Abdominal pain (med.: abdominal pain) or abdominal cramps occurs at least once in every person. Most of the time, they go away after a while. However, in some cases, the pain is prolonged and chronic.

The causes of pain are very diverse - most of them are relatively harmless. But there are also serious diseases that manifest themselves through abdominal pain. It is important to recognize when you need to see a doctor urgently.

Pain can be caused by changes in intra-intestinal pressure in the small and large intestines, stretching of the lumen or contraction of the muscular membrane, as well as circulatory disorders.

Abdominal pain should be distinguished by the following features:

• how long does the pain last
• kind of pain
• what area of ​​the abdomen hurts,
• to which areas of the body it irradiates (gives off or spreads).

Depending on the duration of the pain, there are:

• acute - acutely arising, which are repeated after a while,
• chronic - persistent pain in the abdomen for several weeks, which can either increase or subside,
• chronically recurrent - for a long time they either occur or are absent.

Acute abdominal pain that appears suddenly is quite common, for example, due to a gastrointestinal infection or stress.

Chronic persistent abdominal pain is rare.

Chronic pain with relapses is much more common. They are characteristic, for example, of irritable bowel syndrome or chronic inflammatory bowel diseases such as Crohn's disease.

IN abdominal cavity there are a large number of internal organs. These are primarily the digestive organs, in women the uterus and ovaries, in men the prostate gland. Problems with any of these organs can cause abdominal pain.

The heart and lungs are also in close proximity to the abdominal cavity, and their diseases can cause abdominal pain.

Conditionally pain in the abdominal cavity can be divided into three groups:

• pain in the intestines
• pain in other organs of the abdominal cavity,
• pain that has no connection with the abdominal organs.

Table of symptoms and causes of abdominal pain and first aid

Causes of abdominal pain	Symptoms	Adviсe (does not replace medical advice)
Food intolerance (fructose, lactose, gluten)	After eating the appropriate food: Stomach ache Flatulence Diarrhea	Keeping a food diary Examination by a doctor Exclusion of non-portable products
Atypical heart attack	Sudden onset abdominal pain that radiates to the shoulders Nausea Vomit	Doctor call
Constipation	Stomach ache Difficulty defecation Several days without stool Bloating	outdoor movement Spicy food Prunes, watermelon (chew the seeds), sour fruits Coffee beans belly massage
Inflammation of the fallopian tubes (in women)	Cramping pains in the lower abdomen Nausea Vomit Constipation Diarrhea Pain when urinating Blood between periods Allocations	The doctor's consultation
testicular cancer (for men)	Stomach ache Backache Loss of appetite lethargy	The doctor's consultation
Crohn's disease (chronic intestinal inflammation)	Drawing pains Spasms Diarrhea Fatigue Malaise	The doctor's consultation Drink a lot Vitamins and trace elements
Inflammation of the uterus (for women)	Recurring cramps during menstruation Blood between periods	The doctor's consultation Heat, herbal teas
Reflux esophagitis	Pain in the upper abdomen Pain in the esophagus sour burp	Don't eat much in the evening high pillow avoid stress Avoid alcohol, smoking, fatty foods
Inflammation of the caecum (appendicitis)	Pain in the umbilical region Pain in the lower right abdomen Pain when walking Pallor Elevated temperature Diarrhea Nausea	Mandatory consultation with a doctor If necessary, operation
Flu	Stomach ache Fever Vomit Diarrhea Chills	Bed rest Drink a lot Medications on doctor's advice
Food poisoning	Sharp or dull pain in the abdomen Nausea Fever Diarrhea	Bed rest Drink a lot Hospitalization if necessary
Stress	Abdominal cramps Diarrhea Constipation Flatulence Loss of appetite Nausea	Modern relaxation methods Muscle relaxation Psychotherapy Light food Herbal teas such as fennel and chamomile Prohibition of alcohol and smoking Warm outdoor movement

Bowel disease

1. For diseases, an increase in pain in the second half of the day is characteristic.
2. If the cause of abdominal pain is diseases of the left departments, then the pain on the left side of the abdomen appears before the stool, as a result of bloating and decreases after the passage of gases and defecation.
3. Quite often there are complaints of abdominal pain and the urge to defecate, which appear immediately after eating. Such symptoms are most often associated with intestinal dyskinesia.
4. When abdominal pain gets worse when walking, exercising, or shaking, it is dangerous symptom. It indicates the presence of a deep inflammatory process in the abdominal cavity. It could be a hernia or chronic appendicitis.
   With such symptoms, you should immediately consult a doctor, since the spread of the pathological process can eventually lead to peritonitis.
5. If problems arise in the right half of the large intestine, then they are manifested by pain after a rather long time. In contrast to this change in the left, narrower, part of it quickly leads to pain.
6. Paroxysmal pain can be the result of both functional intestinal spasm and an attack of partial intestinal obstruction due to scarring or partial closure of the intestinal lumen by a tumor.

Other non-abdominal causes

1. Abdominal pain can be associated with brain damage and other diseases of the internal organs outside the abdominal cavity. However, in these cases, it is rarely the main or primary symptom of the disease.
2. Spinal diseases such as curvature, arthritis, arthrosis, tuberculosis, spinal tumors and spinal cord, offset intervertebral hernias can also cause abdominal pain with or without spinal pain.
3. Severe abdominal pain can also be felt as a result of pain in the abdominal muscles, abdominal muscles when they are overstrained during physical activity.
4. Sometimes soreness of the skin can also be perceived as pain in the abdominal cavity.
5. Pain around the navel may be associated with increased sensitivity nerve plexuses and mesenteric plexuses.
6. If you are worried about constant aching pain in the abdomen, which lasts for months and years, and it is not related to the physiology of the intestine, and if there are no organic changes in the intestine, then such pain can be psychogenic. It is often difficult to distinguish between psychosomatic pain gastrointestinal tract from gastrointestinal flu, or from pain for other reasons, because the symptoms may be the same. If the examination does not reveal problems with the intestines and other organs, then the cause of these pains may be psychological discomfort. Feelings such as fear, stress or grief have a destructive effect on the nervous system. No wonder experts call the abdominal cavity the “second brain”. The gastrointestinal tract has its own nervous system, consisting of 100 million nerve cells. Therefore, psychological problems can cause not only pain, but also diarrhea, flatulence and bloating.

It is difficult to objectively assess pain.

Their intensity depends on a number of factors: the type of higher nervous activity, the emotional background, the environment in which the patient is located.

Pain in the upper abdomen

The cause of this localization of pain may be the spleen (left), liver (right) or stomach (center). The pancreas is located in the upper abdomen.

1. Gastritis of the stomach. With gastritis of the stomach, cramping abdominal pains are characteristic. Other symptoms of gastritis are loss of appetite, flatulence, and a feeling of fullness.
2. Inflammation of the pancreas (pancreatitis). With inflammation of the pancreas, there may be abdominal cramps, but more often shingles colic (give to the back).
   During exacerbations, nausea, vomiting, bloating, and fever are possible.
3. Heartburn. With heartburn or gastroesophageal reflux disease, ascending burning pains occur. In most cases, they occur after eating fatty foods. The pains pass behind the sternum, but are also possible in the upper abdomen and partially even in the throat. Often there is an eructation.
4. Stones in gallbladder . With gallstone pain, they can also occur after eating fatty foods, they are in the nature of severe spasmodic colic. Sometimes there is girdle pain in the upper abdomen. Pain, appearing on the right, can sometimes radiate to the shoulder, in addition, fever, vomiting and chills often occur.
5. Hepatic porphyria. Severe abdominal cramps can also be a sign of porphyria. This is a group of various metabolic diseases that result in the formation of toxic intermediates that can lead to liver damage.
6. Liver disease. There are pains in the right hypochondrium and up to the middle of the abdomen, for example, with cirrhosis of the liver or hepatitis. In this case, the pain is not localized at a specific point. Additional symptom is loss of appetite.
7. stomach ulcer. Pain in the upper abdomen can also indicate a stomach ulcer. Cutting pains are felt on the left or in the center and occur immediately after eating or some time after eating.
8. And. This pain occurs on an empty stomach. With an empty stomach, there is a sudden severe pain in the middle of the upper abdomen, most often this occurs at night. If you eat something, then the pain subsides.
9. Cancer. Sometimes cancer can lead to severe cutting pain in the upper abdomen, such as stomach cancer, colon cancer, or pancreatic cancer. This pain is accompanied by a feeling of pressure, weakness, severe weight loss, and other symptoms.

