What are the different types of abdominal pain. How can you differentiate between various causes of stomach discomfort. What are the most effective treatments for digestive system pain. When should you seek medical attention for abdominal pain.

The Basics of Abdominal Pain: More Than Just a Stomachache

Abdominal pain is a common complaint that can range from mild discomfort to severe, debilitating agony. It’s a complex issue that involves various organs and systems within the digestive tract and surrounding areas. Understanding the nature of abdominal pain is crucial for proper diagnosis and treatment.

Abdominal pain serves as a vital warning system for our bodies, alerting us to potential issues within the digestive system. However, not all abdominal pain is created equal. The location, intensity, and duration of the pain can provide valuable clues about its underlying cause.

Key Characteristics of Abdominal Pain

• Location: Upper, lower, or entire abdomen
• Intensity: Mild, moderate, or severe
• Duration: Acute (short-term) or chronic (long-term)
• Pattern: Constant, intermittent, or cyclical
• Associated symptoms: Nausea, vomiting, fever, bloating, etc.

The Science Behind Digestive System Pain

To truly understand abdominal pain, we must delve into the science behind it. Pain in the digestive system is primarily processed through a complex network of nerves and signals that communicate between the gut and the brain.

The enteric nervous system, often referred to as the “second brain,” plays a crucial role in this process. This network of neurons lining the digestive tract is responsible for sensing and responding to various stimuli, including pain.

How Does the Brain Interpret Abdominal Pain?

When the digestive system experiences trauma or irritation, nociceptors (pain-sensing nerve endings) send signals to the brain via the spinal cord. The brain then interprets these signals, taking into account factors such as:

1. The intensity of the stimulus
2. Previous experiences with similar pain
3. Emotional state and stress levels
4. Environmental factors

This complex interpretation process explains why two individuals might experience the same digestive issue differently, or why stress and anxiety can exacerbate abdominal pain.

Types of Abdominal Pain: Nociceptive vs. Neuropathic

Understanding the different types of abdominal pain is crucial for accurate diagnosis and effective treatment. In the context of digestive system discomfort, we primarily encounter two main categories: nociceptive and neuropathic pain.

Nociceptive Pain in the Digestive System

Nociceptive pain is the most common type of abdominal pain. It occurs when nociceptors (pain receptors) in the digestive tract are stimulated by potential or actual tissue damage. This type of pain can be further categorized into:

• Visceral pain: Originating from organs within the abdominal cavity
• Somatic pain: Arising from the abdominal wall, peritoneum, or other surrounding structures

Visceral pain is often described as dull, cramping, or aching, and can be difficult to localize. Somatic pain, on the other hand, tends to be sharp and more precisely located.

Neuropathic Pain in Digestive Disorders

While less common, neuropathic pain can also occur in the digestive system. This type of pain results from damage or dysfunction of the nerves themselves, rather than from tissue injury. In the context of abdominal pain, neuropathic pain may manifest as:

• Burning or tingling sensations
• Hypersensitivity to touch or pressure in the abdominal area
• Pain that persists even after the initial injury or inflammation has healed

Neuropathic abdominal pain can be particularly challenging to diagnose and treat, often requiring specialized approaches.

Common Causes of Abdominal Pain: From Indigestion to Chronic Conditions

Abdominal pain can stem from a wide variety of sources, ranging from simple indigestion to more serious chronic conditions. Identifying the underlying cause is essential for proper treatment and management.

Acute Causes of Abdominal Pain

Many cases of abdominal pain are acute, meaning they come on suddenly and typically resolve within a short period. Common acute causes include:

• Gastroenteritis (stomach flu)
• Food poisoning
• Constipation or diarrhea
• Gas and bloating
• Menstrual cramps
• Appendicitis
• Kidney stones

Chronic Conditions Associated with Abdominal Pain

Some individuals experience persistent or recurrent abdominal pain due to underlying chronic conditions. These may include:

• Irritable Bowel Syndrome (IBS)
• Inflammatory Bowel Disease (IBD), including Crohn’s disease and ulcerative colitis
• Gastroesophageal Reflux Disease (GERD)
• Chronic pancreatitis
• Endometriosis
• Functional dyspepsia

Chronic abdominal pain often requires long-term management strategies and may involve a combination of medical treatments, lifestyle changes, and stress reduction techniques.

Diagnosing the Source of Abdominal Pain: A Multi-faceted Approach

Given the complexity of abdominal pain and its many potential causes, diagnosing the underlying issue often requires a comprehensive approach. Healthcare providers typically employ a combination of methods to identify the source of digestive system discomfort.

