Abdominal pain This is one of the most common complaints from patients. Abdominal pain can be completely different - as in abdominal cavity there are a large number of organs: the stomach, liver, intestines, gallbladder, pancreas, kidneys and ovaries. Each of these organs hurts in its own way and requires special treatment. Sometimes you can get by with economic means, and sometimes you should immediately call ambulance.
How to examine yourself
You need to determine where the stomach hurts the most.
In order to determine where it hurts the most, you should put your palm on the abdominal wall and gently, although trying to push deeply, press on your stomach with your fingers. It should be remembered in which particular place the pressure causes the greatest pain. It is preferable to carry out this palpation while lying on your back. In this position, the muscles of the abdominal wall relax and it is easier to feel yourself.
The nature of the abdominal pain should be determined.
Abdominal pain may be:
- Dull
- Aching
- Dagger
- Compressive
- Acute
- bursting
What accompanies abdominal pain?
Does the pain radiate somewhere, does it get worse when moving, is it accompanied by nausea, fever, diarrhea, etc. All of this is essential for a diagnosis.
How did abdominal pain appear and develop?
Pain in the abdomen could appear unexpectedly, as a result of physical exertion, as a result of stress or hypothermia. How much time has elapsed since the onset of the pain attack. What were the pains at first: mild, then intensified, sudden, dull. Did the pain increase later and how did it happen, quickly or evenly.
Has the pain changed localization: for example, with appendicitis, abdominal pain first occurs in the epigastric region - where the stomach is, and then goes down to the right.
Common causes of abdominal pain
Pain in the epigastric region
Character of abdominal pain: dull or sharp, bursting or aching. It can give behind the sternum along the esophagus. In this case, vomiting may occur at the time of a particular increase in pain. After vomiting, the pain disappears. The appearance of pain in the abdomen depends on the previous physical activity, but may be associated with the use of strong coffee, spicy or acidic foods. This may be caused by gastritis or stomach ulcers.
What should be done? You should be examined by a gastroenterologist. If this diagnosis is confirmed, then gastritis or an ulcer can be cured in a couple of weeks. In order to improve your condition, you should attach a warm heating pad to the sore spot, you can drink something hot, such as tea. If you are vomiting blood, call an ambulance.
Pain in the right hypochondrium
Character of abdominal pain: The pain is compressive, sharp. The pain radiates to the lower back on the right, right shoulder, right half of the chest, under the right shoulder blade.
Pain in the abdomen is accompanied by a feeling of bitterness in the mouth, sometimes there is vomiting of bile (usually after this the condition improves), an increase in temperature is possible.
Pain in the right hypochondrium may appear after the abuse of fatty spicy food. If you have these symptoms, it is most likely cholecystitis.
What needs to be done? An antispasmodic or any digestive enzyme preparation should be taken. Be sure to go for an ultrasound to make sure that there are no stones in the gallbladder.
Pain around the entire abdomen
Character of abdominal pain: encircles the upper abdomen, pain radiates to the lower back.
Pain in the abdomen is accompanied by dryness and an unpleasant aftertaste in the mouth, vomiting. Usually, even after vomiting, the patient's condition does not improve. Pain around the entire abdomen may appear after drinking alcohol, fatty or spicy foods. If you have these symptoms, it is most likely acute pancreatitis.
What do we have to do? You should immediately seek medical attention. Without timely treatment, pancreatic necrosis can occur, and this condition is life-threatening.
Pain around the navel
Character of abdominal pain: discomfort in the abdomen appeared suddenly, sharply, cramping, strong. This state accompanied by weakness and chills.
Most often, pain near the navel appears after drinking coffee, chocolate, or foods rich in fiber. If you have these symptoms, it is most likely intestinal colic.
What do we have to do? You should take an antispasmodic pill and lie down. The pain will go away on its own in 15-20 minutes. To avoid pain in the abdomen, do not overeat and minimize the amount of chocolate and coffee consumed.
