you are bleeding internally, but most bleeding conditions are not painful.
4. Blood in the urine, which may not be visible to the eye, suggests that the patient may have kidney stones.
5. Other blood tests, such as liver and pancreatic enzymes, can help determine which organ is causing the pain, but not a diagnosis.

Abdominal pain – radiological examinations

Radiographs of the patient’s abdomen may be useful, but are not always necessary or helpful.

1. Sometimes an x-ray will show the air outside your bowel, which means something has ruptured.
2. X-rays can also help diagnose intestinal obstruction.
3. Occasionally, an x-ray may show kidney stones.

Ultrasound is a painless procedure useful in detecting some causes of abdominal pain.

1. This test may be performed if your doctor suspects problems with the gallbladder, pancreas, liver or reproductive organs of a woman.
2. Ultrasound also helps diagnose problems with the kidneys and the spleen, or the large blood vessels that come out of the heart and supply blood to the lower half of the body.

Computed tomography (CT) scans provide useful information about the liver, pancreas, kidneys and ureters, spleen, and the small and large intestines.

The patient and physician should discuss the need for an x-ray or CT scan and the associated radiation exposure before proceeding with any radiological examination.

Magnetic resonance imaging (MRI, MRI) is usually less helpful than CT scans when examining the abdominal cavity, although for certain problems and symptoms your doctor may order an MRI in place of a CT scan or as a follow-up to any of the above tests.

However, the doctor does not need to perform any tests. The cause of the patient’s pain may be clear without any research, and it may be known that it is not serious. If the patient undergoes research, the specialist should explain the reason for the research and any contraindications. Once the results are available, the specialist should discuss them with the patient as well as whether the results affect treatment.

If we are treating mild abdominal pain with a known cause at home:

1. keep hydrated by drinking clear fluids;
2. limit the consumption of alcohol, tea and coffee;
3. let’s try to be refreshed;
4. use a hot water bottle or warm compresses on the stomach;
5. eat uncooked foods when we can start eating again, or as directed by a doctor.

Specific methods of treatment, depending on the cause of abdominal pain, include the following options, which, depending on the indications, will be selected by the doctor.

Gas – Medicines designed to break up gas bubbles, such as simethicone antacids, are available over the counter. Gas reducing drugs, such as carbon products, can help with constant wind problems. Dietary changes can also help. It is worth consulting a dietitian on this matter.

Infections of the gastrointestinal tract (gastric flu) – it usually only lasts a few days and is self-limiting. The most important treatment is to hydrate by drinking plenty of clear fluids.

Pain from muscle spasms – intestinal wall spasms can be relieved with antispasmodics. There are several available, so be sure to talk to your pharmacist or doctor about which ones are right for you.

Pain caused by gastro-oesophageal reflux disease (GORD) – this can be remedied by lifestyle changes and / or by taking certain medications to control stomach acid.

Pain caused stomach or duodenal ulcers – this type of pain is usually relieved by trying to heal the ulcer, which will ease the symptoms. This may include medications to reduce acidity and antibiotics prescribed by your doctor.

Inflammatory Bowel Disease (Crohn’s Disease and Ulcerative Colitis) – Relapses of these conditions can be treated with a number of medications and can also be taken on a regular basis to prevent future relapses.

There are many other causes of abdominal pain and your doctor will be able to advise you on appropriate treatment when you know the cause. In some cases, such as appendicitis or intestinal obstruction, the patient may need emergency surgery.

The types of medications that may be recommended to treat abdominal pain include:

1. antispasmodics;
2. anti-diarrheal drugs;
3. Laxatives;
4. anti-nausea drugs;
5. anti-flatulence drugs;
6. antacids;
7. antibiotics.

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Stomach aches – home remedies

The treatment of abdominal pain is highly dependent on the diagnosis. Inflammation-reducing medications can help with stomach pains caused by ulcers. However, other medical conditions, such as kidney stones, may require more intensive treatment, such as shockwave lithotripsy. Inflammation of the gallbladder may require gallbladder surgery. Your doctor may prescribe a pain modifying drug, such as amitriptyline or trazodone, to relieve your pain. They can help change the way the brain processes pain signals.

If you and your doctor determine that your stomach aches are not the result of a serious medical condition, there are a number of home remedies that can provide relief. Here is a short list:

1. stomach drops and soda water;
2. ginger;
3. chamomile tea;
4. diet BRAT (from the English Banana, Rice, Apple, Toast)
5. pepper mint;
6. Apple vinegar;
7. warming pillow;
8. warm bath.

Abdominal pains – prophylaxis

Eating enough fiber and exercising regularly can help prevent constipation and keep your bowels functioning properly, which will help prevent some forms of abdominal pain. It will also reduce the long-term risk of certain diseases, such as diverticular disease or bowel cancer. In case of gastroesophageal reflux disease (GERD), eating within 2 hours before going to bed is not recommended.

Drinking plain water (not soda) will reduce the risk of pain from gas and keep your body healthy.

Following a specific diet can help reduce pain from lactose intolerance, gallstones, irritable bowel syndrome, and gas problems.