- The mechanism of the formation of abdominal pain
- Why is it difficult to identify the cause?
- Diagnostic value of pain localization
- Significance of concomitant symptoms
- Differential diagnostics
- The association of abdominal pain with genital diseases
- What can I do with pain?
- Related Videos
When an adult or a child complains that the stomach is hurting, this is alarming with his versatile interpretation and manifestation. On the one hand - a symptom can cause a normal overeating, a power failure, a nervous overstrain, on the other - is an important component of the pain syndrome in the abdomen and is included in a variety of diseases of the internal organs, intestines, disturbances of innervation and motor function.
The mechanism of the formation of abdominal pain
All internal organs located in the cavity of the peritoneum and in the retroperitoneal space are united by innervation from the sympathetic nodes of the lumbosacral spine, wandering and celiac nerves, and their branches.
It is these nerve centers that receive signals from distended or spasmodically reduced stomach, intestines, bladder and ureters, from capsules enlarged due to edema or compressed dense tissues of the liver, spleen, kidneys, inflamed internal genitalia.
On the fibers of the spinal cord, information enters the painful centers of the head. Here in the special kernels the evaluation of "information" takes place, a command is given to all systems to ensure self-protection.
Sometimes the "solution" is disproportionate to the reason, hyperreaction itself becomes a pathological factor in autoimmune inflammation of the liver, kidneys (hepatitis, glomerulonephritis). Here there is a disruption of the regulatory function.
Why is it difficult to identify the cause?
The difficulty of finding out the main reason why the stomach hurts is due to the possibility of spreading an intense signal to neighboring zones of the spinal canal. This means that painful impulses, for example, from the digestive organs, will be perceived by a person as signs of pathology in the back, spine, wearing a diffuse nature.
Varieties of pain manifestations have been studied for centuries. Clinicians use symptoms that have a nominal name of the authors when examining the patient. Their diagnostic value is confirmed not by one generation of physicians.
Distinguish the origin of pain in the abdominal area is not easy even for an experienced doctor. Help survey methods, obtaining additional data. There are cases that are diagnosed only during the operation.
Diagnostic value of pain localization
In medicine, the division of the abdomen into zones is accepted. Everyone can get sick under certain conditions of defeat. Since patients are rarely familiar with the terminology, they are asked to show on themselves where the stomach is hurting.
Survey of the adult person allows to establish a place of the most intensive pains in a stomach, character of sensations, possible irradiation (distribution)
Pain in the upper part of the abdomen
Pain can be localized to the right or left. Right-sided - are characteristic for liver diseases, pancreas head, gallbladder and ways, duodenum, right kidney, bend of the colon:
- for the bile ducts (inflammation, stones) and the bladder is typically spread to the right shoulder, tenderness in the supraclavicular zone to the right;
- ulcerative lesion of the duodenum, bulbitis, duodenitis, swelling of the head of the pancreas give irradiation to the spine, back, take a shingling character;
- with urolithiasis of the kidneys, the pain covers half of the abdomen, waist, gives into the groin, testicles in men.
Left-sided - are caused by diseases of the stomach, spleen, body and tail of the pancreas, left kidney, splenic corners of the colon, observed with a hernia of the diaphragm where the esophagus passes.
Underlying - under the xiphoid process of the sternum, pain is often characterized as "sucking in the pit of a stomach". This is the place of the projection of the stomach on the abdominal wall. Pain in the abdomen around the epigastrium is a common sign of gastritis, stomach ulcers, tumors.
High, but intense pain after eating is accompanied by gastroesophageal reflux disease, cardiospasm
Can stomach ache with diseases not related to the digestive system? Such manifestations are attributed to false symptoms. With them there are doctors of different specialties. Therefore, to prevent an erroneous conclusion, you need to examine the patient completely, and not just the stomach.
Pain in the abdomen in the upper zone is caused by pleural inflammation, croupous pneumonia, myocardial infarction, infective endocarditis and pericarditis, traumas of the lumbar spine.
Lower abdominal pain
Right-sided pain - accompanies appendicitis, inflammation of part of the ileum, blind and ascending colonic (for example, with Crohn's disease), right kidney, internal genitalia.
Left-sided localization is typical for the manifestation of lesions of the transversal, sigmoid, rectum (colorectal cancer), left kidney, genital organs.
In the place of pain, it is not always possible to establish an affected organ. With peritonitis, the pain spreads first without clear localization, then concentrates in the area of a certain organ. If the perforation of the ulcer causes the contents of the stomach to leak into the peritoneum, the pain may remain local in the right ileal region and mimic acute appendicitis.