Pain in the middle of the abdomen on one side
Character of abdominal pain: Appears suddenly, the pain can be very severe. Pain in the middle of the abdomen is given to the lower back or perineum and is accompanied by increased urge to urinate. Stomach hurts after heavy drinking mineral water, overeating watermelon. This condition may be caused by the passage of a stone from the kidney.
What do we have to do? It should be treated with a heating pad, antispasmodics, a hot bath. But if blood appears in the urine or the pain in the abdomen reaches shock strength, you need to call an ambulance.
Pain lower right
Character of abdominal pain: at the very beginning, pains appear in the epigastric region, then gradually intensify and descend into the right lower abdomen. The pain radiates to the rectum, aggravates when walking and trying to lie on the left side. Accompanied by fever, nausea. It could be appendicitis, so you should call an ambulance.
Pain was all over the stomach
Character of abdominal pain: the whole stomach hurts, constantly. Gives to other parts of the abdomen. Accompanied by dry mouth, fever, nausea, weakness. This condition appears after pain that no drugs could remove during the day. This may be peritonitis (very dangerous disease).
What do we have to do?
Pain in women in the lower abdomen
Above the pubis in the center or on both sides
Character of abdominal pain: fickle, pulling; gives to the perineum or lateral parts of the abdomen; accompanied by secretions from the genital tract, may be aggravated by walking. This condition may occur after taking spicy food, stress, hypothermia. This may be fibromyoma, endometriosis.
What do we have to do? Urgently go to the gynecologist for an appointment.
Right or left above the pubis
Character of abdominal pain: pain appears suddenly, very sharp and strong; gives to anus or nowhere; accompanied by weakness, dizziness, fainting may occur; pain appears after intercourse (rupture of the cyst) or a couple of weeks from an ectopic pregnancy. It may be a rupture of an ovarian cyst or.
What do we have to do? Urgently call an ambulance.
Abdominal pain is the most common complaint in both children and adults. Their causes are manifold, ranging from simple indigestion or disease digestive tract, worms, appendicitis to inflammation of the lungs, kidneys or bladder, infectious diseases (even tonsillitis and acute respiratory viral infections), however, it is important to distinguish when pain is a consequence of intestinal hyperperistalsis, for example, with excessive gas formation, and when it is 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 - reflected transmission 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, is usually accompanied by tension in the muscles of the anterior abdominal wall, has an acute cutting character, and is aggravated by 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 of the stomach.
Possible causes of abdominal pain
The most common cause is the food we eat. Irritation of the esophagus pressing pains) 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 spastic pains in the abdomen, bloating and diarrhea.
Depression, spinal disorders, thyroid disease, anemia, infections urinary tract 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 diseases connective tissue(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 mellitus, 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. It is of great importance here clinical experience doctors, because 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 the 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 small intestine.
Pain in the right iliac region (near the iliac wing on the 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), strong rise temperature 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 surgical intervention. 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, slimy stools, constant desire to empty the bowels. 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. Your 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 way to prevent diverticulitis is a fiber-rich diet. 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.
Sharp burning pain in upper and middle parts abdomen (between breastbone and 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 may also form if the stomach is unable to defend itself against a powerful gastric juice. Helicobacter pylori- a bacterium that lives in the stomach - can also cause an ulcer. 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, lowering 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 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 organs person. 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 vermiform appendix of the caecum; an 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 join the pain in the right iliac region neighboring bodies: 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). A small boost temperature, 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 when severe pain- they shout. 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. In elderly people and old age 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 hernia etc.) and postoperative hernia(after previously performed operations in the area of the scar). Predisposing factors include increased intra-abdominal pressure, hard physical labor, frequent crying and screaming of the child, difficult childbirth, coughing in chronic lung diseases, 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, retention of stools and gases, and an increased pulse. 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 the initial stage of the 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, protrudes cold sweat breathing becomes shallow. 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(diseases of the colon);
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 a tar-like stool (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).
With gastrointestinal bleeding, there is general weakness, frequent and weak pulse, lowering blood pressure, profuse cold sweat, pallor skin, dizziness, fainting.
At heavy 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.
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, radiates 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.