Key Components of Abdominal Pain Diagnosis

1. Medical history: Detailed discussion of symptoms, duration, and associated factors
2. Physical examination: Palpation of the abdomen to identify areas of tenderness or swelling
3. Laboratory tests: Blood work, stool samples, and urinalysis to check for infections or inflammation
4. Imaging studies: X-rays, ultrasounds, CT scans, or MRIs to visualize internal structures
5. Endoscopic procedures: Upper endoscopy or colonoscopy to directly examine the digestive tract

In some cases, especially with chronic or recurrent abdominal pain, a multidisciplinary approach involving gastroenterologists, pain specialists, and mental health professionals may be necessary for accurate diagnosis and effective treatment.

Treatment Strategies for Abdominal Pain: From Home Remedies to Medical Interventions

The treatment of abdominal pain varies widely depending on its underlying cause, severity, and duration. While some cases may resolve on their own with simple home remedies, others may require more intensive medical interventions.

Home Remedies and Lifestyle Changes

For mild to moderate abdominal pain, particularly that associated with common digestive issues, the following strategies may provide relief:

• Dietary modifications: Avoiding trigger foods, eating smaller meals, and increasing fiber intake
• Stress reduction techniques: Meditation, yoga, or deep breathing exercises
• Heat therapy: Applying a warm compress to the abdomen
• Hydration: Drinking plenty of water to prevent constipation and support overall digestive health
• Over-the-counter medications: Antacids, anti-diarrheal agents, or pain relievers as appropriate

Medical Treatments for Abdominal Pain

When home remedies are insufficient or the underlying cause requires more targeted intervention, medical treatments may include:

• Prescription medications: Antibiotics, antispasmodics, or proton pump inhibitors
• Pain management strategies: Specialized medications or interventions for chronic pain
• Cognitive Behavioral Therapy (CBT): To address the psychological aspects of chronic abdominal pain
• Surgical interventions: For conditions such as appendicitis, gallstones, or severe cases of IBD

It’s important to note that the most effective treatment plan will be tailored to the individual’s specific condition and needs, often involving a combination of approaches.

When to Seek Medical Attention: Red Flags for Abdominal Pain

While many instances of abdominal pain are benign and self-limiting, certain symptoms or patterns should prompt immediate medical evaluation. Recognizing these red flags can be crucial in identifying serious underlying conditions that require urgent attention.

Signs That Warrant Immediate Medical Care

• Severe, sudden onset of pain
• Pain accompanied by fever, persistent vomiting, or bloody stools
• Abdominal pain with signs of dehydration
• Pain that radiates to the chest, neck, or shoulder
• Abdominal rigidity or severe tenderness to touch
• Pain associated with pregnancy
• Persistent pain lasting more than a few days

If you experience any of these symptoms, it’s important to seek medical attention promptly. Early intervention can prevent complications and improve outcomes in many cases of serious abdominal conditions.

The Mind-Gut Connection: Psychological Factors in Abdominal Pain

The intricate relationship between the brain and the digestive system, often referred to as the “gut-brain axis,” plays a significant role in abdominal pain perception and management. Understanding this connection is crucial for developing comprehensive treatment strategies, particularly for chronic abdominal pain conditions.

How Stress and Anxiety Influence Digestive Pain

Psychological factors can significantly impact the experience of abdominal pain in several ways:

• Stress can increase gut motility and sensitivity, exacerbating symptoms of conditions like IBS
• Anxiety may lead to heightened awareness of normal digestive sensations, interpreting them as pain
• Chronic stress can alter the gut microbiome, potentially contributing to inflammation and pain
• Depression may lower pain thresholds, making abdominal discomfort feel more intense

Integrating Mental Health in Abdominal Pain Management

Recognizing the mind-gut connection has led to more holistic approaches in treating abdominal pain, especially in chronic cases. These may include:

1. Cognitive Behavioral Therapy (CBT) to address pain-related thoughts and behaviors
2. Mindfulness-based stress reduction techniques
3. Gut-directed hypnotherapy, particularly effective for functional gastrointestinal disorders
4. Psychoeducation to help patients understand and manage the psychological aspects of their pain

By addressing both the physical and psychological components of abdominal pain, healthcare providers can offer more comprehensive and effective treatment plans, leading to improved outcomes and quality of life for patients.

Emerging Research and Future Directions in Abdominal Pain Management

As our understanding of abdominal pain continues to evolve, researchers are exploring innovative approaches to diagnosis and treatment. These advancements hold promise for more targeted and effective management strategies in the future.

