Stomach pain and nausea

If a person has a stomach ache and is sick, the first thing that comes to mind: "Something ate!" The condition can indeed be provoked by overeating, hunger, and poor-quality food. But, what to think about when it hurts stubbornly against the background of a normal diet? To understand, we will consider the mechanisms of pain syndrome formation, dyspepsia, physiological and pathological causes.

The mechanism of the appearance of pain

Physiologists have long proven that the pain in a person occurs when entering the brain centers of signals on special sensitive fibers. The peculiarity of the innervation of the stomach is the absence of painful endings( receptors) in the mucous layer of the wall. Therefore, with fibrogastroscopy, the doctor takes a material without anesthetization.

They are found only in the serous and muscular layers. As is known, the mucosa is the first to respond to inflammation. Means pains appear only when the process spreads to other cells lying deeper.

It turned out that the causes of pain are also hidden in altered motor skills, an abnormal reduction in muscle fibers. Depending on the disability of the muscles, the pain in the stomach region is divided into 3 types.

Spastic

Causes spasm of smooth musculature of the organ wall. The main reason is an increase in the acidity of gastric juice. There is an increase in the production of the hormone-gastrin, which stimulates the lining cells to synthesize hydrochloric acid.

The mechanism is typical for diseases with localization in the antral, pre-piloric, pyloric zone of the stomach and the initial parts of the duodenum. This is the most common location of gastritis and peptic ulcer disease.

The nature of the pain is acute, sudden, the attacks are quite intense. It spreads into the spine. It is well removed by a warm warmer, drugs of antispasmodic and antacid action.

The pain receptors are in the submucosal and muscular layers of the

. The

is caused by muscular stretching. Aggravating factors:

• stenosis of the pyloric( output) part of the stomach caused by cicatrical deformation;
• mechanical obstruction, compression outlet( large polyp, tumor) from the inside or outside( enlarged lymph node or pancreas head);
• delayed peristalsis in hypo- and anacidic conditions.

The characteristic of pain is aching, a feeling of heaviness, and bursting. Follow the abundant meal. Usually accompanied by a feeling of satiety, nausea. Pain in the stomach is removed after vomiting, caused by the patient artificially.

Peritoneal

Due to irritation of peritoneal leaflets involved. Differ:

• acute - if the integrity of the stomach wall is broken or the tumor disintegrates, appear suddenly, very intense, patients are described as "daggers";
• chronic - are caused by the gradual germination of the wall by the tumor, differ in constancy, moderate strength( the cancer is accompanied by intense pains), follow the intake of food, physical activity, sharp movements( jumping, running).

Characteristics of pains

To clarify why the stomach hurts and vomits, it is necessary for the patient to find out specific features, details. These include the answers to the following questions.

Where is the pathological process located? Variants:

• in the body of the stomach, if it hurts in the epigastrium on the left, in the hypochondrium - a sign of cancer or peptic ulcer, since here the cells are most superficially seated, affected first of the disease;
• in the cardiac department - under the xiphoid process of the sternum, pain causes a cancerous tumor;
• in the pyloroduodenal part - to the right of the median line, slightly above the navel, typical for biliary gastritis, gastroduodenitis.

To distinguish angina from gastric pain, all patients after 40 years are removed ECG

Where does the pain radiate? Variants:

• pathology of the body, the bottom, the cardiac part of the stomach promotes spreading to the left, needs differentiation with heart attacks especially in people in old age;
• from the antral section painful sensations go to the right, which is typical for peptic ulcer of the stomach and duodenum;
• , a disease localized on the back of the stomach, gives irradiation to the back, a loin, a circumscribed nature, it is caused by contact with the pancreas, the symptom indicates the penetration of the ulcer.

Are the pains associated with eating? Gastric pain is necessarily associated with eating. By this principle they are divided into early and late. The early ones appear half an hour after the meal, last up to 1.5 hours, decrease gradually depending on the course of food evacuation into the intestine.

Characterize the lesion of the middle and lower third of the stomach. There are possible early pains, they arise "at the table" if the pathology is localized in the cardiac part of the stomach or esophagus.

Late - begin in 1,5-2 hours, typical for the state of hypersecretion of hydrochloric acid, there may be "fasting hunger" on an empty stomach at night. Eating food and antacids reduces intensity.

What affects the intensity of pain? Pain in the abdomen of an adult is comparable in intensity, you can find out why, according to the patient, they change.

Pain enhancement is often associated:

• with gravity lifting;
• lying on the back, if the focus of the pathology is in the stomach on the back wall;
• by the use of acidic products, in the case of a hyperacid state;
• by the reception of abundant food;
• by changing the position of the body.

What makes the pain easier? Chronicle patients can accurately tell how they independently remove unpleasant sensations. To do this, use antispasmodics and a warm heating pad with a spastic form, antacid action in a hyperacid state, narcotic analgesics in cancer.

Mechanisms of nausea and vomiting

Why does the stomach ache and at the same time sick? The combination greatly complicates the condition of the patients. Nausea is called an unpleasant feeling, indicating the approach of vomiting. She with stomach diseases often precedes vomiting, but can stay for a long time and without vomiting.

Causes of nausea due to insufficiently intense( subthreshold) irritation of a special center of the brain. Propagation of impulses to neighboring centers contributes to simultaneous increase in saliva production, dizziness, drop in arterial pressure and tachycardia, blanching of the skin, increase in weakness.

Pain in the stomach and nausea are described by patients as "a feeling of faintness".When a person becomes nauseated, a typically temporary reluctance to eat. This condition can not be confused with disgust and refusal caused by severe pain in ulcerative process, cancer, nausea during pregnancy in women.