Abdominal pain is initially localized in the epigastrium (middle upper abdomen), in the right or, more often, 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, malnutrition leads to hepatic colic (eating meat, fatty and spicy foods, spices in in large numbers), excessive exercise, driving with shaking.
An attack of hepatic (biliary) colic occurs as a result of infringement of a stone in the neck of the gallbladder, in the ducts with 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 extending 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 often 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 without 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, paresis of the intestines, retention of stool and gases, fever increase the similarity with diseases of the digestive system, in particular, such as acute intestinal obstruction, acute appendicitis, cholecystitis, peptic ulcer 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 the following signs: sudden onset and end, restless behavior of patients, lack of 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 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 impaired 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 an 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 transferred in the 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. An important diagnostic value is the combination of abdominal pain with pain in 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 the stomach disease lead to the fact that patients are admitted to the hospital with an erroneous assumption about the presence food poisoning, acute appendicitis, acute cholecystitis or other form of acute surgical disease belly. In some cases, an exacerbation of a 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. A 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 drink a few sips of 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 from diseases such as ulcers, cholelithiasis, inflammatory bowel disease, or surgery in the past?
Do the medicines you take have side effects from the gastrointestinal tract (aspirin, non-steroidal anti-inflammatory drugs)?
Urgent medical attention is needed for the following conditions:
- pain accompanied by fever, jaundice, dark urine, severe nausea or vomiting, light-colored 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 requiring emergency care to 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.
In case of acute pain in the abdomen, call an ambulance!
General blood analysis;
Biochemical analysis blood;
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.
The most common symptom of many diseases is abdominal pain of various localization and it depends on the correct diagnosis whether the correct treatment is offered. Some types of abdominal pain are classified as medical emergencies that require immediate medical attention or hospitalization. It is important to distinguish it from the usual one and provide first aid, and then call an ambulance.
Abdominal pain may occur with diseases of the abdominal cavity and retroperitoneal space, genital organs, spine, abdominal wall muscles, nervous system, or radiate to the abdomen with diseases of the chest organs (for example, right-sided pleurisy, myocardial infarction and pericarditis may occur with pain in the right or left hypochondrium, epigastrium).
Pain in diseases of internal organs can be caused by impaired blood flow, spasm of smooth muscles of internal organs, stretching of the walls of hollow organs, inflammatory changes in organs and tissues. The spread of an inflammatory process or tumor involving the intercostal or splanchnic nerves can cause referred pain.
Spasmodic pain in the abdomen is noted with lead intoxication, in the precomatous stage with diabetes mellitus, as well as with hypoglycemic conditions, with porphyria.
To find out the cause of abdominal pain, first of all, you need to establish its localization (the exact place that hurts), its type ( sharp, piercing, cutting), appearance history ( increasing, intermittent or constant) and concomitant symptoms .
The figure shows the location of the abdominal organs and the zones of pain distribution from the organ are marked:
Localization of pain does not always correspond to the location of the affected organ. Sometimes in the first hours of the disease, it is not clearly localized and only later concentrated in a certain area. In the future (for example, with generalization of peritonitis), it can again become diffuse. With appendicitis, pain may initially occur in the epigastric or umbilical region, and with a covered perforated gastroduodenal ulcer, by the time of examination, it can only persist in the right iliac region (when gastric contents flow into this region).
In addition, complaints of fairly severe abdominal pain can also occur in a number of extraperitoneal diseases. So, abdominal pain in children often accompany infectious diseases, in particular, precede the rest of the symptoms of scarlet fever and appear a few days before the rash (rash) on the body. They can also disturb the flu, SARS and other infections.
It is of great diagnostic value the nature of the pain. Cramping pain is most often observed with spastic contractions of the smooth muscles of hollow organs, most characteristic of mechanical intestinal obstruction, for renal and hepatic colic. Gradually increasing pain is characteristic of inflammatory processes, however and at these diseases it quite often happens constant. Cramping pain in 10-20% of patients is also possible with acute appendicitis, which is due to contraction of the muscular membrane of the process in response to blockage of its lumen. Sometimes periodically aggravated pain can give the impression of cramping:
Sudden onset of stabbing pain indicates an intraperitoneal catastrophe (breakthrough of a hollow organ, abscess or echinococcal cyst, intraperitoneal bleeding, embolism of the vessels of the mesentery, spleen, kidney). The same beginning is typical for renal colic.