Cutting-Edge Research Areas

• Microbiome-based therapies: Investigating the role of gut bacteria in pain modulation
• Neurostimulation techniques: Exploring non-invasive methods to alter pain signaling pathways
• Personalized medicine: Developing tailored treatment plans based on genetic and biomarker profiles
• Advanced imaging techniques: Improving our ability to visualize and understand pain mechanisms in real-time

Potential Future Treatments

While still in various stages of research and development, several promising approaches may shape the future of abdominal pain management:

1. Targeted drug delivery systems to minimize side effects and improve efficacy
2. Gene therapy to address underlying genetic factors in chronic pain conditions
3. Virtual reality interventions for pain management and stress reduction
4. Artificial intelligence-assisted diagnostic tools for more accurate and timely identification of pain sources

As research progresses, these and other innovative approaches may revolutionize our ability to diagnose, treat, and manage abdominal pain, offering hope for improved outcomes and quality of life for those affected by digestive system discomfort.

The Science of Pain – Gastrointestinal Society

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The Science of PainGIS2021-07-06T15:53:16-07:00

Pain serves a vital purpose for living creatures with a nervous system, including humans. The unpleasant feelings of pain convince us to move away from situations that are causing damage to our bodies. Without this built-in alarm system, we would have to try hard to avoid biting our own tongues, we might not notice our hand is on a burning stove, and we wouldn’t go to the doctor to mend broken bones. As unpleasant as pain is, it is extremely important to our survival.

Pain is a defining factor in inflammatory bowel disease, irritable bowel syndrome, functional dyspepsia, GERD, and diverticular disease, and is common in many other GI diseases and disorders.

What is Pain?

According to the International Association for the Study of Pain, it is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. ”

When something injures – or otherwise threatens – your body, the nerve fibres send a message to the brain letting it know that something isn’t right. Most pain experience takes place in the brain, which processes the information from these signals. However, pain isn’t just a simple message from nerve-to-brain. The brain often mediates this message based on your experiences, other stimuli, various environmental factors, and more.¹

For example, people tend to feel more pain when they believe that the injury is major and less pain when they think the injury is minor, regardless of the actual degree of injury. The brain can even send a message back to the nerves to silence them if it finds the situation to be safe. Conversely, the brain can instruct the nerves to continue to fire when it is uncalled for, causing pain that is needlessly strong or pain that lasts much longer than necessary. Your emotional state of mind can also affect the types of messages exchanged between the brain and nerves. Anxiety causes the brain to ask for more signals from the nerves, which increases pain length and severity, whereas feeling safe makes it ask for fewer signals, thereby reducing the amount of pain you feel.

The impact of the brain on pain is clear when you consider that placebo pain relief pills often work remarkably well, and that sometimes people don’t feel pain until they have other stimuli that cause them to acknowledge the injury, such as seeing a wound.

Before we understood that pain is simply neurons signalling something is wrong, many people believed that pain was a punishment from God. The word pain is actually derived from the Latin word poena, meaning ‘punishment, penalty’ and the Greek word ποινή (poine), which translates to ‘price paid, penalty, punishment’. These same root words show up in the English words penalty, pain, punish, etc.¹¹

What are the Different Types of Pain?

Although we typically refer to anything that hurts as pain, there are actually several types of pain, with unique stimuli and treatments, which our bodies process and acknowledge differently.

Nociceptive Pain

Most of the pain you experience is nociceptive pain, which results from stimulation of a type of peripheral nerve fibre, called nociceptors. This is what you feel when you stub your toe, pull a hot dish from the oven with your bare hands, scrape your knee, break your arm, and most other things that cause tissue damage. We can break down nociceptive pain even further by looking at either the type of stimulus causing the pain, or where in the body someone is feeling this pain.

There are three main types of stimuli that cause nociceptive pain:

1. mechanical stimuli, which causes injuries such as cuts, bruises, sprains, and breaks;
2. thermal stimuli, typically from extreme temperatures, which results in injuries such as burns from heat and frostbite; and
3. chemical stimuli, when a substance harms the body, such as with chemical burns and getting soap in your eye.

The way we feel nociceptive pain also depends on where in the body the pain originates:

1. superficial somatic pain is from injuries to the skin. It is typically very easy to locate the source of the pain, which is very specific and often a sharp feeling. This type of pain is what you feel from cuts, bruises, and burns;
2. somatic pain occurs when the wound is deeper, such as injuries to the tendons and ligaments, broken bones, sprains, and pulled muscles; and
3. visceral pain originates in organs, and is often general and hard to pinpoint. Individuals with digestive diseases and disorders are typically most familiar with visceral pain.

