Introduction
Abdominal pain is considered a very general symptom that can reflect physical, mental and psychological processes. Especially in the local culture, many problems are usually projected onto the abdomen, although they do not always have to come from the stomach. On average, every second visit to the doctor with the imaginary cause of abdominal pain is not accompanied by organic diseases.
Along with back pain, abdominal pain is one of the most common reasons for presentation. Basically, the cause of abdominal pain can originate from all organs located between the head and groin. However, the most common source is usually the organs of the digestive tract – starting with the stomach, through all sections of the intestine, as well as the organs adjacent to or involved in the digestive process such as the liver, pancreas or gall bladder.
However, many other internal diseases can also manifest themselves through abdominal pain. A heart attack, for example, is typically accompanied by stabbing pain radiating into the left arm, but this is not the case in all people. Shortness of breath, back pain or even abdominal pain can sometimes be the only symptom of such an event on the heart.
Urological or gynaecological conditions can also hide behind abdominal pain. Diseases of the kidneys or the bladder, but also acute processes on the inner genitals of the woman can be the cause of these complaints. Within the female cycle, abdominal pain is not uncommon, but may require rapid treatment under certain circumstances, such as a stem rotation of the ovaries (also: ovarian torsion).
If abdominal pain occurs more frequently at a certain time of day, this is more likely to be influenced by external factors, such as food intake or exercise. If the pain is accompanied by flatulence, this is more likely to indicate increased fermentation in the intestine due to food intolerance. In the following, the individual possible clinical pictures are dealt with in more detail.
Causes
The causes of abdominal pain usually lie in a malfunction or overload of the digestive organs. Sometimes, however, abdominal pain can also be psychologically superimposed, for example when the stress level in everyday life is very high. Mostly in the evening is the time when one can relax and lie back a little and thus be more receptive to physical symptoms.
Abdominal pain can then occur as an expression of physical and mental overstrain and not necessarily as a result of a digestive disorder. Orthopaedic incorrect posture and malposition may also cause abdominal pain at the end of the day. A typical example of this is watching television on the couch in the evening, where internal organs may be squeezed and thus the food previously ingested cannot be digested well.
Bowel irregularities or constipation (also: constipation) can also cause complaints, especially in the evening. This can cause intestinal contents to congestion and ferment in the digestive tract. Regular emptying of the bowels in the morning can help to alleviate the symptoms.
Inflammation of the stomach lining (also known as gastritis) usually also causes abdominal pain. These complaints often occur more frequently after eating, i.e. possibly also in the evening after dinner. If the symptoms usually occur after particularly fatty and sumptuous meals, such as after an abundant evening meal, or even at night, this can be an indication of biliary colic.
The pain often comes in attacks and is usually described as wavy. The most common cause of biliary colic is gallstones, which should also be removed surgically if the clinical symptoms are correspondingly pronounced. Abdominal pain, which is particularly severe after eating, is usually caused by inflammation of the mucous membrane of the stomach (also known as gastritis) or even a stomach ulcer.
In particular, the symptoms occur after high-fat meals. However, inappropriate eating habits such as eating too fast, eating too much, eating too fat or chewing too little can also cause stomach pain after eating. Many people eat raw vegetables daily as a healthy and uncomplicated form of diet.
Raw food does not need to be prepared and provides many healthy vitamins with low calories. However, digesting the unprepared vegetables can be a challenge for the intestinal mucosa. Raw vegetables tend to ferment undigested in the body, producing large amounts of intestinal gas, which causes bloating and leads to abdominal pain.
Both physical and psychological stress can have considerable effects on the body and various organ functions. This can sometimes lead to immune deficiencies, strong hormonal fluctuations and side effects such as weight gain. Permanently elevated stress hormone levels also reduce the blood circulation in the stomach, which leads to increased production of gastric acid.
The strongly increased stomach acid can have similar effects to a long lasting heartburn due to wrong nutrition. These include changes in the mucous membrane of the oesophagus, but also ulcers on the stomach itself. A common disease is the so-called “stress ulcer“, which is accompanied by severe pain in the stomach area when food is eaten.
Abdominal pain and accompanying flatulence (also: flatulence) usually indicate food intolerance. The body is then not able to digest certain components of the food, which leads to a more difficult intestinal passage and is accompanied by increased fermentation processes. This excess gas in the intestinal lumen can cause a feeling of bloating and usually leaves the body in the form of flatulence.
Those affected often also report diarrhoea. In many cases, stomach pain can be triggered by the stomach. So-called stomach upset can be caused by too much acid production, stress or certain foods.
Irritation of the stomach lining leads to nausea and pain. Some foods or stimulants such as coffee, alcohol or smoking can particularly irritate the stomach lining and stimulate acid production. This can lead to heartburn, stomach ache and even very painful ulcers.
Particularly fatty and heavy food in the evening with subsequent rest and lying or sitting posture can further aggravate the stomach problems. For this reason, a lighter and lower-fat dinner with sufficient distance before going to bed is recommended. Children relatively often tend to project problems or complaints onto the stomach.
The actual cause can also be found in a completely different part of the body, such as tonsillitis or other typical childhood diseases. Mental stress, excessive demands or annoyance at school can also cause abdominal pain in children. Particularly in the context of school stress, stomach pains occur more frequently in the evening, possibly also more on certain days before upcoming tests, teaching units by certain teachers or confrontations with classmates.
In order to recognise such problem situations, a parent-teacher discussion with the responsible class teacher can often be helpful. But of course children can also have food intolerances or have an organic cause for the complaints. Therefore the presentation should always be made at a pediatrician.
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