stomach pain, abdominal pain
General information
Stomach cramps and diarrhea are symptoms to begin with. These can occur separately or together and can be the expression of a wide variety of illnesses. Most of these illnesses, even if they seem unpleasant or annoying, are harmless and there is not necessarily any reason for concern.
Under certain circumstances, however, which will be discussed in more detail below, it is recommended that you consult a doctor. Stomach cramps are often understood to be stabbing or pulling pains in the area of the upper abdomen, which increase and decrease in intensity. Between the individual episodes of pain there can sometimes be absolute freedom from symptoms. The term stomach cramps is somewhat misleading, since the corresponding pain symptoms can also be caused by parts of the intestine. In adults, diarrhea is defined as a stool frequency of more than three unformed (liquid) bowel movements per day with a total stool weight of over 250g.
Causes of stomach cramps with diarrhea
Stomach cramps with diarrhea occur as a complex of symptoms in many different diseases. It is most frequently observed in viral or bacterial infections of the digestive tract. Particularly in the winter months, virus-related diarrheal diseases occur epidemically and mainly affect community facilities such as schools, kindergartens, nursing homes or hospitals.
A common viral pathogen of this kind is the Norovirus, which leads to a large number of cases of infectious diarrhea every year. The viruses are usually transmitted via faecal-oral smear infections, which are favoured by inadequate hand hygiene after toilet use. Contaminated fruit or vegetables are also often suspected of spreading the disease.
Bacteria can also cause stomach cramps and diarrhoea. Common pathogens of this type are Salmonella, Shigella and Campylobacter, which enter the human digestive system via infected food and cause inflammation. Gastritis is an inflammation of the stomach lining that can be caused either by bacteria, medication, an autoimmune disease or chronic alcohol abuse.
Gastritis is an inflammation of the mucous membrane of the stomach that causes frequent stomach cramps, sometimes accompanied by diarrhoea. More rarely, the symptoms are caused by a stomach ulcer, which can sometimes develop at the base of chronic gastritis. More and more frequently, stomach cramps and diarrhea are associated with food intolerances such as lactose or gluten intolerance.
Discharging the suspected foods and a visit to the doctor can help to gain clarity about the triggering factors. Still relatively rare, but of increasing relevance, are the so-called chronic inflammatory bowel diseases (CED), which include Crohn’s disease and ulcerative colitis. They are associated with sometimes severe gastrointestinal cramps and a greatly increased frequency of bowel movements, which can reach a maximum of up to 25 bowel movements per day during an acute flare of ulcerative colitis.
A chronic inflammatory bowel disease is always suspected if stomach cramps and diarrhea occur repeatedly in episodes over a long period of time. If the cramp-like pain is concentrated on the right upper abdomen and occurs preferably after eating, an inflammation of the gall bladder is likely. If no organic cause for the occurrence of the symptoms is found after an intensive search, an irritable bowel syndrome can be assumed if the symptoms persist.
This is often classified as a psychosomatic disease, i.e. a disease in which stress of various kinds leads to physical syndromes. Only in rare cases is a malignant disease such as stomach cancer present. Unfortunately, there is no remedy to treat stomach cramps with diarrhea.
The therapy of stomach cramps can always only start after a thorough diagnosis and then depends on the disease that has caused the stomach cramps. In all possibilities that come into question as a cause, the specific therapy should be accompanied by a protection of the stomach in order not to expose it to additional stress. This includes, among other things, a healthy and balanced diet (for more details, see Prophylaxis) and the avoidance of stressful situations.
Warm compresses or a stomach soothing tea (e.g. chamomile) can also at least support the recovery. Massages or acupuncture are also possible for some people.If the stomach cramps were caused by appendicitis, it may be necessary to remove the appendix surgically to relieve the pain and prevent a breakthrough. An upset stomach as well as diarrhea is very easy to treat.
If you have eaten something that was no longer good, or if you did not tolerate any of the ingredients in your food, it is usually sufficient to follow a diet for two days (this means a light diet in the form of rusk and tea and, of course, abstaining from the triggering substance). If, however, there is a real case of food poisoning, it may be necessary, due to severe diarrhea, to give the affected person more fluid again, which can be in the form of an oral rehydration solution (water, electrolytes and glucose) or an infusion. If the food poisoning is caused by the pathogen, it should be treated with antibiotics.
Flatulence can usually be controlled well with household remedies. Massages and locally applied heat, for example in the form of a hot-water bottle, often show a clear improvement in symptoms. In addition, naturally flatulent foods (such as cabbage, beans, watermelon or sugar substitutes) should be avoided.
Irritable bowel syndrome is in principle harmless and therefore does not necessarily need to be treated if the patient’s suffering is not too great. Often, treatment is not indicated for the reason that no specific point of attack can be identified. In some cases, however, depending on the form of the irritable bowel syndrome, laxatives or intestinal stimulants can lead to an improvement.
Since psychological factors also play a significant role in the development of irritable bowel syndrome, psychotherapy may also be useful. Gastrointestinal infections caused by viruses usually heal on their own after two to three days and therefore usually do not require any therapy at all. Bacterial infections can sometimes be treated with antibiotics, although these should only be used in serious cases, as the infections are usually not dangerous and self-limiting, and the unnecessary administration of antibiotics leads to the unintended development of resistance.
With small children and elderly people, one should also always make sure that the fluid balance is not too much affected by vomiting and diarrhoea, and if necessary resort to fluid substitution. Since the high acidity of the gastric juice plays a major role in inflammation of the mucous membranes of the stomach, treatment here is with drugs that inhibit the production of gastric acid (either so-called protonone pump inhibitors, for example omeprazole, or histamine 2 receptor blockers, for example ranitidine). If the cause of the inflammation of the gastric mucosa is infection with Helicobacter pylori, this should be eliminated by means of so-called “eradication therapy”, which consists of the joint administration of a proton pump inhibitor and two antibiotics.
The same therapeutic approaches apply to the presence of a gastric ulcer. Therapy for stomach cancer depends on how far advanced the cancer is. In some cases, an attempt is made to remove the tumor completely by surgery.
If this is not possible or unsuccessful from the outset, there are also the options of chemotherapy or radiation therapy or a combination of both. Less frequently used treatments are laser therapy or immunotherapy (which aims to activate the body’s own defenses to fight the cancer). You may also need to change your diet.
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