The behavior of the patient during pain attacks is of diagnostic value. A patient with an attack of renal or hepatic colic rushes about, takes various poses, which is not observed in lumbar sciatica having a similar localization of pain. With mental disorders, a painless course of severe pathological processes is possible ( perforated ulcer and etc.).
Pain localization |
Possible disease |
| Upper abdomen on the right | It is observed most often in diseases of the liver, gallbladder and biliary tract, duodenum, head of the pancreas, right kidney and damage to the hepatic flexure of the colon. In diseases of the biliary tract, pain radiates to the right shoulder, with duodenal ulcer and pancreatic lesions - in the back, with kidney stones - in groin and testicles. |
| Upper abdomen on the left | It is noted with damage to the stomach, pancreas, spleen, splenic flexure of the colon, left kidney, as well as with hiatal hernia. |
| Right hypochondrium | If the pain is accompanied by repeated vomiting and fever, it may be an inflammation of the gallbladder. You need to immediately go on a diet, stop eating spicy and fatty foods. The diet should be salt-free. |
| The epigastric region at the top of the abdomen, described as "sucking in the pit of the stomach" | With mild pain in the abdomen, there may be a slight inflammation of the stomach or duodenum. This is the most common cause but there is no reason to panic. Such pains are common in middle-aged and older people. But if the pain is persistent, does not go away after 10-15 minutes, there is a suspicion of an ulcer. Before you go for an examination (and it is necessary), try to give yourself first aid. Divide your meals into 6-7 times a day. Eat more milk and less carbs. If pains in the upper abdomen appear after taking spicy and sour food, coffee, after recent severe stress, with acute, dull, arching, aching pain in the upper abdomen with possible vomiting possible diagnosis of gastritis or gastric ulcer. In this case, the pain increases with vomiting, and after it weakens. Pain can respond in the chest along the esophagus. Consult a gastroenterologist, if blood impurities appear in the vomit, call an ambulance immediately. Treatment of acute gastritis and ulcers is not very long, subject to the doctor's recommendations up to 14 days. To relieve pain, you can apply a warm heating pad to your stomach or drink moderately hot, weak tea or water. |
| Whole stomach hurts | Constant moderately severe abdominal pain covering the entire abdomen, while weakness, dry mouth, possibly fever and nausea may be a sign of peritonitis or inflammation of the peritoneum. |
| Abdominal pain that radiates around the lower back (girdle pain) | Try to feel the upper or left parts of the abdomen on your own. If this makes you sicker, it is likely that you are dealing with an inflammation of the pancreas (pancreatitis). Associated symptoms: bad taste and dry mouth, repetitive vomiting (after vomiting, the pain subsides), possibly an increase in pressure. Pain often occurs after taking fatty foods or alcohol. We exclude everything fried, the patient needs hunger, cold on the stomach and complete rest. In acute cases, you should immediately consult a doctor. |
Pain in the lower abdomen |
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| right lower abdomen | Pain in the lower abdomen on the right may be due to damage to the appendix, the lower segment ileum, blind and ascending colon, right kidney and genitals. In the lower abdomen on the left, pain may be caused by a lesion of the transverse colon and sigmoid colon, left kidney, as well as diseases of the genital organs. Acute pain in the lower abdomen on the right is most often a sign of appendicitis, urgently call a doctor. Pain with appendicitis is not strong at first, it may occur at the top of the abdomen and move down to the right, while fever and nausea are possible. Pain may be aggravated by walking and lying on the left side. |
| left lower abdomen | It may indicate inflammation of the lower sections of the large intestine, and accompanying symptoms will also occur - a violation of the stool, rumbling in the abdomen, increased gas formation. You will have to give up fresh vegetables and fruits, you can not drink milk and eat seasonings and black bread. |
