In principle, a distinction is made between visceral abdominal pain and parietal abdominal pain. Visceral abdominal pain is a stimulation of nerves by abdominal organs. Organs, we do not have their own nerves causing the pain.
- Liver
- Spleen
- Stomach
- Gut
- Pancreas
- Bile ducts
- Ureter
- Female sexual organs etc. For this reason, when these organs are diseased, the pain is transmitted via nerves located further away. In the case of inflammation, stretching or cramping of the organs described, the corresponding stimuli are passed on, which are then recognised as pain in the brain.
The visceral pain is often described as dull, difficult to localize and distributed over a large area. Visceral abdominal pain is often associated with sweating, restlessness and vomiting. Abdominal pain and nausea are a common combination.
Patients with these pains often find no rest, are nervous and walk up and down or roll around in bed. We speak of parietal abdominal pain when the peritoneum (the so-called peritoneum) is affected by a disease. The peritoneum is sensitive to pain and transmits the stimulus to the brain more quickly and in a way that the patient can clearly localise it.
Patients experience this pain as bright, sharp or cutting. Since parietal pain is often aggravated by movement, patients move as little as possible and remain in a position in which the pain is bearable for as long as possible. As can be seen, the causes of abdominal pain are manifold.
Colic is characterized by cramp-like, often severe pain that cannot be changed by any independent action such as changing posture etc. Colic pain is usually shooting, very strong and of short duration. One also speaks of the so-called wave character of colic pains, as they appear suddenly, disappear again, only to reach a painful climax again in the next few minutes.
In most cases, abdominal colic is caused by stones in the gallbladder, which either get caught in the bile ducts and cause severe pain there, or are so large that they cause pain in the gallbladder through movement. Kidney stones can also cause colic, but these are usually located on the side of the kidney. In some cases, however, this type of colic can also cause pain radiating into the abdomen.
A variety of pathogens can cause diseases of the gastrointestinal tract and thus also lead to abdominal pain. The most common pathogens for as the cause of a gastro-intestinal infection are In most cases the not exactly localizable abdominal pain is accompanied by diarrhoea. Depending on how long the symptoms last, a doctor should be consulted.
In most cases, the pain and diarrhoea disappear after a few days. However, it is important to maintain a balanced fluid balance, as one must not forget that diarrhoea not only removes minerals from the body but also fluid. If this lost fluid is not immediately returned to the body, cramp-like abdominal pain develops again.
- Rotavirus
- Coronavirus
- Adenovirus
- Norovirus
- Salmonella
- Campylobacter
- Shigellen
- Yersinia
- Clostridium difficile
- Vibrio cholerae
There is also a large number of inflammations of the gastrointestinal tract or the organs located in the abdominal cavity that can cause abdominal pain. Chronic inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis, sometimes cause severe abdominal pain. In most cases, these pains are also associated with diarrhoea, sometimes even bloody.
When the pancreas becomes inflamed, not only is the patient’s general condition impaired, but abdominal pain also occurs, which the patient feels around his stomach in a belt shape. These pains are dull and cannot be localized exactly. Patients with pancreatitis (inflammation of the pancreas) often complain of radiating into the back.
Patients suffering from inflammation of the stomach (gastritis) will express more of a feeling of pressure than severe pain. Acute gastritis is triggered relatively quickly and usually by fatty food or too much alcohol. The higher consumption of soft drinks such as Cola, Fanta, Sprite can lead to abdominal pain and inflammation of the gastric mucosa.
Acute gastritis usually does not need to be treated. The symptoms often disappear within a few days. However, a chronic form remains and must be treated, as untreated a stomach ulcer can result.
The infection by the bacterium Helicobacter pylori can lead to an ulcer through an inflammatory process and can also cause oppressive stomach complaints. These complaints are relatively easy to localise and can be quickly assigned to the stomach, a hand’s breadth above the navel. A more rare but very serious cause of abdominal pain is occlusion of vessels.
In the case of an infarction, the mesenteric artery supplying the intestine, there is a need for action as soon as possible, as this is a life-threatening condition. Characteristically, patients complain of sudden onset of severe abdominal pain, which is described as biting and stinging and of unprecedented severity. These pains disappear after some time and the often underestimated latency period occurs.
