Gut

Diseases of the intestines are a common cause of abdominal cramps. Like all hollow organs, the wall of the intestine consists of smooth musculature, which can exhibit painful contractions. Most people are familiar with intestinal cramps in infectious gastrointestinal inflammation.

This disease, commonly known as gastroenteritis, is associated with nausea, vomiting, diarrhea and pain. The abdominal cramps it causes usually improve after bowel movements, only to reoccur after a period without symptoms. Triggers for infectious gastrointestinal diseases are usually viruses such as noro- or rotaviruses or bacteria such as Salmonella, Campylobacter, Shigella or certain E-coli species.

Transmission usually occurs from person to person via faecal-oral infection in the case of poor hand hygiene. Transmission through contaminated food is also conceivable and occurs mainly with Salmonella and Campylobacter but also with Noroviruses. Due to the presence of symptoms such as nausea, vomiting, fever and diarrhea, as well as the usually acute but short course, infectious causes can usually be determined by observation and anamnesis without further diagnosis.

If cramps in the abdomen, combined with diarrhea, fatigue and weight loss, occur frequently and intermittently, a chronic inflammatory bowel disease such as Crohn’s disease or ulcerative colitis must be considered. In contrast to the infectious causes, no pathogens can be identified here as triggers for the inflammatory changes. The development of Crohn’s disease and ulcerative colitis has not yet been conclusively clarified, but an autoimmunological cause is being discussed in both cases.

Although the frequent occurrence of diarrhea and spasmodic pain are rather unspecific signs, younger patients with chronic complaints in particular should be clarified with regard to the existence of a chronic inflammatory bowel disease. In addition to weight loss and deficiency symptoms, warning signs are bloody stools in ulcerative colitis and anal fistulas in Crohn’s disease. Symptomatic treatment is possible in both cases and is performed according to the severity of the symptoms.

Irritable bowel syndrome is a common disorder affecting almost one in two patients with gastrointestinal complaints. No organic reasons can be found as a trigger for the symptoms, which is why it is called an exclusion diagnosis, which may be made after a thorough examination without results and the exclusion of other causes. Women are particularly affected by irritable bowel syndrome.

The symptoms consist mainly of diffuse abdominal pain that can affect the entire abdomen, abdominal cramps, diarrhea, constipation and urge to defecate. The symptoms usually improve after defecation. Here, too, no cause could be identified.

A nervous overreaction of the intestine to various factors is suspected.This explains, for example, that irritable bowel syndrome is aggravated by stress and psychological tension. In the foreground of the therapy is a medical education of the patient about the harmlessness of the disease, autogenic training, nutritional advice and the administration of antispasmodic drugs for pain. On average, humans produce about 1.5 liters of intestinal gases per day, which are either excreted through the anus or absorbed by the intestinal wall.

The intestinal gas production can be massively increased by the intake of flatulent foods such as legumes, onions, certain nuts or cabbage. If the excretion is restricted, the smooth muscles of the intestine are stretched, resulting in intestinal cramps. In most cases, flatulence, also called meteorism in medical terminology, is harmless.

Sometimes considerable discomfort can be caused by so-called trapped winds, which are caused by the inclusion of intestinal gases in a section of the intestine. The intestinal passage can be restricted by adhesions after operations, by the bending of the intestine itself or by tumors. Clarification by imaging diagnostics should be performed.

In the majority of cases of abdominal cramps caused by flatulence, however, it is sufficient to avoid flatulent foods and, if necessary, therapy with a defoamer such as Simeticon. Intestinal gases are usually present in the intestinal coils as foam from gas and chyme or stool and can be poorly absorbed or excreted through the intestinal wall. A well-known household remedy against flatulence is caraway, which can be taken either pure or as tea.