Stomach Pain

1 Stomach Pain Summary

Stomach pain or abdominal pain is very common and is often not serious. It can be acute or intermittent, while in some other cases it is dull or crampy. In most of the cases, the reason for abdominal pain is easily detected and this helps in prompt treatment.

In some less common cases, stomach pain may indicate a serious illness. It is important to identify the symptoms of a serious stomach pain. Stomach pain can occur in any age group and population.

The duration and intensity of pain may depend on the actual cause of abdominal discomfort. For example, the pain may be short-lived as in alcohol intoxication or indigestion.

But the pain may persist for a longer duration if it is due to chronic conditions like chronic pancreatitis, gastroesophageal reflux disease (GERD), or serious conditions like stomach cancer. It is notable that stomach pain occurs concurrently with other symptoms, depending on the cause like diseases or disorders.

The experience of stomach pain is often described in different ways like a pressure or dull ache in the upper chest. The pain can be dull, crampy, or acute. The crampy pain in abdomen is often associated with constipation, bloating, or diarrhea.

Crampy pain is intermittent and often subside without any specific treatment. Colicky pain or severe spasms of abdominal muscles are more severe and serious. The pain may be localized to a specific area like right lower part of the abdomen.

In some cases, it is generalized and may spread over the entire abdomen. Stomach pain may be accompanied by a variety of other symptoms like diarrhea, nausea, belching, bloating, fever or constipation. Abdominal pain should be considered serious if it is acute and persistent.

Stomach pain needs immediate attention if it accompanied by any of the following symptoms:

The actual cause of the pain is diagnosed through physical examination, series of tests, and imaging techniques. Laboratory tests include blood, urine, and stool samples. Imaging tests like x-rays and ultrasound scans are also helpful in diagnosing many conditions and disorders that lead to stomach pain.

In some cases, diagnosis may be difficult or delayed due to a variety of reasons. In some conditions, stomach pain is vague or not severe enough, particularly in the case of intermittent, recurring pain. As stomach pain may be a symptom of many different conditions and disorders, it is important to evaluate the same for the accurate cause of the pain.

Treatment of abdominal pain depends on the actual cause of the condition. Medications, lifestyle changes, and surgery are suggested based on the specific cause of stomach pain. Many types of stomach pain are preventable. Most of them can be prevented by having a healthy diet, drinking adequate water, exercising regularly, and by having smaller meals at regular intervals.

2 Causes

Multiple conditions, infections, and disorders have stomach pain as one of the symptoms. The most common causes of stomach pain are infections, inflammation, intestinal disorders and obstruction.

Other common causes of pain in the abdomen include:

Many digestive system diseases may cause stomach pain. This includes gastroenteritis, GERD, irritable bowel syndrome (IBS), inflammatory bowel diseases (IBD), and lactose intolerance (inability to digest lactose).

Location of pain in the abdomen often indicate the possible causes of pain. Generalized pain may be caused by appendicitis, IBD, trauma, urinary tract infection, flu, and IBS. Localized pain also indicates the probable cause of pain.

Probable causes of pain in the lower abdominal area include:

Possible causes of pain in the upper abdominal area include:

Possible causes of pain in the center of abdomen include:

  • Gastroenteritis
  • Appendicitis
  • Uremia

Possible cause of pain in the lower left part of the abdomen include: 

Possible cause of pain in the upper left part of the abdomen include: 

  • Spleen enlargement or rupture
  • Constipation due to hardened stool
  • Kidney infection
  • Gastric ulcer
  • Cancer
  • Heart attack

Possible cause of pain in the lower-right part of the abdomen include:

  • Hernia
  • Appendicitis
  • Flu
  • Cancer
  • Kidney infection

Possible cause of pain in the upper-right part of the abdomen include: 

  • Pneumonia
  • Duodenal ulcer
  • Enlargement of lymph nodes
  • Appendicitis
  • Hepatitis
  • Abdominal injury

Menstrual cramps may also cause abdominal pain in the lower region, but in most of the cases, it leads to pelvic pain. The cause of the pain may also be indicated by other symptoms accompanying stomach pain.

Crampy pain accompanied by bloating is often caused by trapped wind in the abdomen. This can be treated by over-the-counter products. Stomach cramps are often accompanied by diarrhea when caused by gastroenteritis.