Pain in the lower abdomen

There are also many reasons that can cause pain in the lower abdomen. In addition to causes related to the intestines, such as inflammation of the colon and cecum, urinary tract diseases and gynecological diseases or prostate diseases in men can cause pain.

1. . Pain with inflammation of appendicitis begins, as a rule, in the navel, then descends to the lower right side of the abdomen. Pain comes on suddenly and sharply. Symptoms such as fever, nausea, vomiting are also characteristic.
2. . The pain begins sharply, often in the right lower abdomen. Accompanied by vomiting, fever, nausea.
3. - another reason for cramping pain in the intestines, almost always accompanied by vomiting, nausea, diarrhea (diarrhea).
4. . Increased accumulation of intestinal gases can lead to bloating and pain.
5. . With irritable bowel syndrome, pain is associated with violations of the tone of the small and large intestines. The pain is perceived as dull or as spasms. It occurs at different times after eating, often provoked by emotional stress. The pain does not occur at night, but often interferes with sleep. Pain usually continues long years and come in varying intensity and duration on different days. Pain points on the abdomen coincide with the projection of the rectum.
6. . Pain in Crohn's disease occurs mainly in the right lower abdomen, but it can also radiate throughout the abdominal cavity. This disease is characterized by diarrhea, intestinal cramps, and fever. Another symptom is weight loss.
7. Hernia. Men are more likely to suffer from hernias. They cause bloating and aching pain in the groin.
8. Gynecological diseases. In women, diseases such as endometriosis, inflammation of the ovaries or ectopic pregnancy lead to pulling pains in the lower abdomen. In this case, there is a discharge from the vagina.
   Many women suffer from menstrual cramps.
9. . When inflammation of the intestinal diverticula occurs, severe intestinal pain occurs, manifested as colic.
10. Renal colic. Pain occurs in attacks in the lumbar region. Severe pain can be caused by kidney diseases such as pyelonephritis or kidney stones. Pain comes in jerks and can radiate to the leg. Nausea and vomiting often occur.

Pain in the entire abdominal region

Sometimes it can be difficult to pinpoint the exact location of abdominal pain.
Possible causes of such pain include:

• gastrointestinal infections,
• stress,
• peritonitis,
• circulatory disorders,
• intestinal obstruction.

Acute abdomen. It is a sign of a medical emergency and requires an urgent call for an ambulance. The typical symptoms are a hard stomach, pressing pains, sweating and weak pulse.

For more information on the topic of abdominal pain, see the following articles:

When do you need to urgently see a doctor?

If abdominal pain is accompanied by such symptoms, you should immediately call a doctor:

• blood in stool or urine
• severe abdominal pain and nausea
• high or low blood pressure
• hard stomach
• heat
• yellow skin color
• tingling in the chest cavity
• dyspnea.

Any pain in the abdominal cavity deserves the attention of a doctor and requires an examination to identify the causes.

Attention! Our site provides you with primary information on the topic of abdominal pain on the left. However, this information cannot replace medical advice. Any pain in the abdomen requires a medical examination.

Stomach ache can take everyone by surprise, because they can appear at any moment. There are many reasons for the occurrence of such pains, because it is in the abdominal cavity that most of the internal organs responsible for important life processes are located. Depending on the causes, the nature of the pains and their localization differ significantly. Consider the most common diseases that cause pain in the abdomen.

Causes of abdominal pain

Food poisoning

Food poisoning very often has a whole range of symptoms, among which abdominal pain is far from the last. If the sudden onset of pain is accompanied by weakness, headache or dizziness, nausea, vomiting, diarrhea, immediate action should be taken. First aid - cleansing the gastrointestinal tract from the remnants of poor-quality food, taking absorbent drugs and drinking plenty of water. Then, if necessary, the doctor may prescribe antibiotics.

Gastritis

Drawing or cutting pains that occur in the area of ​​​​the solar plexus may herald the appearance. In this case, pain can appear both as a result of a missed meal, and immediately after eating. Painkillers bring only temporary relief, but the essence of the problem remains. Therefore, it is recommended to immediately begin to fight pain with the help of special preparations that gently envelop the inflamed walls of the stomach and normalize the acidity of gastric juice.

Gastroduodenitis

The symptoms of gastroduodenitis are very similar to the symptoms, but there are slight differences. Since gastroduodenitis is an inflammation of not only the stomach, but also duodenum, then the pain can be given a little below the solar plexus (approximately 4-5 cm). The treatment has common features with the simple treatment.

or duodenum

The patient feels pain in the same places as with or gastroduodenitis, but the nature of the pain may differ. During the period of exacerbation peptic ulcer pain attacks occur quite often and most often differ in sharpness. The fact of the relationship between the appearance of pain and meals becomes quite obvious to the patient. The ulcer responds very painfully to spicy, spicy, fried foods, as well as to the timeliness of nutrition (for diseases of the gastrointestinal tract, it is strongly recommended to eat in small portions, but at least 5-6 times a day)

pancreatitis

With inflammation of the pancreas, pain can also appear, localized in the upper left side of the abdomen, at the level of the lower ribs. Often, pain, just like in previous diseases, is closely related to the nutrition system. With pancreatitis, there is usually a sudden severe pain, which especially often worries after 30-40 minutes. after meal. It is necessary to consult a doctor immediately, as damage to other organs, such as the heart, lungs, almost, liver and brain, is possible. The mission of the pancreas in the body is to produce special enzymes that ensure the normal digestion of fats, carbohydrates and proteins. In the event that interruptions began in the work of the pancreas, fatty, heavy food causes a significant deterioration in the condition. When it is recommended to limit the intake of carbohydrates and fats, and, in some cases, start taking pancreatic enzymes with food. This will help the pancreas to rest and recover.

liver problems

If the patient feels at the level of the lower ribs, then this indicates the presence of problems with the liver. For example, pain may occur when a liver cyst appears and develops. True, more often pain signals appear not so much because of diseases of the liver itself, but because of diseases of its eternal companion - the gallbladder.

Cholelithiasis

Perhaps one of the most popular diseases, especially among women. At first, it can develop without making itself known as pain signals, but after a few years, attacks of biliary colic begin. The pain is sharp, stabbing, sometimes the pain can "give" to the lower back, right shoulder blade or forearm. The pain appears due to the fact that the stone blocks the bile ducts and interferes with the normal outflow of bile.

It is often the result of gallstone disease. Due to a violation of the outflow of bile, inflammation develops, bile cannot pass and soon becomes viscous, tarry. There are sharp paroxysmal pains in the right hypochondrium, which may be accompanied by nausea, vomiting, and even fever. With timely treatment to the doctor can be cured. Diet is also extremely important in this matter. The liver and gallbladder are a kind of filter in the human body, therefore, like any filter, they tend to become clogged over time. To avoid this, it is necessary from time to time to carry out complex procedures for cleaning the body. It is not particularly difficult and is available to everyone. Very well proven as a natural grass cleaner. In the pharmacy, you can choose a special one and, after a course of treatment, you will soon notice positive changes in your body. It is also necessary to periodically carry out the procedure of "blind probing". This will facilitate the normal outflow of bile and protect against serious problems.

is another common disease that signals itself with abdominal pain. The appendix is ​​a small dead-end process of the caecum, in which, according to the design of nature, waste products of the digestive process accumulate. When it fills up too much, it becomes inflamed. If this diagnosis is confirmed, surgical intervention. Pain with can migrate throughout the abdomen. At first, the patient can feel it near the navel, later - in the right side of the abdomen. Often the pain is accompanied by fever, loss of appetite, nausea.

Intestinal obstruction

Intestinal obstruction is also characterized sudden pain, which occurs at any time of the day, regardless of meals. May be repeated at intervals of 10-15 minutes. Sometimes pain in the abdomen is accompanied by bloating and nausea, a violation of the stool. If this disease is suspected, the patient should be immediately taken to the hospital.

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Colitis can cause abdominal pain. With inflammation of the mucous membrane of the large intestine, the pains are sharp, cramping, which are accompanied by a feeling of discomfort, heaviness, bloating in the abdomen. During treatment, it is necessary to adhere to a diet, use adsorbents and drugs that normalize stool.

