Introduction
Pulling in the stomach can have very different reasons. There are many different organs and muscles in the abdomen that can trigger a pulling. The pulling can come from the digestive tract, but also from the urinary tract or the sexual organs. There does not necessarily have to be a health reason for pulling in the abdomen in every case. However, the unpleasant feeling can also be an early warning sign of disease-related processes in the abdomen.
Symptoms
The predominant symptom of pulling pain or pulling in the abdomen may occur alone or accompanied by other symptoms that may vary organ-specifically. Pain intensity, localization and radiation may also provide further information about the cause of the pulling. There are many organs on the left side of the abdomen.
The stomach and spleen are located in the left upper abdomen, as are large parts of the colon, which continues into the left lower abdomen. Furthermore, parts of the small intestine and the pancreas are located on the left side of the abdomen. At this point, it is also important to mention the sexual organs, which are located in the lower abdomen.
The location of the pulling in the left abdomen alone does not allow any further conclusions to be drawn about the cause. It must be defined more precisely where the pulling is spreading. If the pulling occurs in the upper abdomen, the stomach is a possible cause.
In this case the pulling usually occurs in connection with food intake. The most common cause is stomach problems, such as inflammation of the gastric mucosa (gastritis). This can be acute, as a result of a stressful or unhealthy lifestyle, and then impresses with pain, which increases during eating and is accompanied by nausea and belching.
Chronic gastritis also leads to a bloated stomach, flatulence or diarrhoea. If the pulling in the stomach occurs only after eating and can be associated with certain foods, the possibility of food intolerance should be considered. These intolerance reactions can occur with lactose, fructose or gluten, for example, and can manifest themselves in many ways.
In addition to the pain, a possible pulling in the abdomen, nausea, vomiting, flatulence, diarrhoea or constipation can occur, but other symptoms that are not caused by the digestive organs are also possible. The spleen, which is also localized in the left upper abdomen, is rarely responsible for a pulling in the abdomen. The pain that occurs in connection with diseases of the spleen is rarely described as pulling but rather as stabbing or drilling.
Nevertheless, an enlarged spleen should also be ruled out in cases of prolonged pain. The surrounding organs in the left upper abdomen (heart, lungs) can also cause pain in the left half of the abdomen through radiation. Pain can also originate from the pancreas, but is then often accompanied by accompanying symptoms such as nausea and vomiting.
Pulling in the left lower abdomen can be caused by digestive problems such as flatulence or constipation and can be remedied with simple laxatives. However, in cases of prolonged pain, it should be determined whether the pulling is not caused by diverticulitis. On the right side there is the liver and the gallbladder, the small intestine and the colon.
It is also possible that the pain on the right side radiates from adjacent organs of the thorax, i.e. the lungs, to the right upper abdomen. In the right upper abdomen, the gallbladder can also be responsible for pulling pain. Inflammatory processes or gallstones can trigger this pain.
A pulling in the abdomen can be caused by intestinal activity on the right side, such as constipation or flatulence. The appendix, a part of the large intestine, can become inflamed and, in the case of appendicitis, can cause a pulling or even much stronger pain. Other inflammatory processes in the bowel can also cause a pulling or pain.
Pulling pain in the area of the middle of the abdomen can have several causes. Problems in the area of the pancreas can be responsible. For example, an acute or chronic inflammation.
Inflammation in the area of the intestine can also cause a pulling sensation in the middle of the abdomen. These include, for example, chronic inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease. They are often accompanied by frequent diarrhea.Appendicitis, i.e. appendicitis, can also cause central pulling abdominal pain.
It is often accompanied by fatigue and fever, and the pain can wander. Other causes of pulling in the middle of the abdomen can be ulcers in the stomach or duodenum. A disease of the gallbladder can also cause central abdominal traction.
For example, a biliary colic in the presence of gallstones. The symptoms then appear in waves. A harmless cause of central abdominal traction can be sore muscles.
Pulling pain in the abdomen that radiates into the back can be present, for example, when the pancreas is diseased. Acute inflammation (acute pancreatitis) often results in belt-shaped pain in the upper abdomen that radiates into the back. Other signs of pancreatitis can include loss of appetite and fatigue.
In the chronic form of pancreatitis, pulling pain in the abdomen and back can also occur, but it is usually less severe and acute than in the acute inflammation. Back pain caused by problems in the spine or muscular tension can also cause pulling pain in the back and abdomen at the same time. Another cause of pulling in the abdomen and back can be kidney stones that have already migrated into the ureters.