Neuropathic Pain

That odd feeling of hitting your ‘funny bone’ is a common example of neuropathic pain, which occurs when the injury affects the nervous system itself. This pain is different from nociceptive pain in that it doesn’t feel aching, throbbing, or stabbing. Neuropathic pain typically presents as the sensation of pins and needles, numbness, itching, burning, coldness, or electric shock feelings. This type of pain is common in people with damage to the central nervous system, such as those with multiple sclerosis or spinal cord injuries, and in those with ailments that affect the peripheral nervous system such as nutritional deficiencies, some types of cancer, HIV, herpes, diabetes, and those exposed to certain toxins. In addition, individuals with celiac disease are more likely to experience this type of pain.

Phantom pain is another type of neuropathic pain, which occurs in amputees when they perceive pain in a missing limb.

Psychogenic Pain

This type of pain occurs when emotional or mental issues cause, increase, or prolong pain. Some examples include stomach aches, headaches, muscle pain, and back pain that are caused by strong emotions such as grief, anxiety, and depression. Psychogenic pain can also occur when mental or emotional distress increases the severity of other pains. As mentioned earlier, most pain occurs in the brain, thus mental illness and emotions can have a huge impact on how we interpret pain signals. This is common in those who have irritable bowel syndrome, for instance, who typically experience more pain and discomfort in their bowels when under stress or experiencing mental health symptoms.

Treating Pain

The first line of defense against pain is to treat the cause. Since pain is typically a reaction to something harming your body, the simplest way to reduce pain is to fix or eliminate the injurious stimulus. However, this isn’t always possible. There are many ailments that can chronically affect your body, which are persistent, incurable, or even untreatable. In some individuals, there is not even an identifiable trigger for the pain, which makes it very difficult to treat. Because of these problems, many people experience chronic pain – pain in one location that has lasted for at least three months.

Right now, one in five Canadians are experiencing chronic pain, which more commonly affects females and seniors. ² This chronic pain can have a huge influence on an individual’s quality of life. Studies show that pain can affect quality of life more than any other diseases or disorders where pain is not present. Those who are in chronic pain have an increased chance of experiencing depression, anxiety, and anger,³ and are twice as likely to commit suicide as those without chronic pain.⁴ Many individuals develop impairments in attention, memory, problem solving, and mental flexibility, often losing the ability to work.⁵ Children who experience chronic pain miss the opportunity to live a normal life, as they often find it hard to participate in most childhood activities, such as social events and school.⁶ Many elderly people experience chronic pain; it affects 25-65% of seniors living in communities and up to 80% of seniors in long-term care facilities, which has a huge impact on their quality of life and, unfortunately, medical professionals often ignore this suffering. ⁷

For individuals in chronic pain, and those in the process of healing from ailments that cause short-term (acute) pain, medications that treat pain (analgesics) can help reduce the discomfort and make the pain more manageable or, ideally, eliminate as much pain as possible.

Chronic pain affects 9% of males and 12% of females aged 12-44 in Canada.¹²

Pain Medications

^8,9,10

Analgesics

Non-steroidal anti-inflammatory drugs (NSAIDs) prevent you from producing compounds called prostaglandins, which are responsible for causing inflammation. In addition, NSAIDs interfere with your body’s ability to send pain signals because prostaglandins are necessary to send signals of pain to the brain. This reduction in prostaglandins means that you experience less pain both from the reduction in inflammation in the injured area as well as from the fact that fewer pain messages are reaching your brain.

Examples include ibuprofen, Aspirin® (acetylsalicylic acid), and naproxen, which are primarily available over-the-counter (OTC), but some higher-dose formulations are only accessible by prescription.

Acetaminophen is widely used to relieve many types of pain because it increases the body’s pain threshold and modifies how your brain perceives pain to reduce pain severity.

It is sold under the brand name Tylenol® as well as in many generic formulations. Acetaminophen is often an active pain relief drug in many OTC medications, including medicines for treating cold, flu, arthritis, menstrual cramps, back pain, and more. If you have a liver disease, be sure to ask your physician whether it’s safe for you to take acetaminophen because it’s processed in the liver and relatively small amounts can worsen liver damage.

Opioids are narcotic agents, which are either natural alkaloids from the opium poppy plant (opiates) or synthetic drugs made to work by mimicking opiates. These medications bind to opioid receptors in the brain and modify pain messages. Side effects include nausea, vomiting, constipation, drowsiness, itching, and respiratory distress. Opioids are also highly addictive and it is easy to develop a tolerance to these medicines, so increasing dosages are often required during long-term use. These drugs eliminate pain by preventing pain messages from getting to the brain, and by working in the brain to alter the sensation of pain. Typically, when we feel pain, our bodies produce chemicals known as endorphins to counteract the pain messages. Endorphins interact with opioid receptors in the brain, reducing pain and making us feel more relaxed. Opioid medicines mimic this natural pain relief by using this same pathway, but they are much more potent than endorphins.