Ectopic pregnancy in women

A possible cause of pain signals in women is an ectopic pregnancy. The pain occurs in the lower abdomen, often on the side, and has a stabbing-cutting cramping character. May be accompanied by bleeding. An ectopic pregnancy can be very dangerous for the health of the mother and requires immediate medical attention. If a woman does not receive the necessary medical care on time, a fatal outcome is possible.

Inflammation of the appendages in women

Another purely female disease- inflammation of the appendages - will please with pains in the lower abdomen, while the temperature may rise up to 38-40˚
Pain signals often occur when a cyst forms on the uterus or appendages. In this case, pain is felt in the lower abdomen, a feeling of pain on the side is possible.

Cystitis

Inflammation of the bladder will give its owner a lot of discomfort. Pain in the lower abdomen, burning, frequent urge to go to the toilet "in a small way", practically tying the sufferer to this place - all these are signs of this disease. First of all, it is necessary to limit the use of spicy and salty foods, take hot baths, drink decoctions of herbs (for example, wild strawberry leaves). In a severe form of the disease, antibiotics will have to be used.

Summing up

As you can see, there are a lot of causes of pain in the abdomen, it is simply impossible to list all of them. However, there is only one advice - you need to pay attention to the occurrence of pain in time and find out the cause, and a qualified specialist will best deal with this. Do not delay the visit to the doctor, because in some cases it can save health and even life.

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Abdominal pain is the most common complaint in both children and adults. Their causes are diverse, ranging from simple indigestion or diseases of the digestive tract, worms, appendicitis to inflammation of the lungs, kidneys or bladder, infectious diseases (even tonsillitis and SARS), however, it is important to distinguish when pain is a consequence of intestinal hyperperistalsis, for example, with excessive gas formation, and when - a serious symptom of the pathological process. Usually, abdominal pain that lasts from a few seconds to a minute is not a major cause for concern.

There are two main types of pain - visceral and somatic. Visceral pain occurs due to irritation of nerve endings in the wall of organs, these are pains associated with spasm or, conversely, with stretching, for example, of the stomach or duodenum (and sometimes with ischemia of their mucous membrane). Visceral pain occurs in the form colic(hepatic, renal, intestinal, etc.) of varying intensity, is diffuse, diffuse, dull in nature, localized not only in the area of ​​the affected organ (often along the midline of the abdomen), but also in other parts of the abdomen, has a certain irradiation - a reflected transmission of pain to areas of the body innervated from the same roots in which sensory fibers pass, carrying impulses from the corresponding internal organs.

Somatic (peritoneal) pain occurs due to irritation of the peritoneum, when, with the development of a pathological process (for example, when a stomach ulcer is perforated), the endings of the spinal nerves located in the peritoneum begin to be irritated.

Somatic pain, in contrast to visceral pain, has a constant character, precise localization, and is usually accompanied by tension in the anterior muscles. abdominal wall, has a sharp cutting character, increases with movement and breathing. Patients lie motionless in bed, as any change in position increases the pain.

Cramping pains usually indicate a limited narrowing of the intestine as a result of various pathological processes (cicatricial strictures in ulcerative colitis and Crohn's disease of the colon, adhesive disease, benign and malignant tumors). Less commonly, they are observed with intestinal dyskinesia with a predominance of the spastic component.

Persistent abdominal pain more characteristic of a progressive inflammatory lesion, they are observed in granulomatous and nonspecific ulcerative colitis, irritable bowel syndrome, intestinal tumors with perifocal inflammation, diverticulosis with diverticulitis and the formation of an inflammatory infiltrate or the development of peritonitis. Dull pain in the epigastric region is often the first manifestation of diffuse familial colon polyposis and can be explained by a violation of the secretory and motor activity stomach.

Possible causes of abdominal pain

The most common cause is the food we eat. Irritation of the esophagus (pressive pain) causes salty, too hot or cold food. Some foods (fatty, cholesterol-rich foods) stimulate the formation or movement of gallstones, causing attacks of biliary colic. Some people have an intolerance to certain foods, such as milk, milk sugar, or lactose. Eating them leads to spasmodic pains in the abdomen, bloating and diarrhea.

Depression, spinal disorders, thyroid disease, anemia, urinary tract infections may be accompanied by abdominal pain. The reason may be the intake of alcohol, drugs, antibiotics, hormonal and non-hormonal anti-inflammatory drugs, iron preparations.

The main groups of diseases and pathological conditions leading to abdominal pain:

• diseases (organic, functional) of the abdominal organs, stomach and duodenum, liver and biliary tract, pancreas, intestines, spleen;
• food poisoning, intoxication;
• diseases and inflammation of the peritoneum;
• kidney disease and urinary tract;
• local circulatory disorders in the abdominal cavity (mainly arterial);
• diseases and injuries of the abdominal wall;
• some diseases nervous system, spinal column (Herpes Zoster, spondylarthrosis);
• some diseases of the blood system (hemorrhagic vasculitis, thrombophlebic splenomegaly);
• diffuse connective tissue diseases (nodular periarteritis), rheumatism;
• pathological processes in the chest (pneumonia, diaphragmatic pleurisy, pericarditis, acute coronary insufficiency);
• abdominal pain in certain, including rare diseases, pathological conditions (abdominal colic in certain types of hyperlipoproteinemia, diabetes, thyrotoxicosis, diseases of the nervous system, etc.).
• in children, abdominal pain can occur with infectious diseases not directly related to the abdominal cavity, for example, with tonsillitis, SARS, scarlet fever.

And one of the rarest but worst treatable causes of abdominal pain is malignant neoplasm i.e. cancer. When examining, first of all, it is necessary to categorically carefully examine for oncology. There were cases when patients were treated for gastritis for a year, and it turned out to be stomach cancer, and already 3-4 stages.

Localization of abdominal pain

Diagnosis of pain in the epigastric region is one of the most difficult and responsible tasks in medicine. Due to the urgency of the situation, the usual systematic examination of the patient is often impossible. The clinical experience of the doctor is of great importance here, since sometimes in the most acute, life-threatening conditions, the picture of the disease is erased. With the brightest picture of "acute abdomen" surgery may not be necessary, and, conversely, mild pain may be the first sign of a disease in which emergency surgery is indicated. Be that as it may, for any acute, unusual pain in the abdomen, a comprehensive examination is necessary.

In classical cases, there is a correspondence between the localization of pain and the affected organ.

The pain is localized below the waist (lower abdomen):
At men possible diseases of the urinary system; monitor urination and urine;
At women possible diseases of the urinary system, pregnancy, painful menstruation, inflammation of the internal genital organs.

Pain above the pubis (lower abdomen, "lower abdomen hurts") in women- pathological processes in the bladder, uterus and appendages, may indicate problems with reproductive system. Pelvic pain that occurs every month before menstruation may indicate endometriosis, a condition in which tissue particles from the uterus move through the fallopian tubes and end up on the ovaries, pelvis, bladder and other organs. Soreness in the lower abdomen can mean pelvic inflammatory disease (infection of the tissues of the uterus, fallopian tubes, or ovaries). In women of childbearing age, an ectopic pregnancy can also cause severe, sharp or stabbing pain in the peritoneum, accompanied by vaginal bleeding, irregular menstrual cycle and pains radiating to the shoulders. Ovarian cysts and uterine fibroids can also cause abdominal pain in women. .

Pain is localized in the projection of the stomach in diseases of the esophagus, stomach, duodenum. However, with myocardial infarction, pneumonia and pyelonephritis, there may be a similar localization: if the stomach hurts, doctors think not only about digestive problems.

Pain in the umbilical region- in diseases of the small intestine.

Pain in the right iliac region (near the wing ilium on right)- caecum and appendix. In the left iliac region- sigmoid colon.

Abdominal pain started in the lower back and moved to the groin: possible pathology of the urinary system, urolithiasis.

Pain in the abdomen spreads in the area of ​​the right hypochondrium (in the abdomen on the right, it can give under the right shoulder blade): pathology of the liver, biliary tract or gallbladder is possible; observe the color of the skin, the color of urine and feces.

