An insidious pain-mask. Does abdominal pain always indicate problems with the gastrointestinal tract?
I have a stomachache? What is this? Gastritis? Stomach ulcer? Why do abdominal pains appear? Can only diseases of the digestive system be their cause?
We are talking about this with Vasilisa Vladimirovna Ishchenko, a gastroenterologist at the Expert Kursk Clinic.
— Vasilisa Vladimirovna, is abdominal pain always a symptom of gastrointestinal tract diseases?
Not always. Pathologies of many organs, in addition to the digestive system and the abdominal cavity as a whole, can be accompanied by pain. For example, pain in this area may be “referred” from another area. In addition, abdominal pain can be of purely psychogenic origin, i.e. without organic damage to any organ.
“Harmonious growth and development should not be accompanied by abdominal pain. Problems with well-being and pain always have a reason.” Quote from the material “What to do if a child has a stomach ache?”
In general, pain is the most common problem that brings a patient to the clinic.
- What are the most common reasons for stomach pain?
It is difficult to say about such statistics. For me, as a gastroenterologist, these are diseases of the gastrointestinal tract. These are gastritis, pancreatitis, diseases of the biliary tract and intestines.
Read material on the topic: How to and how NOT to treat gastritis
At the same time, it is also true that every day we send patients for consultations with related specialists.
— Can my stomach hurt due to problems with my spine?
Of course, there may be pain, for example, with osteochondrosis. In such cases, this is explained by the fact that nerves from the thoracic and lumbar spine are involved in the innervation of the muscles and other tissues of the abdomen.
ABDOMINAL PAIN CAN BE DUE TO OSTEOCHONDROSIS
It is important to find out from the patient what causes the pain - in particular, eating or, conversely, a feeling of hunger, or movement, uncomfortable posture, or physical activity. It is necessary to clarify other characteristics of the pain: nature, after which it goes away, etc. And, of course, the presence of other manifestations: nausea, vomiting, belching, heartburn.
— Can kidney disease manifest itself as abdominal pain?
Yes. Here the connections between the renal-ureteric and gastrointestinal nerve plexuses are important.
“An interesting risk factor for the development of pyelonephritis is the presence of piercings in the umbilical area.” Quote from the material “Pyelonephritis: what is this disease and how to treat it?”
The pain can be one- or two-sided, radiate to the lumbar region, or be located in the hypochondrium. Typical irradiation of pain is along the lateral areas of the abdomen (along the ureters) to the groin area. In addition, there are urinary disorders.
— Lately, stress has been increasingly cited as the culprit of the causes of diseases. Can a stomach ache happen because a person is very nervous?
Yes. “Nervous” abdominal pain is precisely that psychogenic type. No structural changes in the organs are detected.
The origin of this type of pain is an imbalance between factors that suppress pain and the strengthening of normal nerve impulses coming from the periphery to the central nervous system.
Such pain is characteristic of functional diseases, which are always diagnoses of exclusion. In other words, when the patient was examined up and down, no organic cause was found, but there was pain, the diagnosis of a functional disorder may be legitimate.
— Can abdominal pain in women be associated with the menstrual cycle?
Yes. They can be observed before menstruation, during ovulation, and are usually localized in the lower abdomen. Pain of varying intensity and location also occurs with gynecological diseases (for example, endometritis, adnexitis, parametritis, ovarian apoplexy, rupture of an ovarian cyst, etc.).
“Frequent signs of an ovarian cyst: discomfort or pain in the lower abdomen, menstrual irregularities.” Quote from the material “What is an ovarian cyst and how to treat it?”
— Vasilisa Vladimirovna, can diseases of the reproductive organs in men lead to abdominal pain?
They can. Usually the pain is also located in the lower abdomen. They occur, for example, with prostate pathology. In addition to pain, urination may be impaired (frequently, at night).
Pain is also accompanied by testicular torsion, inflammation of the testicle and its epididymis, inguinal and inguinal-scrotal hernia.
— Have there been cases in your practice when abdominal pain was a symptom of diseases not related to the pathology of the gastrointestinal tract?
Such patients occur every day. In the process of examining and excluding “our” pathologies, the patient is eventually treated by a neurologist, surgeon (for example, due to appendicitis), urologist (in particular, due to urolithiasis).
— How to distinguish by the nature of abdominal pain what exactly is bothering you – the gastrointestinal tract or some other organs and systems?
For the gastrointestinal tract, the connection with food intake is important. Those. pain appears or intensifies on an empty stomach or after eating; Are there any other symptoms (nausea, vomiting, heartburn, belching; stool disorders: its frequency, character, connection with pain, i.e. before, during, after).