For an attack of appendicitis, the beginning is characterized by pain in the epigastrium, above the navel, after a few hours the transition to the iliac region on the right with a pulsation sensation
In accordance with the mechanism of education and the clinic, several types of abdominal pain are distinguished. Spastic - are caused in the hollow organs due to spasms of the muscular layer. Possible in diseases of the stomach (gastritis with high acidity, ulcer), intestines, gall bladder, arise against the background of movement of the stone along the bile ducts, ureter.
They always appear as sudden, cramping, rather strong pains in the abdomen. Patients call them "cutting", "shooting" and define as intestinal colic. The causes of pain in the abdomen of the spastic type along the bowel may be associated with lead intoxication, precomatosis in patients with diabetes mellitus, porphyria.
Distension - differ from the spastic overgrowth of the walls of the hollow organ. Observed with banal overeating, narrowing of the pyloric section in the stomach, stagnation of urine in the bladder, bile in the stones, intestinal atony, impaired peristalsis.
Provoked by mechanical obstacles (stone, fecal obstruction, growing tumor), squeezing effect of enlarged lymph nodes. Patients are characterized as blunt pains, aching, "feeling of heaviness".
Peritoneal - are caused by the receptor endings of the peritoneal sheets. In fact, the peritonitis explains why the abdomen is very sore. They are observed in acute destructive processes (perforated ulcer, tumor decay, rupture of an abscess or echinococcal cyst, thromboembolism of mesentery vessels, kidney, spleen). Patients complain that the abdomen is very sore, they refer such manifestations to "dagger" pains.
Inflammatory diseases of the internal organs of the abdomen are accompanied by swelling of the parenchyma, stretching of the capsule (which does not happen with diseases of the stomach and intestines). Therefore, to reveal why the stomach hurts with exacerbation of hepatitis, pancreatitis, nephritis, possibly using instrumental methods, fixing the increase in size.
A study conducted by Google showed that Internet users' requests to the topic of "pain" in general and "abdominal pain" in particular increased significantly. In ¼ cases, the requests are clearly formulated on the causes, symptoms, and methods of treatment. In this case, pain is more often disturbed, described as "aching, pulling, stitching".
Significance of concomitant symptoms
To clarify the disease must take into account, in addition to localization, such characteristics of pain as prevalence, communication with food intake, intensity, duration. To find out why the stomach hurts, the description of additional symptoms helps.
The first stage of the diagnostic examination is palpation of the abdomen
In addition to pain, patients are concerned about:
- constipation and diarrhea;
- difficulty urinating;
- rezi with urination;
- false desires for defecation;
- impaired sensitivity in the limbs;
- menstruation cycle in girls;
- discharge from the vagina or urethra.
Every disease that has caused pain, has its typical symptoms. Inflammation of the gallbladder (cholecystitis) - causes intense cramping pain in the hypochondrium on the right. Possible irradiation in the right shoulder, collarbone, abdomen. The body temperature rises. The patient is disturbed by vomiting with bile.
The abdomen with palpation is soft, sharply painful in the area of the bladder. With calculous cholecystitis, a tense circular formation can be palpated. Characteristic of the occurrence of mechanical jaundice, fecal discoloration.
An attack of cholelithiasis is accompanied by severe pain with irradiation in the lower back, the right side of the abdomen, vomiting. The pathology of the gallbladder often occurs after fatty and fried foods, alcohol intake.
Gastritis is a large group of stomach pathologies that occurs due to infection with Helicobacter pylori, disruption of digestion regulation, autoimmune mechanisms, exposure to toxic substances and poor-quality products.
The pain is more often localized in the epigastrium, spreading into the intestine. Acute forms are manifested by intense pain syndrome, nausea, vomiting sour, belching, heartburn. With a chronic course of aching pain, an early type, loss of appetite, weight loss.
Where does it hurt with appendicitis?
Causes of nausea and stomach pain
Reflux throwing bile into the duodenum and stomach causes biliary gastritis. He often accompanies cholecystitis, is seen as a complication. The pains shift to the central zone, become dependent on any rough food, in the vomiting of bile impurities.
Peptic ulcer disease - the location in the stomach causes pain after eating in the epigastrium, because of this the person does not eat, and then loses the appetite, from the vomiting the pain intensifies, possible admixtures of blood in the vomit.
Duodenal ulcer gives late and "hungry" pain, often spreading into the back, the spine. Similarly proceeds bulbit, duodenitis. Unlike gastric ulcers, patients do not lose their appetite and weight.
Pain in the navel zone causes inflammation of the intestine (enteritis, enterocolitis, Crohn's disease). Most often accompanied by food poisoning, infectious diseases (dysentery, salmonellosis, cholera). The disease is manifested by severe intoxication, diarrhea, signs of dehydration (loss of fluid), a drop in blood pressure.