Sharp pain in the right hypochondrium, aggravated after eating, indicates the presence of a lesion of the gallbladder. Gallbladder diseases include gallstones and inflammation of the gallbladder (cholecystitis). If complications arise, gallbladder damage may have other symptoms, these include: jaundice (yellowing of the skin and whites of the eyes), severe fever and chills. Sometimes people with gallstones experience no symptoms at all. With regularly occurring pain in the right hypochondrium, you should consult a doctor. Bouts of gallbladder pain can be managed in a number of ways, ranging from simply waiting (observing symptoms for some time, no treatment) to taking medicines and even surgery. You can also reduce the symptoms of gallbladder disease by reducing the amount of fat in your diet.

Pain more often localized in the left hypochondrium (in the abdomen on the left) with pancreatitis. Pain with ulcers and pancreatitis, as a rule, radiates through the entire back.

In the center of the upper abdomen:
Perhaps it is a heartache (spreads up the chest and even into the arms);
Digestive disorders as a result of overeating, emotional or physical overstrain are not excluded.

Above waist:
Digestive disorders in the stomach (gastritis) or duodenum are possible.

Below the navel:
With swelling and discomfort in the groin, which is aggravated by physical exertion or coughing, a hernia is not excluded (treated only by a doctor);
Possible constipation or diarrhea;
In women with violation of the function of the genital organs (watch for vaginal discharge) or pregnancy.

Pelvic pain is usually felt as tightness and discomfort in the rectal area.

Abdominal pain relieved by a bowel movement and accompanied by diarrhea or constipation, may indicate irritable bowel syndrome, a common disorder of the gastrointestinal tract, the cause of which has not yet been established. When irritable bowel syndrome occurs, the walls of the intestines contract too much, sometimes too little, sometimes too slowly, and sometimes, on the contrary, too quickly. Symptoms of this disease include: bloating, increased gas formation, mucous stools, a constant desire to empty the intestines. This syndrome cannot be managed with surgical methods or drugs. However, worsening of the condition can be prevented by drinking plenty of water, increasing the amount of fiber in the diet, reducing the amount of caffeine consumed and increasing physical activity.

Pain in the left lower abdomen may be a symptom of diverticulitis. Diverticulitis occurs when small, spherical capsules called diverticula form in the walls of the colon, which subsequently become infected and inflamed. Other symptoms of diverticulitis include fever, nausea, vomiting, chills, seizures, and constipation. Treatment for diverticulitis usually involves cleaning the colon of infection and inflammation. The doctor may prescribe antibiotics and/or pain medication, a liquid diet, and bed rest for several days. In some cases, treatment for diverticulitis requires a hospital stay. If complications occur, surgery may be needed. The best remedy prevent diverticulitis - a diet rich in fiber. Dietary fiber promotes proper digestion and relieves pressure in the colon. Gradually increase the amount of fiber in your daily diet, drink plenty of fluids. Regular bowel movements can also help prevent diverticulitis. The accumulation of waste products of the digestive system entails an increase in pressure in the colon.

Acute burning pain in the upper and middle parts of the abdomen (between the sternum and the navel) may indicate an ulcer. An ulcer is a sore that forms in the tissues of the stomach or upper intestine. There are many causes for an ulcer. Smoking, taking acetylsalicylic acid, ibuprofen, or other non-steroidal anti-inflammatory drugs may play a role. An ulcer can also form if the stomach cannot protect itself from the strong stomach acid. Helicobacter pylori, a bacterium that lives in the stomach, can also cause ulcers. Stress and spicy food cannot cause an ulcer. Heartburn alone cannot be indicative of this disease. Severe pain like heartburn can also be caused by a less serious condition called gastroesophageal reflux disease.

Dagger pain in the abdomen- a dangerous sign. It can be a manifestation of a catastrophe in the abdominal cavity - acute appendicitis or peritonitis (inflammation of the peritoneum). It is urgent to call an ambulance! Before her arrival, do not give the patient any medicine.

The stomach hurts constantly, the pain is acute or increasing- it is necessary to consult a gastroenterologist, who will determine the tactics of the examination.

Attention!
Signs such as persistent pain in the abdomen that do not subside within 2 hours, soreness of the abdomen when touched, the addition of vomiting, diarrhea, and fever should seriously alert. If abdominal pain is accompanied by dizziness, weakness, decreased blood pressure, increased heart rate, visible bleeding, fever, repeated vomiting, increased intensity, fainting, tension in the muscles of the abdominal wall, then urgent diagnostic measures, intensive monitoring, and a decision on the advisability of surgical intervention are necessary.

What to do, where to go for abdominal pain

Abdominal pain cannot be relieved with painkillers. A heating pad should not be used unless the cause is known. You can apply ice. First of all, if you experience pain in the abdomen, you should at least consult a general practitioner. If necessary, the doctor will prescribe an endoscopic examination, which allows you to visually control the organ under study and record the examination.

First aid for abdominal pain

With pain in the abdomen, especially severe, do not self-medicate, in no case take painkillers before making a diagnosis!

Eliminating the pain by lowering the temperature (and many painkillers effectively reduce the temperature) will make it difficult for doctors to make a diagnosis, and this can lead to serious complications. Remember that abdominal pain in almost all cases is a rather serious phenomenon that cannot be treated indifferently, because it is in the abdomen that the most important human organs are located. Problems of the heart, digestive and endocrine systems, reproductive systems can be manifested by pain in the abdomen. Therefore, they should not be taken lightly.

The following diseases require emergency medical attention.

Abdominal pain on the right - suspected acute appendicitis

Acute appendicitis - inflammation of the appendix of the caecum; extremely dangerous disease requiring surgical intervention.

Signs of appendicitis

Abdominal pains appear suddenly, usually in the umbilical region, then they capture the entire abdomen and only after a few hours are localized in a certain place, often on the right lower abdomen. The pain is constant, aching in nature and is rarely severe in young children.

Body temperature rises. There may be nausea and vomiting.
If the inflamed appendix is ​​high (under the liver), then the pain is localized in the right upper abdomen.
If the inflamed appendix is ​​located behind the caecum, then the pain is localized in the right lumbar region or "spreads" throughout the abdomen.
If the inflamed appendix is ​​in the pelvis, then signs of inflammation of neighboring organs join the pain in the right iliac region: cystitis (inflammation of the bladder), right-sided adnexitis (inflammation of the right uterine appendages).
An unexpected cessation of pain should not soothe, as it may be associated with perforation - a rupture of the wall of the inflamed intestine.
Make the patient cough and see if it causes sharp pain in the abdomen.

Acute appendicitis is the most common acute abdominal disease requiring surgical intervention. The disease begins suddenly, with the appearance of pain in the epigastric region or throughout the abdomen, sometimes near the navel, which gradually increase. After some time, they are localized in the right half of the abdomen, the right iliac region (near the iliac wing on the right). Slight fever, increased heart rate, dry tongue. When pressing on the abdomen, a sharp pain is determined in the right half of the abdomen, the right iliac region, which intensifies when the hand is released, muscle tension.

Peculiarities clinical manifestations acute appendicitis in children associated with structural features of the appendix. Children of the first years of life become restless, refuse food, cry, and with severe pain - scream. The tongue is dry, the temperature is up to 38-39 ° C, the pulse is quickened. The abdomen is painful in the right side. It is necessary to call a local pediatrician or an ambulance. Elderly and senile people have the same signs of appendicitis, but they are weakly expressed due to the reduced reactivity of the body, atherosclerosis and the speed of development of changes in the process.

Help

You can put a plastic bag with ice on your stomach.

Pain in the hernia area is a sign of a strangulated abdominal hernia

Infringement of a hernia of the abdominal cavity (inguinal, femoral, umbilical, postoperative, etc.) is accompanied by the following symptoms:
sharp pain in the hernia (may be only in the abdomen)
increase and compaction of the hernial protrusion
pain on touch.

Often the skin over the hernia is cyanotic; the hernia does not retract into the abdominal cavity on its own. When a loop of the jejunum is infringed in the hernial sac, intestinal obstruction develops with nausea and vomiting.

Hernias are divided into congenital (immediately after the birth of a child), acquired, which occur in the most “weak” points of the abdomen (inguinal hernia, umbilical ring, femoral hernias, etc.) and postoperative hernias (after previously performed operations in the scar area). Predisposing factors include increased intra-abdominal pressure, hard physical labor, frequent crying and screaming of the child, difficult childbirth, coughing during chronic diseases lungs, constipation, etc.

