- Features of the location of the stomach
- Pain management
- Basic pathologies
- Methods of revealing the causes of
- Related videos
If a person has back pain along with a stomach disorder, there are two reasons: either the spinal cord pathology, spinal myositismuscles, or unpleasant sensations are caused by irradiation from the internal organs.
Girdle in the stomach and back is a serious symptom of pancreatic, ulcer, tumor metastases in the spine, inflammation of the gallbladder, liver, kidneys.
Features of the location of the stomach
The back area is traditionally considered the posterior surface of the body from the neck to the buttocks. Most often, irradiation occurs in the lower back. This place has more precise landmarks and is anchored anatomically along the lower ribs and the lumbosacral articulation.
The anatomical location of the stomach and adjacent organs is always evaluated in relation to the vertebrae: the
- entry is located to the left of the spine, at the level of the X-XI thoracic vertebrae;
- pyloric part( exit) - on the right, opposite XII thoracic-I lumbar.
A small curvature intersects the vertebral column from left to right and down. The lower pole of great curvature can descend to the level of the iliac crest of the pelvis. In the area of the stomach are:
- in front - the liver with its left lobe;
- spleen surrounds the organ from behind, from above and from the left;
- directly behind is the pancreas;
- below - lies the small intestine.
An important moment in the formation of pain from the stomach, giving back, is the common innervation of neighboring organs from the sympathetic ganglia of the celiac trunk, as well as the parasympathetic fibers of the vagus nerve. Through them on different branches there is a connection with all structures of the abdomen.
Pain signals are transmitted reflexively to the spinal centers, which are also involved in the regulation of the tone of the muscular apparatus of the back, waist, kidneys, adrenals.
In case of excessive intensity, they are superimposed, and the patient feels a reflected soreness in the muscles of the back, between the shoulder blades. Usually, the pathological process begins long before the manifestation of the pain syndrome. The body has a reserve( threshold) of sensitivity.
In order for pain receptors to react, the following changes should occur in tissues:
- destruction of nerve endings, cells at the level of ganglia( destruction);
- obstructed blood circulation, impaired blood supply leads to ischemia with oxygen deficiency and subsequent atrophic processes;
- congestion and fluid congestion, effusion into the intercellular space;
- is an inflammation.
These processes lead to local compression of nerve cells. Through the spinal cord, the signal enters the head and is regarded by the body as a need for help. Sustainable communication is used in medicine as a method of treatment. Specialists in massage, acupuncture are known skin and muscle areas of influence on the giving pain of gastric origin.
On the other hand, the painful mechanism makes differential diagnosis difficult, because it is difficult to understand why the patient is concerned about pain at the stomach level, but in the back. It is necessary to completely exclude manifestations:
- of osteochondrosis of the thoracic or lumbar region;
- pyelonephritis( inflammation of the kidney), hydronephrosis;
- herniated intervertebral disc;
- another pathology of the gastrointestinal tract.
Hernia in the intervertebral canal helps to compress the nerve roots
To clarify the nature of the pain, examination data are examined, the connection with food intake is revealed. Gastric pain usually occurs some time after eating. Provoked by a violation of nutrition, alcohol stress.
A pain of the neurological and articular type is more likely to accompany injuries, physical overloads, are provoked by hypothermia, respiratory diseases, and angina.
The main pathologies of
We will consider the main diseases that can be accompanied by pain in the area of the stomach giving back.
Hernia of the diaphragmatic hole
The disease is caused by congenital insufficiency of the connective tissue, heavy physical exertion, inflammation in the stomach, increase in body weight. There are 2 types:
- sliding - provided that the subdiaphragm part of the esophagus with the upper stomach can move freely to the position above the diaphragm, and then return to the place;
- mixed - part of the contents of the hernia( sub-diaphragmatic zone of the esophagus) remains above the muscular ring, the other - moves when the body position changes.