Women in the first trimester often feel nausea and vomiting in the morning, sometimes shortly after vomiting hurts the stomach, appetite disappears. This state passes by itself.

The vomiting center is located in the brainstem of the

Vomiting occurs when irritation of the central nuclei of the brain reaches a threshold level, after a period of nausea and stomach pain. The mechanism of vomiting is more complicated than in case of nausea. In addition to the involvement of the center of the brain, the following factors are involved:

• increased pressure in the stomach;
• stretching of the walls, causing irritation of the receptors of the vagus nerve( cholinoreceptors);
• , although there are no pain receptors on the mucosa, there are sensitive endings that react to the chemical constituents of the products( for example, with poor quality food).

Vomiting can be considered as a reflex protective process, which allows to clear the stomach of excessive irritation and pain. Muscular groups participate in the act: the walls of the stomach, diaphragm, abdominal press.

Their simultaneous contraction causes an increase in pressure in the abdominal and thoracic cavity, relaxes the sphincters of the esophagus, reduces the area of ​​the pylorus. Increases the tone of the muscles of the pyloric department, duodenum and jejunum. The mechanism of reflux cast into the stomach, from the stomach to the esophagus, is triggered. As a result, the contents are pushed into the mouth.

What are the signs of gastric emesis?

Abdominal pain and vomiting in patients may occur simultaneously. For diseases of the stomach is characterized by:

• the appearance of vomiting after 30 minutes-1.5 hours after eating, in the midst of digestion;
• a previous condition of distention pain in the abdomen and nausea;
• a large amount of vomit, the content of food residues from food eaten on the eve;
• acidic odor, indicating a high acidity;
• usually brings relief to the patient, abdominal pain decreases, nausea and hypersalivation disappear.

perforated wall gap gastric ulcer accompanied by severe pain, gastric contents transition into the peritoneum

Among the clinical signs of gastric disorders is isolated stenotic vomiting. It manifests itself in the stenosis of the pyloric department( exit) due to post-ulcer scars. The passage of food masses into the duodenum is delayed, the stomach stretches, which leads to vomiting.

The signs of stenotic vomiting are:

• abundant volume of vomit due to accumulation from previous meals;
• smell of "rotten eggs" - hydrogen sulphide is released when decaying stale proteins;
• act of vomiting occurs "fountain" because of the significant pressure created inside the stomach, a sign in children is observed with congenital pyloric stenosis. The quality

vomitus individual may be suspected diseases and their complications:

• if the patient feels the bitter taste, it indicates the presence of bile - a symptom duodenitis, pancreatitis, pancreatic head tumor, gallstones, adhesive obstruction( feature peculiar to individuals with chronic alcoholism);
• feces smell - indicates intestinal obstruction, is a manifestation of the fistula between the stomach and the colon;
• presence of blood is an irrefutable sign of gastric bleeding.

Gastric vomiting during prolonged repetitions significantly complicates the course of the disease: it causes exhaustion of the patient, contributes to loss of fluid( dehydration), accompanied by severe metabolic disturbances.

Due to the deficiency of chlorine, sodium, potassium, metabolic alkalosis is formed( the shift of acid-base equilibrium in the alkaline side), possible swelling of the brain tissue), decreased blood pressure, heart rate appears arrhythmias, acute renal failure is generated.

Diagnosis

What to do to the patient, if the stomach hurts and vomits, the doctor can only recommend after finding the reason. For this it is necessary to undergo a survey. In the analysis of the blood are important indicators that indicate bleeding( hematocrit, erythrocytes, hemoglobin, reticulocytes), inflammation( leukocytosis, increased erythrocyte sedimentation rate).

presence in stool samples positive Gregersen, a signal bleeding ulcer or tumor studies

detecting Helicobacter important for purposes of treatment on eradication procedure.pH-metry - helps to detect daily fluctuations in acidity, to evaluate the effectiveness of treatment.

Esophagogastroduodenoscopy is a visual examination of the internal surface of the esophagus, stomach and duodenum. Allows you to draw a material from suspicious areas of the mucosa. When studying the biopsy specimen, tumor cells, degree of differentiation and type are identified.

X-ray examination of the stomach is carried out with the obligatory preliminary drinking of barium suspension. It reveals signs of gastritis, ulcers, neoplasms.

Home Remedies for Pain and Nausea

Persistent, repetitive pain with nausea, can not be treated alone or use folk advice. The disease mechanism requires serious therapies.

If the pain occurs for the first time, nausea and vomiting are caused by food poisoning, then you can gently rinse the stomach with a slightly pink solution of potassium permanganate. To remove toxins shows the reception of activated carbon, Smecta, enterosorbents.

The drug should be kept in the home medicine cabinet

As an enveloping and anesthetic, you can take Almagel A, decoction of flaxseed. Spastic pain will calm tea from the flowers of chamomile. Adding mint, ginger root helps to remove nausea.

It is recommended to adhere to a strict diet for several days: only boiled dishes, liquid porridges, broth of wild rose, mineral water without gas. Exclude strong tea and coffee, spicy and fatty dishes, rye bread, baked pastries, vegetables.

If the condition occurs not for the first time, it is provoked by alcohol, overeating, stress, then you will not be able to get rid of stomach pains and nausea without switching to healthy food and regimen.

Pains in the stomach often arise due to inattention to your body, bad habits, addiction to fast food, snacks, and attempts to solve the weight problem by exhausting diets.

In return, a person becomes a frequent visitor to medical institutions, looking for ways to recover. To implement the recommendations of a doctor should be taken seriously, as a way to avoid serious consequences.