Depending on the location of the hernia (in the groin, in the navel, postoperative scar), when it is infringed, there is severe pain in the abdomen, nausea, vomiting, stool and gas retention, and the pulse quickens. In the area of ​​the hernia, along with pain, a dense formation of a round or oblong shape is determined, sharply painful, not reduced into the abdominal cavity: this is what distinguishes a strangulated hernia from a reduced one.

Help

Do not try to set the hernia into the abdominal cavity, as you can damage the strangulated intestine!
The patient is forbidden to take painkillers, eat and drink!
Urgently call an ambulance (tel. 03) to hospitalize the patient in a surgical hospital. Delay in calling an ambulance is fraught with dangers and can lead to necrosis (death) of the strangulated intestine.

Acute pain at the top of the abdomen - a perforated ulcer of the stomach, duodenum is possible

With exacerbations of gastric ulcer or duodenal ulcer, a life-threatening complication may suddenly develop - perforation of the ulcer (rupture of the ulcer, in which the contents of the stomach or duodenum pour into the abdominal cavity).

signs

Pain for this disease is a cardinal symptom, it occurs suddenly, “like a stab in the stomach with a dagger”, it can be very intense, constant. IN initial stage disease (up to 6 hours), the patient feels a sharp "dagger" pain in the upper abdomen, under the pit of the stomach. The patient takes a forced position (legs are brought to the stomach), seeks to limit respiratory movements .. The skin turns pale, cold sweat appears, breathing becomes superficial. The abdomen does not participate in the act of breathing, its muscles are tense, and the pulse may slow down. In the first hours, the pain is localized in the epigastric region, right hypochondrium. With free, open perforation, it quickly spreads to the entire abdomen. Possible irradiation of pain in the back, right shoulder, shoulder blade or subclavian region. Less often pain gives to the left. The second most important sign of perforation is a sharp tension in the muscles of the anterior abdominal wall. As a result, the stomach becomes “hard as a board”, retracted.

In the second stage of the disease (after 6 hours), abdominal pain subsides, abdominal muscle tension decreases, and signs of peritonitis(inflammation of the peritoneum):
frequent pulse;
increase in body temperature;
dry tongue;
bloating;
retention of stool and gases.

In the third stage of the disease (10-14 hours after perforation), the clinical picture of peritonitis intensifies. Treating patients at this stage of the disease is much more difficult.

Help

Provide the patient with rest and bed rest.
A patient with a suspected perforated ulcer is forbidden to take painkillers, eat and drink!
Urgently call an ambulance (tel. 03).

Abdominal pain accompanied by bloody stools or vomiting is a sign of gastrointestinal bleeding

Gastrointestinal bleeding - bleeding from the esophagus, stomach, upper jejunum, colon into the lumen of the gastrointestinal tract.

Gastrointestinal bleeding occurs with diseases:
liver (from the veins of the esophagus);
peptic ulcer of the stomach;
erosive gastritis;
gastric cancer in the last stage;
duodenal ulcer;
ulcerative colitis (colon disease);
hemorrhoids of the rectum;
other diseases of the gastrointestinal tract ( infectious diseases, diathesis, trauma).

signs

The onset of the disease is usually acute.
With bleeding from the upper gastrointestinal tract (stomach, veins of the esophagus), there is hematemesis - fresh blood or coffee-ground-colored blood.

The rest of the blood, passing through the intestines, is excreted during defecation (fecal excretion) in the form of tarry stools (liquid or semi-liquid black feces with a pungent odor).
With bleeding from the duodenum with peptic ulcer, hematemesis is less common than with bleeding from the esophagus or stomach. In this case, the blood, having passed through the intestines, is excreted during defecation in the form of tarry stools.
For bleeding from the colon appearance blood changes slightly.
The hemorrhoidal veins of the rectum bleed scarlet blood (with hemorrhoids).
At gastrointestinal bleeding there is general weakness, frequent and weak pulse, lowering blood pressure, profuse cold sweat, pallor of the skin, dizziness, fainting.
With severe bleeding - a sharp drop in blood pressure.

Help

Place an ice pack or cold water on your stomach.
When fainting, bring a cotton swab moistened with ammonia to the nose of the patient.
Do not drink or feed the patient!
Do not flush your stomach and do not do enemas!
Call an ambulance (tel. 03).

Girdle pain in the epigastric region, radiates to the shoulders and shoulder blades - Acute pancreatitis (inflammation of the pancreas):

signs resemble acute appendicitis, but the pain can be severe. In a typical case, the patient complains of constant pain in the epigastric region, which, unlike acute appendicitis, gives to the shoulders, shoulder blades and has a girdle character. The pain is accompanied by nausea and vomiting. The patient usually lies motionless on his side. The abdomen is swollen and tense. Perhaps the accession of jaundice.

The development of acute pancreatitis is promoted by the pathology of the liver, biliary tract and other digestive organs, nutritional disorders, alcohol abuse, severe vascular lesions, allergic conditions, injuries, and operations.

Pain in the abdomen is initially localized in the epigastrium (middle upper abdomen), in the right or, more often, the left hypochondrium, and radiates to the left shoulder blade, to the region of the heart. In almost half of the cases, it is shingles. The pain differs in duration, very painful, drilling, squeezing. Sometimes the pain periodically weakens, but does not completely stop. In severe cases, the pain spreads to the entire abdomen. Vomiting joins the pain, often indomitable, not bringing relief. Sometimes there is icterus of the sclera.

Help

Urgently call an ambulance (tel 03).
Do not give the patient any medicine.
You can put a plastic bag with ice on your stomach.

Pain and feeling of heaviness in the stomach - Acute gastritis (inflammation of the stomach):

this disease is characterized by pain and a feeling of heaviness in the epigastric region of the abdomen ("in the pit of the stomach") after eating. Other symptoms are nausea, vomiting, loss of appetite and belching.

Help

With the development of these symptoms, it is necessary to call a doctor at home or go to the clinic.

Pain in the abdomen on the upper right - hepatic colic is possible

Hepatic colic is usually caused by stones in the gallbladder or bile ducts that prevent the free flow of bile from the liver and gallbladder. Most often, hepatic colic is caused by malnutrition (eating meat, fatty and spicy foods, spices in large quantities), excessive physical activity, and shaking driving.

An attack of hepatic (biliary) colic occurs as a result of infringement of a stone in the neck of the gallbladder, in the ducts during cholelithiasis or when an infection enters the gallbladder and develops acute non-calculous cholecystitis. An attack of biliary colic is provoked by errors in diet, physical and nervous tension.

Suddenly there is a very sharp, often rapidly growing pain in the right hypochondrium, epigastric region with irradiation to the right shoulder, collarbone, scapula, right side base of the neck, rarely - to the left side, iliac region, lower back. The pain is aggravated in the position on the left side, with a deep breath. An attack of intense pain can last from several hours to several days. During an attack, patients are restless, constantly changing position. The pain is accompanied by nausea, vomiting of bile, which does not bring relief, sometimes icteric sclera, fever, neutrophilic leukocytosis.

signs

In the right hypochondrium there is a sharp acute paroxysmal pain, often radiating to the right half of the back, right shoulder blade, to other parts of the abdomen.
Vomiting brings no relief. The duration of pain - from several minutes to several hours (sometimes more than a day).
The patient is usually agitated, groaning, covered in sweat, trying to take a comfortable position in which the pain causes less suffering.

Help

Provide the patient with complete rest and bed rest.
Call an ambulance (tel. 03).
Before the arrival of the doctor, do not feed, do not give water to the patient and do not give him medicines!

Sudden pain that began in the lumbar region is a sign of renal colic

Renal colic is a painful attack that develops when there is a sudden obstruction to the outflow of urine from the kidneys. An attack most often occurs with urolithiasis - during the passage of urinary stones from the kidney through the ureter to the bladder. Less commonly, renal colic develops with other diseases (tuberculosis and tumors of the urinary system, injuries of the kidney, ureter, etc.).

More often, an attack of renal colic is manifested by a sudden, acute, excruciating pain in the lumbar region, extending along the ureters to the groin, genitals, and leg. The attack is accompanied by urination disorders, nausea, vomiting, flatulence.