Clinical signs of pain:
- is localized in epigastrium;
- is given to the shoulder blades, behind the sternum;
- do not look like angina, as they appear after a plentiful meal, with the torso tilted forward, in the supine position;
- disappear with belching, after defecation, drinking water.
To attack the hernia is characterized by an attack of very intense pains
Acute or chronic inflammation of the renal pelvis is called pyelonephritis. Its cause is infection in the urinary system. The swelling of the organ causes the outer capsule to stretch and pain in the lower back and shoulder blades. They give epigastric region.
The disease is accompanied by a sharp increase in temperature, chills, przyazmi and frequent urination. Inflammation is confirmed by blood and urine tests. Upon examination, the doctor discovers a positive symptom of Pasternatsky on the side of the lesion( pain is aggravated by pocking on the waist).If the patient does not suffer from obesity, then it is possible to palpate an enlarged painful kidney.
Calculous pyelonephritis occurs against the background of an existing calculus in the pelvis or in the ureter. Exacerbations associated with shaking in transport, physical work. After an attack of pain, the appearance of blood in the urine due to injury to the vessels moving stone.
Cholecystitis and hepatic colic
Inflammation of the gallbladder and excretory ducts is expressed in cramping pains in the right upper quadrant, in epigastrium with irradiation in the back, right shoulder blade. The most intense attacks of cholelithiasis, it is almost always accompanied by calculous cholecystitis. The cause is infection in the stagnant contents of the bladder.
Clinically, the attack is manifested by nausea, vomiting with bitterness, soreness in the area of the right supraclavicular zone( frenicus-symptom), stool disorder, fever.
In chronic course, patients feel a constant weight in the hypochondrium on the right, dull aches. Exacerbations are observed after oily, fried foods. Possible discoloration of the feces and yellowing of the sclera.
Upon examination, the doctor checks the symptoms:
- Kera - tenderness in the right upper quadrant in the area of the gallbladder during exhalation;
- Ortnera - strengthening of pain during fretting on the right costal arch.
The disease is common among the elderly, their calls to the doctor significantly increase during the holidays when overeating. Patients are restless, press their hands to the right side of the abdomen.
Inflammation of the duodenum often passes from the stomach, so the disease is called gastroduodenitis. The most vulnerable is the nearest part - the bulb( bulbite).If, against a background of chronic gastritis, the patient has an irradiation of pain in the back, then this is regarded as the attachment of a bulbite.
The belly at the top, the lower back can hurt. Characteristically beginning 1.5-2 hours after a meal or at night. Strong pains accompany the erosive form of bulbit. Patients complain of vomiting with an admixture of bile, an eructation sour.
Most often, the pain in the stomach renders in the back with the localization of the ulcer on the back wall and in the duodenum. Characteristic following signs of pain:
- mandatory appearance after eating, with defeat of the duodenum are possible at night and on an empty stomach;
- patient is constantly sick, vomiting with acidic content and bitterness improves the condition;
- "hungry" pain disappears after eating;
- there is a combination with heartburn, eructation, stool disorders;
- is enhanced with physical stress, in stress and after it;
- at rest in compliance with the forced position with bent legs intensity decreases;
- has the significance of seasonality of exacerbations( in spring and autumn).
With gastric ulcer, appetite is lost, patients lose weight, duodenal lesions differ in preserved weight and satisfactory appetite.
The perforated ulcer is accompanied by "dagger" pains in the upper half of the abdomen( above the navel on the left) with rapid spreading throughout the entire surface, in the lower back. The patient has signs of shock: pallor, drop in blood pressure. Because of pain, a person is afraid to move, to breathe. The tension of the muscles of the abdominal wall indicates a diffuse peritonitis.
Inflammation of the pancreas proceeds with pronounced girdle pains, which are not eliminated by antispasmodics. Swelling of the body with stasis secretion causes nausea and vomiting, they do not relieve the patient's condition, hiccups, dry mouth, belching.