| Pain above the pubis in women | Pain in the lower abdomen above the pubis on the right and left in women most often indicates gynecological diseases - diseases of the urinary-genital system. Pain in this case can be of a different nature: sharp, strong and barely noticeable, sharp or pulling, often accompanied by discharge from the genital organs, weakness, increased fatigue If the pain in the lower abdomen is growing, cramping, and sudden sharp pains are possible, which are aggravated by movement, dizziness, weakness are felt, there may be bleeding when menstruation is delayed up to 1-2 weeks - this may be due to ectopic pregnancy or spontaneous abortion. Immediately consult a gynecologist, with bleeding and acute pain, an ambulance call is necessary. Severe, sharp pain after intercourse, combined with weakness, possible fainting and bleeding, may be a sign of a ruptured cyst or the presence of a tumor. Call an ambulance. Intermittent, aching pain in the lower abdomen directly above the pubis, accompanied by general weakness or chills, radiating to the perineum - a sign of gynecological diseases such as endometritis, adnexitis (including infectious), endometriosis, etc. Consultation with a gynecologist is necessary. |
| Pain in the lower abdomen in a man | Pain in the lower abdomen on the right or left in a man is most often a sign of problems with the intestines. However, sometimes chronic prostatitis manifests itself in this way. Therefore, in addition to a visit to a gastroenterologist, it makes sense to undergo an examination by a urologist. |
Pain in the middle of the abdomen |
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| Sharp pain in the middle of the abdomen | Sharp, severe pain in the middle of the abdomen, radiating to the lower back, combined with a frequent need to urinate, can be a sign of the movement of kidney stones. Such pain is exacerbated by taking diuretics and drinks. Use antispasmodics only with a diagnosis confirmed by a doctor, you can take a hot bath, a hot heating pad to relieve pain. In case of particularly severe pain or the appearance of blood in the urine, call an ambulance. |
| In the middle of the abdomen near the navel | Sharp, sudden, rather strong cramping pain in the center of the abdomen, accompanied by weakness and chills, which appears after overeating, drinking fatty foods or coffee is called intestinal colic. Apply an antispasmodic and take a lying position. The pain will pass within 20 minutes, if it does not pass, you need to look for the cause in another. Don't overeat later. |
Treatment of abdominal pain
With unknown pains in the abdomen, you can not drink painkillers before the doctor arrives, they only drown out the pain and at the same time extinguish the clinical picture of the disease. The doctor, without finding a banal appendicitis or mesenteric thrombosis, cannot make any other diagnosis. 25 out of every 1,000 people with appendicitis die because of a misdiagnosis.
For severe, prolonged, recurring abdominal pain, be sure to consult a doctor and in no case self-medicate. Abdominal pain can be a symptom of a very dangerous disease!
Usually, abdominal pain is a symptom of a temporary and harmless disorder, such as cramps, indigestion, or motion sickness. However, despite a fairly harmless cause, abdominal pain can cause severe discomfort. Because of it, you can forget about everything else. Fortunately, there are many ways to get rid of stomach pain, including simple exercises, homemade drinks and certain dietary changes. If none of these methods help, it may mean that the pain in the abdomen is caused by more serious causes, such as appendicitis. If you experience prolonged severe abdominal pain, seek immediate medical attention.
Steps
Simple and fast ways
- Don't strain or strain when trying to have a bowel movement, as this can lead to serious complications such as hemorrhoids.
- If there is blood in the discharge from the intestines or stool, you should immediately consult a doctor - these symptoms are called hematochezia.
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Apply a warm compress to your abdomen. The heat will help relax the muscles and relieve tension and possible cramps. Take a heating pad, a microwave-heated compress, or an electric blanket and place it on your stomach for a few minutes.
- If you don't have any of the above items on hand, put some rice in a pillowcase or sock and microwave it for 1-2 minutes.
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Stand up and reach for your toes. Often, mild indigestion can be eliminated simply by getting rid of the gases accumulated in the stomach and intestines. Forward bends and other equally simple exercises will help to do this.