With stones of the kidneys, ureters, an attack often occurs for no apparent reason, with nephroptosis - after physical exertion, long walking. The attack is caused by stretching of the pelvis with urine with a delay in its outflow. In addition to these reasons, it may be associated with the presence of a blood clot in the urinary tract. The attack usually lasts for several hours. In the interictal period, dull pain in the lumbar region may persist. Sometimes pain in renal colic is localized in the epigastric or iliac region, spreads to the entire abdomen. Concomitant dyspeptic phenomena, intestinal paresis, stool and gas retention, fever increase the similarity with diseases of the digestive system, in particular with such as acute intestinal obstruction, acute appendicitis, cholecystitis, peptic ulcer of the stomach and duodenum, colitis, etc. Such renal colic with gastrointestinal syndrome is observed more often with ureteral stones and is very difficult to diagnose. From the listed diseases of the digestive system, renal colic with gastrointestinal syndrome can be distinguished by the following signs: a sudden onset and end, restless behavior of patients, the absence of an increase in the severity of clinical manifestations during an attack, and other symptoms.

signs

The attack usually begins suddenly.
The pain is initially felt in the lumbar region from the affected kidney and spreads along the ureter towards the bladder and genitals.
Increased urge to urinate.
Cutting pains in the urethra.
Nausea, vomiting.
The duration of renal colic is from several minutes to several hours.
Sometimes an attack with short breaks can last several days.

Help

Provide the patient with rest and bed rest.
Put a heating pad on the patient's lower back or place him in a hot bath for 10-15 minutes.
Call an ambulance (tel. 03).

Acute intestinal obstruction

Intestinal obstruction - various pathological conditions with violation of the evacuation of intestinal contents. Intestinal obstruction is divided into dynamic (due to intestinal spasm or paresis) and mechanical (blockage of the intestine by a foreign body, a ball of worms, gallstone, tumor, adhesions, etc.). In 70% of patients, obstruction is due to postoperative adhesions in the abdominal cavity. The immediate cause of compression or infringement of the intestine may be a sudden tension of the abdominal press during physical work, a violation of the diet. The cause of intestinal volvulus are adhesions, a large length of the intestine.

The disease begins suddenly, with cramping pains in the abdomen of varying intensity. The cramping character is more pronounced in the obstructive form ( foreign bodies, worms, fecal stones, tumor). With strangulation obstruction (adhesions, intestinal volvulus, strangulated hernia), the pain is intense and constant; cramping pains so strong that people moan, scream. There is no acute intestinal obstruction without pain syndrome. By this sign alone, it can be assumed that there is an obstruction. In the later stages of the disease, the pain subsides and disappears. The second symptom is vomiting, dry tongue, increased heart rate, decreased blood pressure in the later stages, and bloating. Even later, there is a sharp pain in the abdomen in all departments, retention of stool and gases. In acute intestinal obstruction in the later stages, there is a high mortality; to prevent this from happening, you must immediately call “ ambulance". Treatment of this type of obstruction is surgical. Laxatives are not recommended. You can take no-shpu or baralgin, which should then be reported to the doctor.

Exacerbation of peptic ulcer

In typical cases, an exacerbation of peptic ulcer is accompanied by a sharp pain in the abdomen some time after eating. Sometimes an attack of severe pain ends with profuse sour vomiting. In other cases, after reaching maximum strength, the pain gradually subsides. Night pains, pain on an empty stomach, weakening after eating, are possible. More often the pain is localized in the epigastric region (middle upper abdomen), less often in the right or left hypochondrium. Gives to the lower back, less often to the chest, even less often - down the abdomen. Pain in the abdomen increases with physical exertion, decreases in a motionless, bent position with legs drawn to the stomach, as well as when pressing on the stomach with hands. Constant pain in the abdomen is characteristic of ulcers penetrating the pancreas. Peptic ulcer pain is often associated with heartburn and vomiting, which brings relief. Patients' appetite is preserved, but there is a fear of eating due to fear of increased pain.

Acute gastritis

Sharp pain in the epigastric region occurs with acute erosive gastritis. At the same time, pain in the oral cavity, pharynx, along the esophagus, dysphagia, vomiting with an admixture of mucus and blood are observed. Possible deterioration of the general condition of the patient, shock, collapse.

Exacerbation of chronic enteritis

Chronic enteritis is a disease characterized by inflammatory and dystrophic changes mucosa of the small intestine. May be associated with damage to the large intestine (enterocolitis). Cause this disease are past intestinal infections, giardiasis. The clinic is manifested by a blurred, dull, aching diffuse pain that occurs after eating or independently of it; a feeling of fullness, heaviness, fullness in the epigastric region and near the navel (these sensations increase after eating and in the evening); loss of appetite or normal appetite; bloating and rumbling in the abdomen. The skin is dry, brittle nails, bleeding gums, weakness, fatigue are noted.

Exacerbation of chronic colitis

Chronic colitis is an inflammatory lesion of the colon mucosa. In its development, an important role is played by the use of rough and insufficiently processed food, a large amount of carbohydrates, a lack of protein (in the summer, a large amount of raw vegetables and fruits). Abdominal pains are insignificant, are either diffuse in nature, or are localized in the lower half of the abdomen; there is a feeling of heaviness, burning, itching in the rectum; characterized by bloating, rumbling, abdominal pain along the colon.

Abdominal pain in diseases of the heart, aorta

Gastralgic form with irradiation of pain in the epigastric region, the upper abdomen is observed in patients with myocardial infarction. Important diagnostic value has a combination of pain in the abdomen with pain in the region of the heart.

Features of the pain syndrome in the gastralgic form of myocardial infarction, its occurrence sometimes after an error in food or coincidence with an exacerbation of a stomach disease lead to the fact that patients are admitted to the hospital with an erroneous assumption about the presence of food poisoning, acute appendicitis, acute cholecystitis or another form of acute surgical disease belly. In some cases, exacerbation of the disease of the digestive apparatus can be a provoking factor in the development of acute coronary insufficiency.

Pain in the upper abdomen occurs with a heart attack complicated by atrial fibrillation, pericarditis. The mechanism of pain in the abdomen in myocardial infarction partially coincides with the mechanism of pain in respiratory diseases. In addition, with myocardial infarction, impulses may occur that disrupt the activity of the digestive apparatus.

In relatively rare cases, the cause of abdominal syndrome in myocardial infarction is not only an unusual irradiation of pain, but also the occurrence of acute pancreatitis, acute ulcers of the esophagus, stomach, and intestines. Erosions, ulcers in the digestive apparatus develop more often in the first days of myocardial infarction due to anoxia of the stomach wall and intestines, caused by general hemodynamic disorders, increased vascular tone of internal organs, their ischemic anoxia in the initial period of the disease, followed by congestive anoxia.

Pain with such complications of myocardial infarction is persistent, accompanied by nausea, vomiting, bleeding from the stomach and intestines, and sometimes perforation of ulcers. similar clinical picture can be observed in chronic circulatory failure.

Perhaps a combination of pathology of the abdominal organs and chronic or acute coronary insufficiency. With peptic ulcer, diseases of the liver, biliary tract, stomach, pancreas, pain can radiate to the region of the heart. Calculous cholecystitis and coronary atherosclerosis often develop in parallel.

hiccup

Hiccups are involuntary, stereotypically repetitive, short and vigorous breaths with a closed or sharply narrowed glottis. It occurs due to a sudden convulsive contraction of the muscles of the diaphragm and larynx. The cause of hiccups can be irritation of the intestines, cooling of the body, emotional experiences.

Help

Swallow a piece of ice;
or take a few sips cold water;
or squeeze strongly with your hands the diaphragm area (above the waist);
or several times quickly and deeply inhale the air and exhale it very slowly.
with persistent hiccups, put a mustard plaster on the "subcutaneous" area of ​​\u200b\u200bthe abdomen.
You can not drink water with your head held high, as the liquid can enter the respiratory tract.

When is it necessary to consult a doctor for abdominal pain?

Pain that lasts for hours or even days is a serious symptom and you should have a medical examination as soon as possible. If you answered yes to at least one of the following questions, you should contact a gastroenterologist:

Do you often experience abdominal pain?

Does the pain you experience interfere with your daily activities and performance at work?

Are you experiencing weight loss or decreased appetite?

Is your pain accompanied by vomiting or nausea?

Are you seeing changes in bowel habits?

Do you wake up with intense abdominal pain?

