When your stomach hurts: Stomach pain – one symptom, many causes

Abdominal pain often comes on suddenly and varies greatly in severity. Often it is also not possible to say exactly where in the stomach it hurts. Find out here what causes it and what you can do about the pain.

Abdominal pain is pain that can be felt in the abdomen – the so-called abdomen. The abdomen extends from the bottom of the ribs down to the pelvis. In this quite large area there are some organs that can cause pain in case of illness. Often these cannot be precisely localized; especially not when they radiate into the entire abdomen.

Children are very often affected by abdominal pain, and the causes are very diverse. Digestive problems are often the cause – infant colic in babies and mostly constipation in infancy.

Infections with intestinal germs or noroviruses can also trigger severe diarrhea and the associated abdominal pain. Often it is a gastrointestinal flu (infectious gastroenteritis).

But not only pathogens or non-infectious physical diseases cause abdominal pain. Especially in children and adolescents, the pain is often psychological.

Forms of abdominal pain

Depending on which organs or structures are involved, doctors differentiate between different types of abdominal pain:

Visceral pain affects the abdominal organs.
(Psycho)somatic pain (psychological) occurs without reference to an organ, but affects the peritoneum.
Referred/projected pain originates from an organ and is transmitted to the outer skin or body surface via nerves.
In addition, abdominal pain can be divided into acute and chronic depending on the course. Doctors speak of acute abdominal pain when the pain occurs suddenly. Often these are severe and indicate a more serious problem, such as appendicitis or pancreatitis. Inflammation of the balloon-like bowel protuberances (diverticulitis) or inflammation of the peritoneum (peritonitis) can also be the cause of acute abdominal pain.

Abdominal pain, on the other hand, is considered chronic if it lasts longer than three months or keeps recurring. This means that the symptoms improve or even disappear for a certain period of time, but then come back (relapse). Diseases that cause chronic abdominal pain are, for example, irritable bowel syndrome or ulcers.

What are the causes of abdominal pain?

The most common cause of visceral abdominal pain is problems with the gastrointestinal or digestive tract. This includes organs such as the pancreas, liver and gallbladder. The pain often extends over the entire abdomen or is particularly felt in the upper abdomen. Possible triggers for the pain are:

Indigestion or trapped air (wind)
constipation or diarrhea
Heartburn caused by reflux of stomach acid (reflux)
ulcers
inflammation of the intestines
Irritable bowel syndrome (IBS) or irritable stomach
Inflammation of the peritoneum (peritonitis)
Gallstones, gallbladder disease
Inflammation of the pancreas (pancreatitis)
Appendicitis (Appendicitis)
Food intolerance such as milk sugar intolerance (lactose intolerance)
However, other organs (such as the kidneys and urinary tract, lungs and heart) as well as pelvic organs (such as the uterus) can also trigger abdominal pain in the case of illness. These include, for example:

urinary tract infections
Kidney stones
pelvic inflammatory disease
menstrual pain
Heart and lung diseases (such as heart failure, angina pectoris or pneumonia)
If organs in the pelvis are affected, the abdominal pain usually spreads to the lower abdomen. In the case of kidney disease, on the other hand, the pain moves from the back towards the abdomen.

When the soul is in pain

A factor that should not be underestimated and that causes abdominal pain for many people is stress or mental stress. Because not only diseased organs send pain, but also the soul. This is most commonly observed in children and adolescents.

The pain sensations triggered by the psyche are routed, among other things, via the extensive network of nerves in the abdomen, which is mainly located around the organs of the digestive tract.

This network of nerves is the enteric nervous system, also known as the second brain (abdominal brain). It is actually responsible for sending information about the condition of the organs to the brain – and impulses from the brain to the organs. However, the processing of emotions is obviously closely linked to the control of the abdominal organs. Negative feelings can therefore quickly “hit your stomach”. Doctors also describe such pain as psychosomatic.

Signs of abdominal pain

There are no typical symptoms of abdominal pain. Depending on the cause, they range from mild to severe pain, which can feel very different. For example, in the case of constipation or strong intestinal gas, where more food or gas accumulates and builds up in the gastrointestinal tract, there is often initially oppressive or dull pain.

If the constipation persists for a longer period of time, the intestines will contract spasmodically and the abdominal pain will become worse. Experts refer to these spasms as colic. With irregular and increased movement of the bowel, the pain is sometimes stabbing or pulling.

Abdominal pain is often accompanied by other side effects such as nausea and vomiting as well as diarrhea. However, these are also strongly dependent on the actual cause and the severity of the abdominal pain.

Typical symptoms of stomach pain

Abdominal pain, especially in the stomach area, often occurs after eating. This is mostly due to the stomach acid that forms when eating food or taking medication.