Let you throw up. If you feel very sick, then you may need to vomit. This unpleasant action may seem like the worst option, but in fact, vomiting helps the body get rid of ingested bacteria, viruses, and food that causes irritation. If vomiting continues for several days, you should consult a doctor, as this may indicate a serious illness.
- If you're feeling nauseous but not throwing up, try chewing on soda crackers or using magnetic anti-nausea bracelets to help relieve your symptoms.
- Vomiting can lead to rapid dehydration, so if you vomit repeatedly, drink sports drinks that restore electrolyte balance. These drinks contain sodium and potassium, which the body needs to fight disease.
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Take a hot bath. warm water improves blood circulation and relaxes muscles. A warm bath can help relieve stomach pain and reduce tension. Soak in the bath for at least 15-20 minutes. To reduce inflammation, you can add 1-2 cups of Epsom salt (epsom salt) to the water.
- If you can't take a bath, warm your abdominal muscles with a heating pad or heating pad.
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Massage your belly. Abdominal cramps can be caused by muscle tension. This voltage can be reduced with with the help of a lung massage: press lightly on various sections belly and then release your hand. Pay special attention to the places where the pain is felt the most, but do not overdo it - do not press or rub too hard.
- During the massage, focus on breathing: inhale through the nose and exhale through the mouth. Deep breathing will help you relax your muscles and take your mind off the pain.
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Take over-the-counter medications. There are many medications available to help with common nausea, indigestion, and abdominal cramps. Constantly take similar drugs you shouldn't, but you can use them quite effectively from time to time. Be sure to follow the recommended dosage and ask your pharmacist if there are any additional recommendations or warnings regarding the drug you are purchasing.
Visit the restroom. Often, nausea and pain in the abdomen are caused by such a simple reason as the need to empty the intestines. Therefore, before resorting to other methods, try sitting on the toilet for a few minutes. At the same time, lean forward and raise your knees to your chest. This posture helps to empty the bowels without much effort.
Treatment of chronic indigestion and heartburn
- If you find yourself having bad eating habits, try to correct them: eat smaller portions and take your time while eating. This will give your stomach more time to digest food, and smaller portions will reduce the load on it.
- Stomach problems after eating are called non-ulcer dyspepsia, or indigestion.
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Drink after meals. Wait about one hour after eating before drinking water or other beverages to relieve indigestion. It may seem strange, but when you drink water with food, it dilutes the gastric juice and reduces its effectiveness.
Avoid fatty and spicy foods. Indigestion is often caused by hard-to-digest foods that exacerbate pain and stimulate the secretion of gastric juices. Therefore, one of the easiest ways to deal with indigestion is to identify the trigger foods and eliminate them from your diet.
- Instead, try to eat lighter foods: oatmeal, broths, toast, applesauce, crackers, rice. These foods are easy to digest and do not overload digestive system.
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Wear loose clothing at the waist. Although it may seem like a small thing, clothing does play an important role in indigestion and acid reflux. Trousers or a skirt that are too tight at the waist can cut into the stomach and put pressure on the lower esophageal sphincter, which interferes with normal digestion and causes stomach acid to rise up into the esophagus.
- This does not mean that you should completely abandon your favorite skinny jeans. Just change into looser clothes before a big meal.
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Take nutritional supplements to improve digestion. Digestive enzymes, hydrochloric acid supplements, and enteric (intestinal) oil capsules are widely used to combat indigestion. peppermint. For example, enteric-dissolving peppermint oil capsules have been shown to help reduce or eliminate indigestion in 75% of cases.
- Although it is believed that in many cases indigestion is associated with increased activity of gastric juice, it can also occur as a result of a lack of acid. If you think that your indigestion is due to a lack of stomach acid, talk to your doctor and, if recommended, try taking hydrochloric acid supplements.
- Regardless of which nutritional supplements you choose, be sure to follow the recommended dosage and consult your doctor if you experience any side effects.