Have you suffered in the past from diseases such as ulcers, gallstones, inflammatory diseases intestines, surgical interventions?

Do the medicines you take have side effects from the gastrointestinal tract (aspirin, non-steroidal anti-inflammatory drugs)?

Urgent health care under the following conditions:
- pain accompanied by fever, jaundice, dark urine, severe nausea or vomiting, light pasty stools;
- sharp sharp stabbing pain in the abdominal cavity, accompanied by vaginal bleeding, irregular menstrual cycle, pain radiating to the shoulders;
- severe persistent pain in the peritoneum after an injury;
- sudden, severe pain lasting more than 2 hours

Urgent hospitalization is required if the following symptoms appear:

abdominal pain accompanied by sudden bright red rectal bleeding or vomiting of blood or a substance that looks like coffee grounds
dizziness, delirium, rapid pulse, cold clammy skin.

Diagnosis for abdominal pain

Proper assessment of pain is very important. This symptom is of particular importance in acute diseases that require emergency care for the patient.

Need to find out pain intensityin a stomach and if possible localization (location). With severe pain, the patient prefers to lie down, sometimes in an uncomfortable, forced position. Turns with effort, carefully. The pain can be piercing (dagger), in the form of colic, or dull aching, it can be spilled or mainly concentrated around the navel, or "under the spoon". It is important to establish the relationship of the appearance of pain to food intake.

To determine the cause of pain, your doctor may ask you the following questions: “Describe the pain you feel” (crampy, sharp, or dull) Is it constant or intermittent? Where do you feel pain? Where did she appear? How long does it take? When does pain appear? (During menstruation? Does the pain get worse after eating?) More testing is likely to be needed.
The method of treatment will depend on the cause of the pain in the abdomen.

Which doctor to contact for abdominal pain

The specialization of the doctor depends on the cause of the pain. The first doctor to contact is a general practitioner (GP). He will send you for tests and, according to the results, he will send you to a specialized specialist.

At acute pain in the stomach, call an ambulance!

General blood analysis;
Blood chemistry;
Analysis for antibodies to Helicobacter;
Ultrasound of the kidneys and abdominal organs, pelvic organs;
colonoscopy;
Analysis for markers of viral hepatitis;
Analysis of feces for dysbacteriosis;
X-ray contrast studies of the gastrointestinal tract;
MRI.

Complaints about abdominal pain just as common as headache. Patients say “my stomach hurts”, “twisted” or “grabbed” the stomach, “pulls the lower abdomen”, “stomach hurts”.

When we say that the stomach hurts, we mean a fairly large area - down from the chest and all the way to the groin. In this area there are various organs, primarily the digestive and genitourinary systems. The first includes the stomach, liver, gallbladder, pancreas, intestines. To the second - the kidneys, bladder, in women - the ovaries, uterus, in men - the prostate gland. And any of these organs can hurt.

Pain is different. It is useful to distinguish exactly where and how the stomach hurts. This will allow you to more accurately describe the problem at the doctor's appointment, and a little earlier - to separate the pain caused by a random factor (for example, poor-quality food) from the really fearful one. The appearance of pain in the abdomen (often in combination with other symptoms) can be a sign of a serious, dangerous disease.

The causes of abdominal pain in children are collected in a separate article (). The present one is more general.

What is abdominal pain?

The pain is acute and chronic.

Acute pain can be paroxysmal in nature, or it can be constant. It can occur abruptly, suddenly (in this case, they sometimes say “grabbed the stomach”), or it can be weak at first and gradually increase. Chronic pain in the abdomen, as a rule, is weaker, passing, but always returning. Exacerbation of chronic pain can be caused, for example, by eating.

The strength of pain does not always correspond to the severity of the disease. An attack of severe pain can be caused by a banal accumulation of gases (due to overeating or a specific food) or viral infection poses no serious danger. Whereas habitual chronic pain can be the result of, for example, colon cancer.

Sometimes the pain is localized (the patient can clearly indicate the place where it hurts), and sometimes it is distributed (a significant part of the abdomen hurts).

Causes of abdominal pain

Cramping abdominal pain (colic) caused by irritation of the nerve receptors of the inner surface of the hollow organs. In this case, a spasm of smooth muscles occurs - the muscle tissue lining the corresponding organ. Such pains are usually very strong, painful, but do not last long - a few minutes, after which they pass. Attacks can follow one after another, the pain first increases, then decreases ...

Attacks can be caused by the movement of stones (in the kidneys, in the gallbladder or duct, in the ureters), inflammatory diseases, poisoning. One of the common reasons is a violation of the diet (too spicy, salty, fatty foods, excesses in eating).

Attacks of pain can be combined with other symptoms - fever, chills (typical of infections and blockage of the biliary tract), discoloration of urine and feces (during blockage of the biliary tract, the urine darkens and the feces become lighter).

Pain can be caused stretching of hollow organs or tension of their ligamentous apparatus(for example, due to injury). It is usually aching or drawing and may not have a clear localization.

Pain may be caused local circulatory disorders(congestion in the vessels of the abdominal cavity), the so-called "abdominal toad" - an attack of pain at the time of the greatest functional activity of the digestive organs.

Acute pain occurs when pathological structural changes or damage to internal organs- inflammation, tumor growth, ulceration, rupture (perforation), transition of the inflammatory process to the peritoneal tissue (peritonitis).

Pain in the abdomen is not always associated with diseases of the organs located there. Quite common referred pain. In this case, the pain is said to radiate: its source is elsewhere, but the patient feels pain in the abdomen. This is possible with heart disease, pleurisy, diseases of the esophagus and in some other cases.

Abdominal pain may also psychogenic origin. Stress, emotional tension, fear can lead to pain, in some cases quite severe.

Localization of abdominal pain: in which disease where does it hurt

Epigastric (epigastric) region

The epigastrium (pit of the stomach) is located in the center of the body between the costal arches, below the sternum. Pain in this area is mainly associated with diseases of the stomach (, duodenitis,). Similar pains occur after taking sour or spicy food. With a stomach ulcer, pain is possible during long breaks in food (for example, at night). The pain is usually dull, aching, less often acute. Pain in the epigastric region can also be caused by occasional digestive problems (indigestion, heartburn). In the same area, radiating pain is possible in case of heart disease.

Right hypochondrium (stomach hurts from the side of the right side above the navel)

Left hypochondrium (stomach hurts from the left side above the navel)

The stomach is not located directly in the center of the body, but is shifted to the left, so pain in the left hypochondrium can also be of gastric origin (gastritis, stomach ulcer). The pancreas is also located on the left side, so pain in this area can occur with. Pain can also be caused by diseases of the spleen. Heart pain can also radiate to this area.

Umbilical region

In this area, the intestines (small intestine) make themselves felt. Pain can be caused by such causes as lack of enzymes (problems with digestion of food), intestinal infection, serious inflammatory diseases (Crohn's disease, ulcerative colitis). It can also hurt here with.

Left and right lateral areas of the abdomen

Pain that is displaced to either side of the middle part of the abdomen can be caused by problems with the urinary system. The cause may be inflammation of the urinary tract. However, with kidney disease, pain is still more often localized in the lumbar region. Pain on the side of the abdomen can be caused by constipation and gases in the colon (). The left side more often becomes the area where bowel diseases affect. Pain here can also be a manifestation of colitis or diverticulosis.

Right iliac region (stomach hurts below the navel and on the right)

In this area, most people have an appendix - a appendix of the caecum. Inflammation of the appendix - appendicitis - a dangerous disease. The development of appendicitis is usually characterized by sudden and sharp pain, but in some cases the pain may increase gradually. Sometimes at first the pain is felt in the umbilical region and only then it shifts to the right iliac region. There are people in whom the appendix is ​​located higher, respectively, and the pain of appendicitis will have a different localization.

Pain in the lower abdomen

Pain in the lower abdomen is typical for diseases of the urinary system, in women - for gynecological diseases. It can be caused by kidney stones, inflammation of the kidneys (), prolapse of the ureter, gynecological problems: acute and subsequent adhesions, tumors that have arisen, and ectopic pregnancy. Depending on the location of the problem, pain may be concentrated in the left or right iliac region or in the center (suprapubic region). Another one possible reason – varicose veins veins of the small pelvis (more typical for women). In this case, discomfort in the lower abdomen occurs from time to time, intensifying after physical exertion, shortly before menstruation or after sexual intercourse.