The infection may be caused by bacteria or virus. Both infections may be treated successfully within few days. Recurrent stomach pain and diarrhea may be due to chronic conditions like IBS.
Sudden sharp pain in a localized area of the abdomen could indicate a serious illness.

This issue should be treated immediately as it may become worse without medical attention. Sudden and severe stomach pain may be caused by appendicitis, ulcers, cholecystitis (inflammation of gall bladder), diverticulitis or kidney stones. In some cases, sudden sharp pain in the stomach may be caused by gastroenteritis.

Recurring abdominal pain may be caused by IBS, IBD, urinary tract infection, constipation, menstrual periods, and stomach ulcers.

In children, conditions like heartburn, urinary tract infection, and constipation may cause stomach pain. Some other causes of abdominal pain in children include infection in the abdominal cavity, blockage of the stomach, twisting of loops of intestine, and overlapping of one portion of the intestine into another.

In most of these cases, stomach pain is accompanied by other symptoms like vomiting, diarrhea, bloody stools, fever, severe constipation, and disinterest in food. In infants, excessive and episodic colic crying is also noted.

3 Diagnosis and Treatment

The actual cause of stomach pain is diagnosed based on physical examination, medical history, laboratory tests and imaging techniques.

Physical examination – during physical examination and medical history evaluation, the doctor may try to analyze the type of pain. Pain may be acute, intense, intermittent, chronic, progressing, crampy, sharp, dull, or steady.

Doctor tries to evaluate the same based on the response of the patient. Location of pain also is important in the diagnosis of the cause of pain. Radiating pain or pain localized to certain parts of the abdomen indicates specific causes.

Doctor also tries to assess whether the pain increases with activities, coughing, alcohol consumption, food, menstrual cycle, or just stress. Some types of stomach pain may be relieved by antacids, having more water, or eating certain foods.

Doctor analyzes these responses too to evaluate the actual cause of pain. Accompanying symptoms are also noted during the physical examination. During the examination, the doctor checks for tenderness and swelling by gently pressing on the abdomen.

Laboratory tests – complete blood test, liver function test, pancreatic enzyme test, and urinalysis are the most common laboratory tests performed during the diagnosis of the condition. Inflammation or infection is indicated by an increase in the white blood cells.

The level of red blood cells shows a sharp decrease with intestinal bleeding. Pancreatic inflammation is also shown in a blood test by an increase in the levels of enzymes amylase and lipase. Hepatitis and gall stones are indicated by elevated liver enzymes. The presence of white blood cells in the stool indicates diarrhea.

Imaging techniques – x-ray helps to detect an intestinal obstruction, ulcers, kidney stones, and pancreatitis. An abdominal ultrasound scan is used in identifying gallstones, appendicitis, and ovarian cysts.

Computed tomography or CT scan, and MRI are useful in diagnosing cancer, appendicitis, and diverticulitis. Diseases of the arteries are also detected using imaging methods. Capsule enteroscopy is a method in which a swallowed pill helps to take images of the small bowel and transmit the same to a receiver.

Other imaging methods used in the diagnosis of the cause of stomach pain include colonoscopy, esophagogastroduodenoscopy (EGD), endoscopic ultrasound and balloon enteroscopy. Treatment for stomach pain depends on the actual cause.

It is often individualized based on the comorbidities, health of the patient, age, and severity of pain. Any treatment plan focuses on the underlying cause and tries to minimize the pain and discomfort. It also tries to decrease the risk of complications of the underlying disease.

If the pain is caused by self-limiting conditions like viral infection or indigestion, adequate hydration and restricting diet are the most common recommended treatment method.

The treatment of choice in most of the cases is the medication that helps to control the underlying disease. For example, antibiotics are prescribed for bacterial infections like bacterial food poisoning.

More serious causes of stomach pain like intestinal obstruction and appendicitis may need hospitalization. Surgery is recommended for some specific causes like a hernia and appendicitis.

Lifestyle choices can also help in reducing pain. Many types of stomach pain can be controlled by having a healthy diet and avoiding excess alcohol and smoking. Good hygiene that controls the food contamination also goes a long way in preventing and controlling stomach pain caused by infections.

One can minimize the risk of abdominal pain with adequate hydration, regular exercise, and by having smaller meals at regular intervals. Some diseases like Crohn’s disease requires the person to follow a strict diet.

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