Opioids are primarily available through prescription, and include morphine, codeine, oxycodone, and fentanyl.

Adjuvant Analgesics

The following medicines aren’t typical analgesics; they have a primary indication for specific ailments and pain relief is a secondary effect. They often only work in very specific situations, but they are an important part of the pain-killing arsenal. These are the most commonly used:

• muscle-relaxants cause a sedative action in the central nervous system, reducing pain from tense muscles;
• corticosteroids are very powerful anti-inflammatory drugs;
• anti-anxiety medicines relax muscles, reduce anxiety, and help people cope with pain;
• antidepressants reduce pain transmission in the spinal cord; and
• anticonvulsive medications stabilize nerve cells.

Alternative Therapies

There are a variety of non-medication techniques you can use to help reduce chronic pain. Adequate sleep, stress management, relaxation, and hypnotherapy offer varying degrees of relief.

Marijuana and Pain

While not a common analgesic, there is research showing medical marijuana to have pain-relieving properties. A recent meta-analysis¹³ compared studies conducted from 1948 to 2015 on the effects of marijuana and found “high-quality evidence” that marijuana can help reduce chronic pain. It isn’t clear exactly how marijuana relieves pain, but one study shows that it might modify the way we perceive pain.¹⁴

Summary

Since pain serves a vital purpose for us, we must give it the respect it deserves and respond appropriately. If you have any type of pain, but particularly gastrointestinal pain, be sure to discuss this with your physician. It is important that the treatments and medications you are using are appropriate for your condition, considering that certain medications might adversely affect your existing GI condition.

First published in the

Inside Tract® newsletter issue 194 – 2015

Image Credit: © bigstockphoto.com/evgeny atamanenko

1. Pain is Weird. Pain Science. Available at: https://www.painscience.com/articles/pain-is-weird.

php. Accessed 08-07-2015.
2. Schopflocher D et al. The prevalence of chronic pain in Canada. Pain Research Management. 2011;16(6):445-50.
3. Bruehl S et al. Pain-related effects of trait anger expression: neural substrates and the role of endogenous opioid mechanisms. Neuroscience and Biobehavioral Reviews. 2009;33(3):475-91.
4. Tang NK et al. Suicidality in chronic pain: a review of the prevalence, risk factors and psychological links. Psychological Medicine. 2006;36(5):575-86.
5. Hart RP et al. Cognitive impairment in patients with chronic pain: the significance of stress. Current Pain and Headache Reports. 2003;7(2):116-26.
6. King S et al. The epidemiology of chronic pain in children and adolescents revisited: A systematic review. Pain. 2011;152(12):2729-38.
7. Hadjistavropoulos T et al. Transforming Long-Term Care Pain Management in North America: The Policy–Clinical Interface. Pain Medicine. 2009;10(3):506-20.
8. Pain Management Medication Types. RxList. Available at: http://www.rxlist.com/pain_medications/drugs-condition.htm. Accessed 08-07-2015.
9. Pain Medications. WebMD. Available at: http://www.webmd.com/pain-management/guide/pain-relievers. Accessed 08-07-2015.
10. Analgesic. Wikipedia. Available at: http://en.wikipedia.org/wiki/Analgesic. Accessed 08-07-2015.
11. Pain. Online Etymology Dictionary. Available at: http://www.etymonline.com/index.php?term=pain. Accessed 20-02-2015.
12. Ramage-Morin PL et al. Chronic pain at ages 12 to 44. Statistics Canada Health Reports. 2010;21(4)
13. Hill KP. Medical Marijuana for Treatment of Chronic Pain and Other Medical and Psychiatric Problems: A Clinical Review. Journal of the American Medical Association. 2015;313(24):2474-83.
14. Lee MC et al. Amygdala activity contributes to the dissociative effect of cannabis on pain perception. Pain. 2013;154(1):124-34.

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Abdominal pain in adults – Better Health Channel

About abdominal pain

Abdominal pain is pain felt anywhere from below your ribs to your pelvis. It is also known as tummy pain or stomach pain. The abdomen houses many organs, including your stomach, liver, pancreas, small and large bowel, and reproductive organs. There are also major blood vessels in the abdomen.

Serious causes of abdominal pain include appendicitis and pregnancy problems. However, most abdominal pain is harmless and goes away without surgery.

Most people only need relief from their symptoms. Sometimes, abdominal pain can stop and the cause will never be known, or the cause may becomes more obvious with time.