Especially in people with a sensitive stomach, but also in otherwise healthy people, it irritates the gastric mucosa and causes pain – mostly in the upper left abdomen.

If the stomach acid flows back into the esophagus (reflux), this is noticeable as an unpleasant burning sensation in the throat (heartburn) or in the form of upper abdominal pain – especially if the esophagus is inflamed by the reflux. Factors that particularly irritate the stomach include:

Foods high in fat, sweet foods such as chocolate, alcohol and caffeine
Medicines such as painkillers and rheumatism medicines as well as medicines for heart diseases and osteoporosis
substances such as tobacco smoke
When to see a doctor for abdominal pain
In most cases, abdominal pain is harmless and does not require medical attention. It is often enough to give yourself a rest for a day or two. If, for example, spoiled food or overeating is the reason, the body usually manages to process or excrete it itself (often in connection with diarrhea) and then calms down again. If diarrhea occurs, those affected should drink enough liquid during this time and make sure that the diarrhea does not last too long.

Acute abdominal pain, which indicates a more serious illness, is usually accompanied by certain symptoms or warning signs. It is advisable to go to the doctor’s office if you have the following symptoms:

Acute, severe (spasmodic) abdominal pain
hardened, severely tense abdominal wall
swollen stomach
severe, prolonged diarrhea or vomiting
Abdominal pain that has persisted for a long time without recognizable causes
Side effects such as fever, chills, rashes on the skin, blood in the stool
Signs of shock such as rapid heart rate, drop in blood pressure, paleness, sweating, sensitivity to touch, loss of consciousness (confusion)

For example, cramping or colicky abdominal pain that spreads across the entire abdomen indicates a disease of the gallbladder. You may have gallstones that are blocking the flow of bile. If this is the case, the gallbladder can become inflamed. Such pain is usually acute and very severe and should definitely be clarified by a doctor.

A tightened abdomen can be a sign of heart disease, but it can also be a sign of peritonitis (acute abdomen), both of which can be life-threatening. In these cases, it is therefore particularly important to discuss the abdominal pain with a doctor.

Caution should be exercised if diarrhea lasts longer than three days: especially in small children and elderly people, diarrhea can quickly lead to the body literally drying out due to the severe loss of water. Here, too, it is important to have the diarrhea clarified. If the diarrhea is caused by a bacterial infection, treatment with an antibiotic is usually necessary.

For example, if children suffer from constipation for a long time or repeatedly, it is necessary to seek advice from a pediatrician. They have helpful tips on how to prevent constipation and, if necessary, prescribe medication that causes a gentle discharge and soothes the intestinal tract.

What helps against stomach pain?

So what to do with stomach pain? For more harmless symptoms, such as constipation or if something spoiled has been eaten, bed rest and a hot water bottle or heat pad on the stomach can sometimes help. This calms the stomach or intestines and has a positive effect on digestion. Possible blockages or too much gas in the intestine dissolve and the digestion process works again.

In the case of abdominal pain and diarrhea, it is particularly important to eat light food – i.e. not too fatty, too spicy or too sweet – and to drink a lot to compensate for the loss of water. Mild teas such as fennel, chamomile or peppermint are particularly suitable for this.

Depending on the cause, medication to prevent diarrhea (antidiarrheals) can also help. Be sure to talk to your doctor about this before taking it.

The same applies to the drug treatment of constipation with laxatives, which can cause diarrhea, among other things.

In the case of heartburn, it is important to avoid acidic foods, heavily sweetened drinks and alcohol as much as possible. In severe cases, acid inhibitors (antacids) can also be used to reduce the production of stomach acid. Some antacids are freely available at drugstores and pharmacies. However, consult your doctor, especially if the heartburn lasts longer than two weeks or comes back frequently.

If there is a hypersensitivity to food or an allergy behind the abdominal pain, no medication will usually help. The key here is to avoid triggers. In some cases, an antihistamine can also be useful. However, this only has a symptom-relieving effect. Symptoms usually return when the offending food is eaten again.

Irritable bowel syndrome is a condition that sufferers should also not take lightly. The causes are varied, as are the symptoms; the treatment is correspondingly difficult. Be sure to consult a doctor about this.

If bacterial infections are the cause of the abdominal pain, medical treatment with antibiotics is usually required.

Medical help is also required for severe, acute pain such as acute abdomen and persistent cramping abdominal pain. Treatment then depends on the cause. Antispasmodic painkillers are often used for mild and moderate colic.

If, for example, there is an intestinal rupture or small gallstones have lodged in the bile duct, painkillers are usually not enough: an operation is then necessary.