Abdominal pain accompanied by nausea is a very common complaint, but it is not a disease in its own right and can only be considered a secondary symptom complex of other underlying diseases. The term “abdominal pain” covers abdominal pain (localised in the abdominal cavity) which can be caused by diseases of various internal organs. The stomach and intestines often cause abdominal pain in combination with nausea.
However, the gallbladder, liver or pancreas may also be the site of pain. In women, menstruation is an additional important trigger of abdominal pain, which should not be forgotten in the search for the cause of the pain. Typical for abdominal pain is also the manifold way in which it manifests itself.
For example, the pain can be of a piercing quality, manifest itself as a burning sensation, or is often symptomatic in the form of cramps. The accompanying symptoms of abdominal pain, such as vomiting, diarrhoea or fatigue, can narrow down the cause of the pain more precisely and are therefore of great importance in making a diagnosis. In most cases of abdominal pain and nausea, the symptoms are commonplace, such as a gastrointestinal infection (gastroenteritis).
However, there are some warning signs, and a doctor should be consulted immediately if they occur. These include an unusually intense pain or a long period of discomfort without improvement of the symptoms. Accompanying symptoms such as blood in the stool or a black coloration of the stool (tarry stool), as well as vomiting blood or a black, coffee-like appearance of the vomit, indicate bleeding in the area of the gastrointestinal tract and often require immediate intervention.
If, however, chest pain occurs in addition to abdominal pain and nausea, this may indicate a heart attack. If the abdominal pain radiates around the body in a belt shape at the level of the navel, this indicates an inflammation of the pancreas (pancreatitis), which should be treated as soon as possible. If appendicitis is present, a typical migration of the pain, which can initially only be localised imprecisely, into the right lower abdomen occurs. These can then be provoked by pressure and rapid relief of the abdominal wall on the opposite side.
Possible accompanying symptoms
Abdominal pain and nausea in combination with diarrhoea indicate a gastrointestinal infection (gastroenteritis), which is usually caused by viruses. These viruses can be transmitted through smear infections, for example through inadequate hygiene in the preparation of food, or directly from person to person. The virus-triggered illness lasts on average four days.
Typical of infectious gastroenteritis is the simultaneous occurrence of symptoms in several people who live closely together. In addition, stomach ache, nausea and diarrhoea can occur after eating spoiled food. The symptoms are often triggered by bacteria or their toxins, such as salmonella, and start about six hours after eating the contaminated food.
A visit to a doctor is usually not necessary in either case and is only recommended in the case of very severe symptoms or their persistence over several days. In most cases, relief is provided by a light diet in which fatty foods in particular should be avoided. Grated apples, mashed bananas or rusks are suitable for this.
It is particularly important to drink a sufficient amount of water, as the body loses a lot of fluid through diarrhoea. In addition, liquids such as herbal tea or still water should be drunk in small sips. Children in particular are quickly at risk of dehydration (exsiccosis) of the body, which is why it is very important to make sure that they drink enough.
Thorough washing of hands after going to the toilet and before preparing food is very important for the prophylaxis of pathogen transmission. If the symptom complex consists of abdominal pain, nausea and diarrhoea in mild intensity over a longer period of time, food intolerance, for example to fructose or lactose, can be the cause. In this case, the affected persons usually notice that the symptoms are directly related to food intake.
In this case, a visit to a doctor is essential for a definitive clarification of the causes of the symptoms. Abdominal pain and diarrhoea are very often accompanied by nausea when the gastrointestinal tract is disturbed. The reason for this is that the gastro-intestinal tract strongly co-regulates the nausea.
The most common disease causing abdominal pain and diarrhoea is gastrointestinal infection. It is usually caused by viruses and should improve significantly within a few days with the right therapy. However, such symptoms can also occur with food intolerances.
Those affected suffer for weeks or months from recurring, weak to moderate pain, diarrhoea and nausea. Depending on the intolerance, the symptoms can occur a few minutes to hours after eating and never occur independently of food intake. Cause for concern should be abdominal pain in combination with diarrhoea and nausea if they are unusually severe, persist for a long time or occur with other symptoms such as blood in the stool, high fever or yellowing of the skin and eyes.
In these cases, a doctor should be consulted as soon as possible in order not to overlook an illness that may require treatment. Important clinical pictures in this context are, for example, inflammation of the pancreas, irritable bowel syndrome and acute clinical pictures such as appendicitis. Vomiting is usually preceded by nausea.