When to see a doctor about abdominal pain

Go straight to your doctor or the emergency department of the nearest hospital if you have any of the following:

• severe pain
• pain lasting for several hours
• pain or vaginal bleeding if you are pregnant
• pain in your scrotum if you are a male
• pain and vomiting or shortness of breath
• pain and vomiting blood
• blood in your bowel motions or urine
• pain that spreads to your chest, neck or shoulder
• fever and sweats
• become pale and clammy
• unable to pass urine
• unable to move your bowels or pass gas
• any other concerns.

Symptoms of abdominal pain in adults

The type of pain can vary greatly. When abdominal pain occurs, it can:

• be sharp, dull, stabbing, cramp-like, twisting or fit many other descriptions
• be brief, come and go in waves, or it can be constant
• make you throw up (vomit)
• make you want to stay still or make you so restless that you pace around trying to find ‘just the right position’
• vary from a minor problem to one needing urgent surgery.

Causes of abdominal pain in adults

There are many reasons why you may have pain in your abdomen. People often worry about appendicitis, gallstones, ulcers, infections and pregnancy problems. Doctors also worry about these, as well as many other conditions.

Abdominal pain may not come from the abdomen. Some surprising causes include heart attacks and pneumonia, conditions in the pelvis or groin, some skin rashes like shingles, and problems with stomach muscles like a strain. The pain may occur along with problems in passing urine or with bowel motions, or period problems.

With so many organs and structures in the abdomen, it can be hard for a doctor to be absolutely sure about the cause of your problem.

The doctor will ask you several questions and then examine you carefully. The doctor may perform no further tests. The cause of your pain may be quite clearly not serious. Another scenario may be that the doctor is unable to find a cause, but the pain gets better within hours or days. The doctor will assess whether the pain requires surgery or admission to hospital.

Diagnosis of abdominal pain in adults

To diagnose abdominal pain, doctors and healthcare professionals are likely to ask you the following questions:

Where is the pain?

Doctors and other health professionals will first ask you where you feel the pain. Pain above the umbilicus (belly button) but below the ribcage on the right may be gallstone pain. Gallstone pain may spread (or radiate) to the right shoulder or the back.

Pain from kidney stones is felt in the right side or left side, more in the back than the front of the abdomen, and tends to radiate downwards into the groin on the same side.

Pain in the very centre of the abdomen is more likely to be coming from the intestines, however in males, testicular pain is also felt in the centre of the abdomen.

When did the pain start?

Abdominal pain is ‘acute’ if present for less than a day or 2, ‘persistent’ if longer than a day or 2, and ‘chronic’ if present for more than 2 weeks.

How severe is the pain?

Health professionals will usually ask you to rate the pain or give a pain score out of 10. Mild pain might be rated 3 to 4, noticeable and unpleasant (like a toothache) but not severe enough to interfere with usual activity.

Severe pain stops all other activities (like labour pain in childbirth). Gallstone or kidney stone pain is often severe.

Does the pain come and go?

Abdominal pain that comes and goes in waves is called colic, and comes from the contraction of a hollow organ such as the bowel, the gallbladder or the urinary tract. Pain from other organs may be constant – for example stomach ulcers, pancreatitis or pain from an abdominal infection.

Have you had this pain before?

Gallstone pain and kidney stone pain will often recur every few months.

Period pain can be severe and may indicate an underlying problem such as endometriosis or pelvic inflammatory disease, while pain in the middle of the menstrual cycle can be due to an ovarian follicle.

What events led up to the pain?

This is an important question as it might point to the cause of the pain. Examples are trauma such as a sporting injury or car accident, recent medication such as anti-inflammatories or antibiotics, or heavier than usual alcohol intake, which might trigger pancreatitis.

Are there associated features?

Blood in the urine, together with flank pain (pain between the pelvis and the ribs), point to kidney stones.

Vomiting with pain in the centre of the abdomen can point to a small bowel obstruction. Severe constipation with pain in the side may point to a large bowel obstruction.

Do you have a history of previous surgery or radiation therapy to the abdomen?

Recent surgery to the bowel or other abdominal organs might result in complications, such as infection, that could cause abdominal pain.

Scarring to the tissue surrounding the bowel, or adhesions, can be caused by surgery or radiation therapy and trigger bowel obstruction.