The pain can be localized in the area of the flanks, the lower abdomen (groin area) and the genitals. Even simple sore muscles, for example after unusual sporting activity, can cause pulling pain in the back and abdomen. The causes of a pulling pain in the region of the navel are similar to those of a pulling pain in the region of the middle of the abdomen.
Inflammations in the area of the intestine, which are often accompanied by diarrhoea, an inflammation of the appendix, inflammations in the area of the pancreas, diseases of the gall bladder and ulcers of the stomach or duodenum play a role here. The abdomen is also home to many organs. In addition to urological or gynaecological causes, a hernia can also cause pulling pain.
In the case of an inguinal hernia, the peritoneum slips through a weak point in the inguinal canal and abdominal viscera can slide into the peritoneum. This bulge can also be felt through the skin. Such an inguinal hernia must be surgically treated promptly, but is not an acute life-threatening emergency.
In the abdomen, at least in women, the reproductive organs are located in the abdominal cavity: uterus, fallopian tubes and the ovaries. These organs can also be responsible for pulling in the abdomen. The uterus is located in the middle of the abdomen and from there the fallopian tubes go down in pairs to the ovaries, which are located once on the right and once on the left.
So when there is a pulling in the abdomen, especially when it occurs in the lower abdomen (pulling in the lower abdomen), the female reproductive organs should be considered, regardless of which side is involved. Pulling in the abdomen often occurs in many women before or during menstruation. The uterus, which is a very muscular organ, contracts during menstruation to expel the mucous membrane.
In case of heavy bleeding, these contractions can be perceived as more or less painful pulling in the abdomen. Many women are helped by heat or antispasmodic drugs, such as Buscopan, to relieve the discomfort. Severe pain should be discussed with the gynaecologist to rule out that no other diseases of the genitals or urinary tract are the cause of the pain.
Inflammations of the uterus or the adnexes are possible, but also cysts on the ovaries. These cysts grow over time until at some point, when they have reached a certain size, they become painful. These cysts should be observed by a doctor to prevent a rupture or stem rotation of the fallopian tubes or ovaries, because in the event of a rupture, the abdominal cavity can become infected or the ovary can be permanently damaged, causing severe acute pain.
In addition, polyps of the uterus, so-called myomas, can also provoke a pulling in the abdomen. They often occur together with bleeding disorders. In addition, the clinical picture of endometriosis can be responsible for pulling in the abdomen.
In endometriosis, the uterus’s own tissue grows in places for which no such tissue is intended. The affected women suffer from severe pain during menstruation and often complain of inter-bleeding.Unfortunately, tumor diseases of the genital organs can also trigger a pulling in the abdomen, but often occur with other accompanying symptoms. In summary, a pulling in the lower abdomen can have various causes and should be clarified by a specialist (general practitioner, gynecology, urologist) if it occurs over a longer period of time or recurrently or is particularly severe.
Not only women are affected by abdominal pain, but men can also feel pain in the lower abdomen. The prostate lies in the lower abdomen of the man. Inflammations of the prostate, in acute (due to ascending infections) or chronic (due to enlargement of the prostate or cancer) form, can cause a pulling in the abdomen.
In this clinical picture too, in addition to the pulling and the pain, there are problems urinating. Testicular torsion is associated with much stronger pain: the testicle rotates around itself and thus squeezes the blood vessels that supply it. The immediate onset of severe pain is accompanied by nausea and vomiting.
Testicular torsion is a urological emergency and must be treated in hospital immediately. Pulling pain when urinating occurs when the urinary tract is inflamed. Most often these symptoms are caused by cystitis (inflammation of the bladder).
The trigger for this is that bacteria enter the bladder through the urethra. This is easier in women, as the urethra is much shorter than the man’s. But men can also develop cystitis at an advanced age.
The bacteria are often carried from the anus to the urethra by incorrect hygiene or certain sexual practices. Sexually transmitted diseases, such as chlamydial infections, can also play a role. A bladder infection manifests itself through frequent urge to urinate with emptying disorders.
The urine comes only in droplets, urination is painful or burns and after going to the toilet the bladder does not feel completely empty. Timely therapy is important in the case of cystitis. It is recommended to drink a lot (water, cranberry juice, special bladder tea) to flush out the pathogens.
If in this case there is no improvement within 1-2 days, a doctor should prescribe a therapy with antibiotics. Otherwise, the inflammation rises from the bladder via the ureters to the kidneys and causes a very painful inflammation of the renal pelvis. In this case, the feeling of illness is even stronger and fever and chills occur.