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Add probiotics to your diet. These are beneficial bacteria that are present in the digestive tract and aid in the digestion of food. Studies have shown that taking probiotics helps with chronic problems with digestion, such as irritable bowel syndrome and infectious diarrhea. Daily consumption of yogurt and other dairy products increases the levels of probiotics in the digestive system. At the same time, pay attention to the composition of the products and make sure that they contain live cultures.
- If your body does not absorb yogurt well, you can take probiotic capsules instead. Try Florastor and Align probiotic supplements to promote gastrointestinal health.
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Take artichoke leaf extract three times a day. The artichoke promotes the secretion and circulation of bile, which speeds up the passage of food through the digestive system. Recent studies have shown that artichoke extract significantly alleviates the symptoms of indigestion such as gas accumulation and premature feeling of fullness in the stomach.
- Although artichoke extract is widely used in Germany, it is harder to find in other countries. Look for it in pharmacies, health food stores or online stores.
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Pay attention to nitrates and anti-inflammatory drugs. Indigestion and heartburn can be caused by a variety of medications, so review the medications you are taking for possible side effects. However, don't stop taking important drugs. Before giving up any medicine, you should consult your doctor and try to find a replacement for this drug.
- Nitrates are often used to treat heart disease because they dilate blood vessels. In turn, popular non-steroidal anti-inflammatory drugs such as aspirin and ibuprofen help relieve pain.
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Rest after eating. After eating, rest is necessary so that it is properly digested. Physical activity immediately after a meal can disrupt normal digestion, as instead of the digestive tract, blood will flow to active muscles and lungs. This can slow down the digestion of food and cause stomach pain. Sit quietly or lie down after eating for about an hour.
Watch your diet. If you often experience indigestion and heartburn, it's important to find the cause and not just try to treat the symptoms. First, look at what you eat and your eating habits. Such seemingly insignificant habits as fast eating, swallowing large pieces, too large portions and overeating can exacerbate indigestion.
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« Acute abdomen"- a threatening condition in which significant damage to the abdominal organs occurs and requires immediate surgical care. This condition can be in many diseases, but the signs characteristic of an "acute abdomen" will be common. This the following symptoms:
Intolerable sudden onset pain in the abdomen, causing groaning
Increased pain with the slightest movement and coughing
Can't find a position to relieve suffering
Signs of intestinal obstruction: no stool, bloating
Protective tension of the abdominal muscles
heavy general state with tachycardia, cold sweat, disastrous weakness, pallor, drop in blood pressure.
"Acute abdomen" may occur as a single symptom for the first time without a previous disease. This, for example, is a rupture of the spleen with an abdominal injury or acute appendicitis, which will immediately require surgical care.
But very often "acute abdomen" occurs as a complication of an already existing disease. For example, perforation of a long-existing stomach ulcer or rupture of an ovarian cyst, renal colic in urolithiasis, which is not eliminated by taking antispasmodics.
Therefore, timely and adequate treatment chronic diseases is the prevention of their exacerbation and severe consequences.
Diseases that can give a picture of "acute abdomen"
Acute intestinal obstruction
Acute appendicitis
Acute pancreatitis
Hepatic and renal colic
Perforated ulcer of the stomach or duodenum
Peritonitis
Ruptured abdominal aortic aneurysm
Thrombosis, embolism and spasm of mesenteric (mesenteric) vessels
ovarian cyst torsion, ovarian rupture
Aborted ectopic pregnancy with rupture fallopian tube
Tumors
Heart attack or rupture of the spleen
Liver rupture
Strangulated hernia, etc.
In any of these conditions, you can not hesitate to call an ambulance for a minute.
Here is a brief description of the main symptoms of these diseases.
Acute intestinal obstruction
Causes leading to intestinal obstruction: spasm of the intestine or its paresis (disappearance of peristalsis), tumor, strangulation of the hernia, adhesions, fecal stones, thrombosis and embolism of the mesenteric vessels, foreign bodies, peritonitis, helminthic and hair balls, overeating after hunger. Moreover, adhesive disease accounts for up to 70% of all cases of obstruction.