Examinations and tests

If examinations and tests are needed, these may include:

• a rectal exam to check for hidden blood or other problems
• a check of the penis and scrotum
• a pelvic exam to check for problems in the womb (uterus), fallopian tubes and ovaries, and a pregnancy test
• a blood test to look for infection (which causes a raised white cell count) or bleeding (which causes a low blood count or haemoglobin)
• other blood tests may look at enzymes in the liver, pancreas and heart to sort out which organ may be involved
• a urine test to look for a urine infection or blood (if there is a kidney stone)
• an ECG (an electrical tracing of the heart) to rule out a heart attack
• other tests, including x-ray, ultrasound or CT scan
• an endoscopy – an examination where a flexible tube with a light and video camera at the tip is used to examine some internal organs without the need for surgery. Different names are used depending on which organ is being looked at
• sometimes you may be referred to another doctor to help find the cause of the problem.

If you do have tests, the doctor will explain the results to you. Some results may take a number of days to come back and these will be sent to your local doctor.

Treatment for abdominal pain in adults

Your treatment depends on what is causing your pain, but may include:

• Pain relief – your pain may not go away fully with painkillers, but it should ease.
• Fluids – you may have fluids given into a vein to correct fluid loss and rest your bowel.
• Medicines – for example, you may be given something to stop you vomiting.
• Fasting – your doctor may ask you not to eat or drink anything until the cause of your pain is known.

Taking care of yourself at home

Most abdominal pain goes away without special treatment. Be guided by your doctor, but there are some things you can do to help ease the pain, including:

• Place a hot water bottle or heated wheat bag on your abdomen.
• Soak in a warm bath. Take care not to scald yourself.
• Drink plenty of clear fluids such as water.
• Reduce your intake of coffee, tea and alcohol as these can make the pain worse.
• When you are allowed to eat again, start with clear liquids, then progress to bland foods such as crackers, rice, bananas or toast. Your doctor may advise you to avoid certain foods.
• Get plenty of rest.
• Try over-the-counter antacids, to help reduce some types of pain.
• Take mild painkillers such as paracetamol. Please check the packet for the right dose. Avoid aspirin or anti-inflammatory drugs unless advised to take them by a doctor. These drugs can make some types of abdominal pain worse.

Where to get help

• In an emergency, always call triple zero (000)
• Your GP (doctor)
• NURSE-ON-CALL Tel. 1300 606 024 – for expert health information and advice (24 hours, 7 days)
• The emergency department of your nearest hospital

Treatment of diseases of the gastrointestinal tract

Signs, symptoms and treatment of diseases of the gastrointestinal tract

If the gastrointestinal tract is functioning properly, it properly processes food to provide the body with the energy it needs. But sometimes in his work there is a failure, which causes many diseases of the gastrointestinal tract and the whole organism.

When seeking medical help, patients most often complain about abdominal pain, nausea, flatulence which are the main symptoms of diseases of the gastrointestinal tract.

In diseases of the stomach pains often occur. Most often discomfort is felt in the upper abdomen (under the pit of the stomach). The nature of the pain can vary, they can be weak or intense. Mild pain, or rather even a feeling of discomfort and heaviness under the sternum, is experienced by patients with reduced production of gastric juice. It is difficult for them to determine the specific place of pain, and indicate exactly where it hurts. These pains occur at any time of the day, regardless of the time of eating. In addition to pain, signs of diseases of this part of the gastrointestinal tract are decrease or loss of appetite, belching “rotten” , may appear tendency to diarrhea .

If the production of gastric juice is too active (gastritis with increased secretory activity or gastric ulcer), then the nature of the pain is completely different. Moreover, if the patient has a stomach ulcer, then, unlike a patient with gastritis, he can accurately indicate the place where he has pain. Also, the patient can clearly associate the time of meals with the appearance of pain. As a rule, the stomach begins to hurt either during a meal, or a few minutes after the end of the meal. Sometimes at night, when a person’s stomach is empty, he may experience hungry pains .

Abdominal pain is a symptom of diseases of the small intestine . Most often it is localized in the middle sections of the abdomen and in the umbilical region. With these diseases, the pain is dull and bursting, it is associated with the accumulation of gases in the intestines.

Inflammatory processes in the colon , such as chronic colitis, can also cause abdominal pain. They are localized in the lower abdomen and in its lateral sections (most often, on the left side). If the inflammation begins in the transverse colon, then the pain can spread to the upper intestines.

In chronic colitis the pain is cramping, which is why it is often called intestinal colic. A person feels a tight knot in the abdomen, which can twist sharply (an attack of pain) and then relax. Such attacks are often accompanied by nausea and vomiting. Often, colic can provoke the intake of food that causes increased gas formation.

Treatment of people with diseases of the gastrointestinal tract (suggesting organ dysfunction) is a rather difficult task. To prevent the development of more severe forms of diseases, it is necessary to treat chronic inflammatory processes of the digestive system in the early stages.

Diseases of the digestive system – diagnostics at Narva Clinic.