Symptoms of pancreatic necrosis are significant deterioration of well-being:
- pulse is rapid;
- dyspnea occurs;
- the temperature rises;
- skin turns pale, covered with a sticky cold sweat.
Pancreatitis often accompanies cholecystitis, peptic ulcer disease. Therefore, it is difficult to clinically diagnose. Laboratory and instrumental methods are encouraged.
Cancer of the stomach and pancreas
Malignant tumor in the stomach and in the pancreas can be suspected of continuing pains of a permanent nature, independent of the time of ingestion. At the beginning of the process, patients pay attention to the aching pain in the epigastrium, which gives to the hypochondrium, the back.
Growth of cancer causes exhausting pain, disgust for food, weight loss
Gall bladder cancer
Neoplasm in the gallbladder is masked by signs of cholecystitis, cholelithiasis, liver diseases. Almost every symptom requires a follow-up:
- pains are blunt permanent, located in the hypochondrium on the right or upper abdomen, irradiate in the back, scapula, not associated with eating;
- yellowing of the skin and sclera of the eyes;
- temperature rises to 38 degrees;
- is disturbed by nausea, vomiting of bile;
- stomach is swollen;
- is palpated with dense painful formation in the hypochondrium on the right;
- in the advanced stage there is weakness, weight loss.
Renal cell carcinoma( hypernephroma) is the most common malignant tumor. It is located in the cortical substance, it starts from the tubular epithelium. Men are more often ill after 40 years.
Clinical symptoms include:
- pains with the epicenter in the lower back, give in the hypochondrium, abdomen, can have the nature of renal colic, the intensity of manifestation depends on the stage;
- in the zone of the lower pole of the kidney specialist palpates tight formation;
- in men increases the testicle from one side( varicocele), there is visible blood in the urine after the act of urination;
- the temperature rises moderately, but lasts a long time, is rarely accompanied by chills;
- with hypertension worried about headaches;
- no appetite;
- the patient feels weak, loses weight.
Kidney cancer quickly metastasizes to other organs( lungs, bones, liver, brain tissue).Stubborn metastases can manifest themselves a few years after the removal of the primary tumor with the kidney.
Methods of revealing the causes of
For the differential diagnosis of the origin of the surrounding pain, the doctor is not sufficiently inquired about the complaints of the patient and his examination. A great help is provided by the results of a general clinical study and instrumental.
- general blood test - for any inflammation is typical leukocytosis, shift formula, the growth of ESR, in tumors, a long course of peptic ulcer, kidney disease develops anemia;
- biochemical tests are important for detecting impaired liver function, pancreas;
- protein and blood sugar - signal about undesirable changes in the kidneys, secretory deficiency in pancreatitis;
- in the urine check the number of leukocytes, bacteria, protein, mucus, erythrocytes, these types of studies indicate an impaired filtration and absorption function of the kidneys, inflammation in the urinary tract;
- in feces analysis examines scatology( excess fat and undigested proteins appear in pancreatitis), latent blood, typical for the ulcer process, a disintegrating tumor.
Diagnosis of diseases of the stomach and duodenum is accompanied by an accessible method of fibrogastroduodenoscopy. The doctor makes a visual inspection, establishes not only the pathology, but also its stage, localization. The method is necessary for taking biopsy specimens from the mucous membrane on the cytological and histological analysis for suspected tumors.
X-ray images of the spine are carried out in different positions of the patient( special piling).They are needed to detect changes in shape, structure of the vertebrae and discs. Magnetoresonance tomography helps to clarify the development of pathology in areas beyond the reach of other methods. In complex cases, diagnostic laparoscopy is used on the operating table.
The occurrence of simultaneous pain in the area of the stomach and back should alert any person, especially it concerns patients with chronic diseases of the gastrointestinal tract. Changing the nature of the painful syndrome requires a mandatory referral to the doctor.