Also, the cause of pain in the lower abdomen, especially in the left iliac region, can be intestinal diseases: inflammation of the sigmoid colon (sigmoiditis), irritable bowel syndrome, worms, colitis, intestinal dysbacteriosis and some other diseases.

What to do if your stomach hurts?

Be sure to see a doctor, If:

• pain arose for the first time;
• a feeling of discomfort in the abdomen persists for a significant time (more than a week). If it is not about discomfort, but already pain, do not wait more than 1-2 days;
• bloating (flatulence) does not go away within 2 days;
• pain is accompanied by a burning sensation during urination (or);
• more than 5 days upset stool;
• pain is accompanied by fever;
• pain radiates to the chest, neck and shoulders.

In case of pregnancy, the appearance of abdominal pain is a serious reason to consult a doctor.

Conditions of serious concern(immediate medical attention required):

• sudden and/or very severe pain;
• change in behavior (a person becomes lethargic, apathetic);
• pain sensations are accompanied;
• lack of stool;
• refusal to eat;
• increased heart rate, cold sweat, pallor of the skin;
• heat;
• tension in the abdominal wall.

Which doctor should I contact for abdominal pain?

For outpatient treatment of abdominal pain, you should contact your doctor:

• if gastrointestinal diseases are suspected (this may be indicated by the relationship of pain attacks with food intake) - to;
• if you suspect a disease of the urinary system - to;
• women with suspected gynecological diseases - to;
• for pain in the groin - to or;
• in other cases, to

Sharp and dull, pulsating and cutting, bursting and aching - abdominal pain can be very different.

The reason may be various diseases from appendicitis to heart attack.

The main thing is to recognize the symptoms in time and immediately consult a doctor.

Reason 1. Appendicitis

The attack most often begins suddenly: first there is constant pain around the navel, which then descends to the right iliac region. In rare cases, it gives to the lower back. May be aggravated by movement and coughing. At the beginning of the attack, vomiting is possible, which does not bring relief. Usually there is a delay in stool, the stomach becomes rigid. The body temperature rises to 37.5–38°C, the pulse quickens to 90–100 beats per minute. The tongue is slightly coated. When the appendix is ​​located behind the caecum, the abdomen remains soft, pain and muscle tension are noted in the right lumbar region.

What to do?

Urgently call an ambulance. To alleviate the condition on the right side, you can put an ice pack. In no case do not apply a warm heating pad to the stomach. Before the arrival of the doctor, do not take painkillers and laxatives, it is advisable not to drink or eat.

Reason 2. Irritable bowel symptom

For this condition, in which the bowel is disrupted, but it remains healthy, periodic severe cramping (twisting) or cutting pains in the abdomen are characteristic - usually only in the morning, combined with a strong urge to defecate. After a bowel movement, the pain disappears and does not return during the day.

What to do?

Contact a gastroenterologist who will prescribe the necessary studies. The diagnosis of "irritable bowel syndrome" is established only after the exclusion of all other possible diseases digestive tract.

Reason 3. Diverticulitis

Pain in the left lower abdomen, fever, nausea, vomiting, chills, cramps, and constipation are all characteristic signs of diverticulitis. With this disease, peculiar “protrusions” are formed in the walls of the colon, called diverticula, which are formed as a result of the divergence of the fibers of the muscular frame of the intestinal wall. This occurs, as a rule, against the background of chronic constipation, with an increase in intra-intestinal pressure. Also, with age, the muscular frame of the intestine loses its tone and individual fibers may diverge. Diverticula may not bother you for life, but in some cases they may become inflamed.

What to do?

Consult with a gastroenterologist. The doctor may prescribe the necessary medicines, liquid diet and bed rest for a few days. In some cases, treatment for diverticulitis requires a hospital stay. If complications occur, surgery may be needed.

Reason 4. Diseases of the gallbladder

Dull pain in the right hypochondrium or in the right side, worse after eating, - feature cholecystitis (inflammation of the walls of the gallbladder). In the acute course of the disease, the pain is acute, throbbing. Often, discomfort is accompanied by nausea, vomiting, or a bitter taste in the mouth. Unbearably severe pain in the right hypochondrium (hepatic colic) can occur in the presence of stones in the gallbladder or bile ducts.

What to do?

Consult a gastroenterologist who will refer you to an ultrasound of the abdominal organs. When cholecystitis is exacerbated, painkillers are prescribed and antispasmodic drugs, antibiotics, unloading diets. During the period of remission of the disease are prescribed choleretic agents natural and synthetic origin. The treatment of gallstone disease in the early stages is to dissolve the stones with the help of drugs and crushing. In the presence of large stones, as well as the development of complications, they resort to surgical removal of the gallbladder - cholecystectomy.

Reason 5. Peptic ulcer of the stomach and duodenum

Acute (sometimes dagger) pain in the epigastric region (between the sternum and the navel) may indicate the presence of an ulcer - a defect in the mucous membrane of the stomach or intestines. With a peptic ulcer, the pain is often strong, burning, but sometimes it can be aching, similar to a feeling of hunger, or even absent. The pains are usually "hungry" in nature and appear at night, on an empty stomach or 2-3 hours after eating, but sometimes they can intensify after eating. Other common symptoms of an ulcer are heartburn and sour belching.

What to do?

Make an appointment with a gastroenterologist who will refer you for a gastroscopy. Requires general and biochemical blood tests, as well as a test for antibodies to bacteria Helicobacter pylori which causes an ulcer. You will also need an ultrasound of the abdominal organs. The doctor will prescribe treatment and diet: exclusion of alcohol, coffee, too hot or cold food, spicy, fried, salty, coarse food (mushrooms, coarse meat).

Reason 6. Diseases of the pancreas

Dull or aching, girdle pains in the middle part of the abdomen (near the navel) or in the left hypochondrium are characteristic of chronic pancreatitis (inflammation of the tissues of the pancreas). Unpleasant sensations usually increase after eating fatty or spicy foods. In acute pancreatitis, the pain is very severe, in the upper abdomen, often accompanied by vomiting, bloating, and constipation. Most often, acute pancreatitis occurs after overeating and alcohol abuse.

What to do?

Consult a gastroenterologist who will refer you for an ultrasound scan of the pancreas, as well as a blood test for pancreatic enzymes and glucose. The doctor will prescribe enzyme and anti-inflammatory drugs, and most importantly, dietary fractional nutrition. Acute pancreatitis requires emergency hospitalization.

Reason 7. Thromboembolism of the mesenteric (mesenteric) vessels

Spasm or blockage by a thrombus of the mesenteric vessels supplying blood to the intestinal tissues leads to changes in the secretory and motor activity of the gastrointestinal tract and is accompanied by severe, sharp, intolerable pain in the abdomen. At first, unpleasant sensations can be intermittent, cramping, then they become more uniform, constant, although just as intense. Other symptoms include nausea, vomiting, constipation or diarrhea, often bloody stools, and shock may develop. The progression of the disease can lead to intestinal infarction and peritonitis.

What to do?

summon emergency care, since patients with thrombosis of the mesenteric vessels often need emergency surgery. As a treatment, enzymatic, astringent preparations, agents that improve blood microcirculation, antispasmodics, including nitroglycerin for pain, are prescribed.

Reason 8. Gynecological diseases

In women, pain in the lower abdomen in the center or on one side of the abdominal cavity can occur with the development of inflammatory processes in the uterus, ovaries, fallopian tubes, and appendages. Usually they have a pulling character and are accompanied by secretions from the genital tract. Sharp pain, dizziness, fainting - all these symptoms are characteristic of an ectopic pregnancy, a rupture of an ovarian cyst.

What to do?

Contact a gynecologist. If you suspect an ectopic pregnancy, call an ambulance immediately.

Reason 9. Heart failure

Pain in the upper abdomen (in the pit of the stomach), bloating, nausea, sometimes vomiting, weakness, tachycardia, low blood pressure - all these symptoms can indicate a myocardial infarction (the so-called abdominal form). Hiccups, a feeling of stuffiness, pallor are possible.

What to do?

Call an ambulance and do a control ECG. Especially if you are over 45-50 years old, have just experienced a physical or emotional Lately complained of discomfort in the heart and pain radiating to left hand, lower jaw.