Pancreatitis - joins in case of chronic digestive disorders, may be a major disease. Pains occupy the entire upper floor of the abdomen, "girdle" the patient's body. Typical frequent diarrhea with the release of stools, covered with fatty film.
In old age with a pronounced atherosclerotic process, pulsating pain in the abdomen is caused by an aneurysm of the abdominal aorta. Epicenter is located above the navel in the middle line, irradiation throughout the abdomen, in the scrotum and labia.
The attack lasts from several minutes to 5-6 hours. Occurs after dinner or at night. A large aneurysm compresses the intestine, stomach, kidney, spinal roots, inferior vena cava. There are paresis and paralysis.
With palpation, the formation pulsating in all directions is revealed. In such cases, to remove the pain in the abdomen by the usual means, which are used in the treatment of digestive organs, is impossible. The dissecting aneurysm is characterized by a sudden, cutting pain throughout the abdomen with irradiation in the legs, shortness of breath, shock state.
The pain on the right in the iliac region of the abdomen is considered a sign of inflammation of the appendix. In this zone, it "descends" in half a case in 5-6 hours, and begins in epigastrium. Gradually, the intensity increases, signs of intoxication intensify. The temperature rises, vomiting is repeated. Characteristic gain in position on the left side.
The pain of intestinal tumors depends on the location
Greater attention requires pain in the left side of the abdomen. The zone of the descending colon, sigmoid and direct, is most susceptible to malignant processes (transformation into a malignant tumor). It is here that the localization of colorectal cancer is located.
Pain spreads to the navel and lower abdomen. Become intense in the severe stage of the disease. Long hiding under the signs of colitis. Initial symptoms (constipation, increased gas formation) are often overlooked.
Pyelonephritis, cystitis, urolithiasis can cause severe pain in the abdomen, lower back. Usually one-sided. Accompanied by cuts with urination, rapid urge, increased temperature. An attack of urolithiasis is associated with physical stress, jolting in transport. Can be removed by yourself after the stone has departed. In the urine, blood appears.
The association of abdominal pain with genital diseases
Below the stomach and in the small pelvis are the internal genital organs of women and men. The main difference from diseases of the digestive system - the lack of connection with the quality and time of eating. Therefore, in choosing what to do if the stomach hurts, the main thing is that it is not diet food, but a timely appeal to a gynecologist, urologist andrologist.
Pain in the lower abdomen, in the area above the pubic in women, is more often a sign of gynecological diseases. It has a different character: sharp, pulling, aching. It is accompanied by weakness, secretions from the vagina. "Tearing" pain occurs with inflammation of the appendages, the temperature rises.
If the pain is acute and gradually increases, increases with movement, then a rupture of the ovarian cyst, an ectopic pregnancy is suspected. In this case, the woman has a slight delay in menstruation.
Girls often complain of severe pain in the lower abdomen before and during menstruation. They are caused by a reduction in the walls of the uterus. The examination reveals a violation of the hormonal balance.
If the pains appeared against the background of pregnancy, then this is an important sign of trouble
In pregnancy, detachment of the placenta, premature birth or interruption in the early stages is possible. Such pains are accompanied by bleeding. Do not look for ways to get rid of pain at home. The condition is dangerous for a woman's life and threatens the retention of pregnancy.
In men, pains in the lower abdomen, in the perineum, chronic prostatitis is manifested. The enlargement of the prostate with adenoma leads to compression of the urethral canal and a mechanical obstruction to the outflow of urine. Above the pubis, a stretched painful bladder is palpable.
What can I do with pain?
How to remove pain in the abdomen and what to do so that he no longer hurts, can recommend a doctor after a full examination. If the pain is associated with digestion, then you should exclude the use of alcohol, fatty and roasted meat, fish, spicy sauces and dishes, pickles, carbonated water, fresh vegetables.
With dysuric symptoms, it is recommended to "wash" the urinary organs by taking up to 2 liters of water, cranberry juice, decoction of chamomile or dog rose. Only with repeated typical attacks of urolithiasis it is permissible to take a warm bath. In the absence of confidence in the pain, this can not be done.
Diseases of inflammatory nature will necessarily require the use of antibacterial drugs. They are prescribed after bacteriological culture of feces or urine. With pain in the abdomen is not recommended to delay the time, to hope that "it will pass by itself".
It is necessary to call an ambulance, with moderate symptoms to go to see a doctor
Only in a medical institution can they deal with the cause of the pain and give the right help. It is useful for a reasonable person to know what can not be done if the abdomen is very sore:
- take drugs of doubtful properties that "helped a friend, neighbor, grandmother";
- long-term treatment with folk remedies;
- apply the heating pad to a painful place;
- induce vomiting, wash the stomach and intestines.
Getting rid of pain is associated with the efforts of the patient and doctors. Specific tactics are discussed only when survey data are available.