Although the combination of nausea and vomiting is very unpleasant, it ensures a proportionate elimination of spoiled or even toxic stomach contents and thus protects the body from absorbing the entire amount of the harmful substance. Thus vomiting can be considered a protective measure of the body. Information on other causes of vomiting can be found here: Causes of vomiting These complaints are often based on an infectious cause.
Such a gastro-intestinal infection can be caused by viruses or bacteria that are ingested with contaminated food and often cause diarrhoea as well. The colour and consistency of the vomit can be used to draw various conclusions about the underlying cause. For example, in connection with a gastrointestinal infection or after consumption of a spoiled food, vomit often consists only of unadulterated or only digested food components, which requires no further action apart from a temporary abstinence from food to protect the stomach.
The same primary consequence results from greenish vomit, which gets its colour from the contained bile. In this case the stomach was empty before vomiting. In rare cases, vomiting of faeces (Miserere) may occur, which is a warning signal and should be examined immediately by a doctor, as vomiting in connection with stool retention and abdominal pain can be an indication of an intestinal obstruction that must be surgically removed immediately.
Vomiting of blood or a coffee-like appearance of the vomit should also be considered an emergency and occurs when bleeding occurs in the oesophagus or stomach. Vomiting, nausea and acute chest pain can also be the symptom of a heart attack and must therefore be examined more closely immediately. Flatulence can also cause severe stomach pain.
A common cause of flatulence is the consumption of flatulent foods such as pulses, cabbage, onions and unripe fruit. You can find other causes under: Causes of flatulence A permanent remedy in these cases is to reduce or avoid these foods. Sufficient exercise also helps, as it promotes the transport of the food pulp through the large intestine and consequently reduces the digestive gases produced by the intestinal bacteria.
Flatulence also occurs in cases of food intolerance, for example lactose intolerance, where the lactose lactose is not broken down by the intestinal enzymes and thus cannot be absorbed by the body. The lactose remaining in the intestine is metabolized by bacteria, producing gases that cause flatulence in the intestine and can lead to severe pain. If these pains occur regularly and do not disappear completely within a few days, it is advisable to consult a doctor, who can check for food intolerances or identify other causes for the complaints.
If abdominal pain, nausea and diarrhoea precede the headache, in most cases it is a gastrointestinal infection and the headache is usually caused by a lack of fluid. These can be alleviated by drinking sufficient amounts of herbal tea or water. If headaches and nausea, as well as possibly abdominal pain, occur at the same time, this can be an indication of the presence of a migraine.
In this case, the headache is usually only localised on one side and has a pulsating pain character. Other accompanying symptoms can be vomiting and sensitivity to sounds and light. In the acute phase, treatment is carried out with painkillers such as ibuprofen or aspirin.
If nausea is present, metoclopramide is also administered. Headaches combined with nausea until the opposite is proven are a sign of meningitis in connection with fever and neck stiffness. Patients must be examined immediately by a doctor and treated with antibiotics.
If abdominal pain and nausea are accompanied by the appearance of fatigue, there are several possible causes. It is possible that anaemia (lack of blood) is present at the same time. This anaemia is often initially symptomatic of fatigue.
In addition, the person affected is usually conspicuous by fatigue, shortness of breath and paleness. A stomach ulcer, for example, can be responsible for the combination of symptoms mentioned above, consisting of abdominal pain, nausea and fatigue. This can be the source of bleeding, which can lead to a continuous loss of blood and even anaemia.
The blood lost via the peptic ulcer can manifest itself as coffee grounds-coloured vomiting or black colouring of the stool. If this occurs, a doctor should be consulted immediately, as such bleeding can be potentially life-threatening. Sometimes the ulcer bleeds only in such small amounts that the blood does not cause vomiting and is not visible in the stool to the naked eye.
In these cases, a test for hidden (occult) blood in the stool, which can be detected by analysing stool samples, is recommended for the diagnosis of possible anaemia. Another reason for anaemia in women of childbearing age may be heavy menstrual bleeding, which can also be accompanied by abdominal pain and possibly nausea. If the anaemia is caused by menstruation, it can usually be treated by drinking enough and eating a balanced diet, which causes the fatigue to disappear by itself.
Other causes of abdominal pain and simultaneous fatigue can be diseases of the liver. Typical further complaints associated with liver diseases are pressure pain in the right upper abdomen and loss of appetite. In the case of more severe damage to the liver, the skin may also turn yellow and the signs of hepatic fibrosis may manifest themselves. If there is a food intolerance or a disturbance in the absorption of essential food components, such as vitamins in the intestine, fatigue can occur in addition to abdominal pain and nausea. This can be explained by the resulting deficiency of certain nutrients in the body, which prevents it from developing its full potential, which in turn can manifest itself as fatigue.