Therapy

Dozens of eating disorders and diseases of the gastrointestinal tract and digestive tract are known to physicians. Some ailments are classified as chronic, others as acute conditions, which, with proper treatment, quickly disappear.

Diseases of the digestive tract are among the most common in the world. According to statistics, up to 40% of all patients who seek medical help daily complain of discomfort and the area in the stomach, intestines, liver, and gallbladder. Primary diagnosis is carried out by a general practitioner.

Cost of treatment

Consultation of a general practitioner

1500 rubles

Issuance of a sick leave certificate

800 rubles

Gastropanel

40 00₽

Collection of material

250₽

All prices

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Symptoms of diseases of the digestive system

The main symptoms of diseases of the digestive tract are:

• pain during swallowing,
• burning sensation in larynx and esophagus,
• belching,
• sharp stitching, cutting, pulling, aching and other pains in the stomach;
• increased gas formation;
• frequent vomiting – eg after every meal;
• stool disorder – regular diarrhea or constipation;
• blood in stool;
• anal fissures accompanied by bleeding, pain and other unpleasant symptoms;
• bloating;
• weakness, constant headaches.

Major diseases of the digestive system

Diseases of the digestive system can be found in different organs. If there is discomfort in the esophagus, this may indicate a hiatal hernia, esophagitis. Pathological conditions of the stomach are gastritis, peptic ulcer, pneumatosis. A change in the nature of the stool, pain in the lower abdomen, increased bloating and gas formation may indicate duodenitis, hemorrhoids, colitis, appendicitis, duodenal ulcer, dysbacteriosis, irritable bowel syndrome and other pathological conditions.

Common diseases of the digestive tract also include lesions of the liver (hepatitis, cirrhosis), gallbladder (stone formation, cholecystitis, dyskinesia), pancreas (pancreatitis).

Diseases also include various neoplasms – for example, colorectal cancer, cancer of the esophagus, pancreas, stomach.

How are diseases of the digestive system diagnosed?

In medicine, various research methods are used to accurately determine the disease and prescribe effective treatment. All diagnostic tests can be divided into several categories:

• Laboratory tests. This can be a fecal occult blood test, a general urinalysis, throat swabs that allow you to determine the content of bacteria in saliva that cause pathology.
• Visual tests. For example, a study of colorectal transit, which allows you to understand how well food moves along the tract and through the colon. CT scan, which uses x-rays. After computer processing, doctors receive detailed images of organs, bones, muscles, and fat. Ultrasound of the gastrointestinal tract, MRI scans are other studies that provide detailed images of structures, blood vessels and organs. Magnetic resonance cholangiopancreatography is used to examine the bile ducts in detail.
• Endoscopic procedures. Colonoscopy allows you to examine the condition of the colon in order to detect neoplasms, inflamed tissues, and ulcerative lesions. Endoscopic retrograde cholangiopancreatography (ERCP) is used for suspected diseases of the liver, gallbladder, pancreas. Esophagogastroduodenoscopy (FGS) is used to diagnose the inside of the esophagus, duodenum, stomach.
• Other procedures. These are rarer diagnostic tests that are needed to clarify diagnoses. This may be monitoring the pH of the contents of the esophagus, manometry of the esophagus or stomach, capsule endoscopy, and others.

Methods of treatment

Therapy of diseases of the digestive system requires an accurate diagnosis and an individual approach. Treatment is prescribed only when the doctor has studied the patient’s history and is confident in the correctness of the diagnosis. The appointment of certain drugs and procedures depends on the type of disease, the severity of its course, the patient’s condition and many other data.

• Medicines. These can be antacids, enzymes, painkillers, anti-inflammatory and other drugs. They are available in the form of tablets and capsules, creams and gels, powders that must be diluted in water.
• Surgical techniques. They are used if the treatment does not bring relief, and the disease progresses. In some cases, urgent surgical care is required – for example, with a perforated ulcer or appendicitis. Therefore, any discomfort, pain and other unpleasant symptoms are a reason to consult a doctor to identify and treat diseases of the digestive tract.

Preventive measures

Any inflammation in the gastrointestinal tract is the result of dietary errors and an unhealthy lifestyle. Diseases of the digestive system can and should be prevented. The main recommendations are:

• Eat more fiber. We are talking about the inclusion in the daily diet of fruits, berries, vegetables and herbs.
• No stress. The mental state affects the digestive system and, in particular, the gut microbiota. If you can’t handle stress on your own, see a psychologist.
• Adequate fluid intake. We are talking about clean drinking water. The norm per day is from 1.5 liters.
• Active lifestyle. Sufficient physical activity during the day prevents constipation, the formation of stones and many other pathological conditions of the digestive system.