If a treatment is not initiated immediately, an intestinal obstruction occurs with a sometimes septic and fatal course. Especially a heart attack in women often manifests itself as abdominal pain and is understandably not correctly assessed. In most cases, abdominal pain is also associated with accompanying symptoms such as restlessness, sweating and palpitations.
In the vast majority of cases, heart attacks that manifest themselves through abdominal pain are not detected or are detected too late. Abdominal pains that are the cause of a heart attack are usually classified as dull and cannot be localised correctly. In gynaecology, patients often complain of abdominal or abdominal pain.
In many cases, depending on when the pain occurs, it is not dangerous period pain, which can radiate from the abdomen to the stomach. If the pain is not regular or if it occurs for the first time in an adult patient, then in addition to an ectopic pregnancy, fibroids in the uterus and malignant changes must be ruled out. In young patients who complain of a lack of periods and abdominal or stomach pain, the so-called Maier Rokitansky–Hauser syndrome, in which the vagina has not been created and can therefore lead to pain during menstruation, must also be excluded as a cause.
Abdominal pain during pregnancy is understood to be abdominal pain in the period between the first month and the ninth month of pregnancy, which can be of harmless origin but can also be caused by serious diseases. The pain is not always directly related to the pregnancy. It should not be forgotten in this context that not all illnesses that can happen to pregnant women have something to do with the actual carrying of the child.
Thus, there is a danger that numerous internal medical problems will initially be pointed to gynaecological causes. Abdominal pain in pregnant women can have gynaecological or internal medical causes. Internal causes include colics of the bile and kidneys, inflammation of the pancreas, diverticulitis as well as intestinal obstructions and gastrointestinal infections.
Gynaecological causes of abdominal pain include ectopic pregnancies, ovarian inflammation, ovarian cysts and premature labour. These can have different causes. Psychological reasons should not be underestimated, although placental insufficiency must also be ruled out.
Irregularities in the digestion are often caused by different pressure conditions exerted by the foetus. However, they usually do not require further treatment. Ectopic pregnancies are either treated with medication, in which a hormone is applied that is intended to repel the foetus.
If this is not successful, the patient must have her fallopian tubes surgically removed. Inflammation of the fallopian tubes is treated with bed rest, anti-inflammatory drugs and antibiotics. Cysts on the ovary need only be observed at first.
Above a certain size or in case of complaints, surgical removal is necessary. Numerous urological diseases can also cause abdominal pain. If there are bladder stones in the bladder, a feeling of pressure in the abdominal region with radiation into the abdomen can occur.
Kidney stones or stones caught in the ureters can also cause pain radiating into the abdomen in addition to the colicky pain in the flank region. Abdominal pain can also be triggered by causes without an abdominal organ being affected. In the case of a slipped disc, for example, pain radiating into the abdominal region can also occur in addition to the back pain.
Postural anomalies, especially stooping postures, can lead to an unnatural displacement of the abdominal organs and thus to pain. People who sit a lot sometimes complain of abdominal pain, which then, after exclusion of other diseases, must be assigned to the postural anomalies. Sometimes abdominal pain presents itself as an absolute emergency.
This is also known as an acute abdomen. The acute abdomen is characterised by severe abdominal pain. The patient, whether lying down or standing, will try to get into a relieving posture.
In most cases this will be a curved or, when lying down, a crouched leg. In addition, the patient with an acute abdomen has a stomach as hard as a board, which is caused by a reflexive defensive tension. In most cases, the only treatment for an acute abdomen is surgery.
An exception is the so-called pseudoperitonitis, which can occur due to a derailed blood sugar level in the clinical picture of diabetes mellitus. The symptoms are similar to peritonitis, but in contrast to this, they can be resolved by adjusting the blood sugar level. The peritonitis mentioned above, in its most severe form, can also trigger an acute abdomen with a hard belly and a tight immune system.
The most common causes of peritonitis are acute appendicitis and intestinal obstruction. Immigrating bacteria such as E. coli or enterococci can then cause peritonitis with severe abdominal pain, very poor general condition and danger to life. In principle, every torn and opened (ruptured) abdominal organ, whatever the cause, is accompanied by peritonitis. This is an absolute emergency, because the patient is in absolute danger of death. Failure to treat the condition is very often fatal.