— Please advise, doctor, what is the right thing to do when you have abdominal pain? How to understand when pain is a random and harmless symptom, and when urgent medical attention is needed?
Pain should always be treated carefully. You should immediately consult a doctor if the pain is severe. In such cases, the search for the causes of its occurrence necessarily involves a surgeon, and in women also a gynecologist.
PAIN SHOULD ALWAYS BE TAKEN CAREFULLY. IT IS NECESSARY TO CONTACT A DOCTOR IMMEDIATELY IF THE PAIN IS ACUTE
In addition, the following “symptoms of anxiety” are a reason for urgent consultation:
— the pain arose after the age of 50, although it had never bothered me before;
- pain bothers you at night and can wake a person up;
- unexplained increase in body temperature to 37.5°C or higher;
- the appearance of blood in the stool, its dark coloration;
- vomiting “coffee grounds” or with bile;
- lack of appetite, weight loss.
When conducting a diagnostic search, it is also necessary to clarify with the patient whether there are or have been cases of oncological pathologies, Crohn's disease, or ulcerative colitis in the family.
Even if the pain was short-term and mild, a doctor’s consultation is necessary. First, you can do a general blood test, a basic set of biochemical blood tests and a survey ultrasound of the abdominal organs.
You can find out the cost and sign up for an ultrasound of the abdominal organs here
Please note: the service is not available in all cities
— What specialty should you see a doctor for abdominal pain?
If the pain is acute, then call an ambulance or quickly contact a surgeon, women + a gynecologist. If you have chronic pain, you may want to see a therapist. If the patient was able to establish a connection with food intake, or other signs of disorders of the gastrointestinal tract, which I mentioned earlier, then you should make an appointment with a gastroenterologist.
Sometimes abdominal pain is a “mask” of coronary heart disease, including myocardial infarction. You can suspect it if the pain “radiates” to the left arm, under the shoulder blade and between them, to the neck, lower jaw; weaken or disappear after stopping physical activity or taking nitroglycerin. There are manifestations such as sweating, fear, panic, palpitations, and heart rhythm disturbances. In this case, you should call an ambulance, which will do an ECG.
If the pain is associated with a change in body position, you may need to consult a neurologist.
Other materials on topics:
What to do if you suffer from heartburn?
Where can I find the courage to make up my mind? Gastroscopy – WITHOUT fear!
What to do if gallstones are found?
For reference
Ishchenko Vasilisa Vladimirovna
In 2015, she graduated from Kursk State Medical University with a degree in General Medicine.
From 2015 to 2016, she studied at an internship in the specialty “Therapy”. In the same year, she completed professional retraining in gastroenterology.
Currently working as a gastroenterologist at Clinic Expert Kursk. Receives at the address: st. Karl Liebknecht, no. 7.
Gastroscopy for abdominal pain at night, on an empty stomach
When visiting a gastroenterologist, some of our patients complain about so-called hunger pains: discomfort in the stomach that occurs when more than 6 hours have passed since the previous meal. Often, such abdominal pain occurs at night when a person is sleeping and becomes the cause of overwork based on lack of sleep. It is important that when eating food, such symptoms disappear on their own, so there are not so many people who come with complaints about them, and in vain.
Make an appointment with a specialist through the website
Abdominal pain that occurs at night and on an empty stomach is the first harbinger of peptic ulcers and gastritis, therefore, in order to diagnose and receive treatment as soon as possible, you should immediately visit the medical center in South Butovo, making an appointment with a gastroenterologist in any convenient way.
An experienced doctor, equipped with modern medical equipment, will conduct the most informative examination - gastroscopy. It will most likely show the presence/absence of inflammatory processes in the stomach and intestinal diseases.
The doctor will also tell you about possible reasons, among which the most popular are:
- changes in gastric motor function;
- irritation of receptors near the ulcer site;
- increased acidity resulting from increased secretion;
- spastic contractions around the resulting ulcerative defect.
All these causes can be successfully treated with medication, before the onset of a deeper stage of the disease, but in order to prescribe certain drugs, the doctor needs to make a diagnosis as soon as possible. A modern gastroscope with a thin diameter of only 4.9 mm will help with this, which can be easily inserted into even the smallest patients without causing the usual discomfort. You will only need minor preparation for the examination: stop eating 8 hours before the procedure, drinking 4 hours before, so that nothing interferes with the insertion of the gastroscope, and the visible “picture” is especially clear.
Is there constantly not enough time to visit doctors or is the patient easily excitable and prone to unrest within the hospital walls? No problem, the doctor will come to your home with everything you need.
The main thing is to constantly listen to your body, the signals it gives, so that unpleasant abdominal pain at night, on an empty stomach, does not become a harbinger of more serious diseases. A timely gastroscopy will help avoid sad consequences.