Cramping unbearable pain all over the abdomen occurs suddenly, and its intensity increases, the patient groans from pain.
It is during this first period that it is urgent to call an ambulance. Before her arrival, you can give the sick antispasmodic (no-shpu, baralgin, papaverine), laxatives are categorically contraindicated.
Then (without the provision of medical assistance), against the background of some decrease in pain, repeated vomiting occurs, first with food remnants with bile, later it acquires a fecal character, severe dryness in the mouth, and thirst.
There is no stool and gases do not go away, the abdomen is swollen and asymmetrical, intestinal peristalsis can sometimes be seen by eye.
With some types of obstruction from the rectum, mucus with blood may be released.
The patient is very restless, tossing about in bed.
Pallor of the skin, tachycardia, decreased pressure, shock are characteristic.
Before the development of peritonitis, the abdomen is soft, painful in the area where the obstruction to feces is located.
Acute appendicitis
This disease is the most common acute conditions stomach, but its danger cannot be underestimated.
Characterized by a sudden onset with pain in the epigastric or umbilical region. Gradually, the pain intensifies and goes to the right lower abdomen. Often gives to the rectum, lying on the left side and increases during walking (especially when the right leg is behind).
There is an increase in temperature up to 37.2-38 ° C, nausea or vomiting, tachycardia, dry mouth.
When probing the right lower abdomen, the pain intensifies, especially during the withdrawal of hands (positive symptom of Shchetkin-Blumberg), the muscles in this area are tense.
In old age, signs of appendicitis can be smoothed out, because. with age, there is a decrease in the sensitivity of nerve endings, and the process proceeds sluggishly.
Acute pancreatitis
In acute pancreatitis, massive destruction of pancreatic tissue occurs. This is an extremely dangerous disease that requires immediate medical attention. If this help is not provided to the sick person, he may die after a few hours or days from the onset of the disease.
The pain first occurs in the right or left upper abdomen or under the "spoon", then becomes girdle. May spread throughout the abdomen.
The pain is severe, unbearable, as in myocardial infarction or perforated ulcer.
Often the onset of pain is preceded by the use of large amounts of strong alcoholic beverages or fatty foods.
Repeated vomiting is typical, which does not bring relief and bloating.
The general condition is severe, inhibited, the skin is cold and wet, the pressure is reduced, tachycardia, shock is possible in severe pancreatitis.
The stool becomes light or gray, its amount increases significantly.
The tongue is dry and inflamed, the inflammation may cover the whole mouth.
The skin is pale, icteric or cyanotic. There may be small hemorrhages around the navel and on the buttocks.
biliary or hepatic colic (Acute cholecystitis)
It usually occurs in the evening or at night in patients with cholelithiasis or a tumor, when a stone or tumor blocks the outflow of bile from the gallbladder, i.e. there is an infringement of the stone in the bile ducts.
A sharp, sharp, cramping pain in the right hypochondrium or right side is characteristic, it radiates to the back, under the right shoulder blade, to the shoulder or neck.
The temperature can rise to 37.5-38.5 ° C and be accompanied by chills, nausea, vomiting, a feeling of bitterness in the mouth, tachycardia. Occasionally - jaundice and itching of the skin.
Patients often groan and rush about to find a position in which the pain would decrease, but they cannot find it.
The occurrence of an attack is preceded by the use of fatty or fried foods, alcohol, cold drinks, as well as overeating, physical activity, shaking driving, stress.
When probing, there is tension in the muscles of that part of the abdominal wall where the projection of the gallbladder is located. Shchetkin-Blumberg's symptom is positive (maximum pain during taking hands off the stomach).
An attack of biliary colic can be a single one, when the removal of the gallbladder is immediately required, or it can last up to 5-6 hours and pass after the use of antispasmodics.
nephrolithiasis (renal colic)
This condition develops when stones (and sometimes a tumor) block the outflow of urine from the kidneys.
The pain is unilateral in the side or lower back, unbearable, cutting, cramping with irradiation to the lower abdomen, thigh and inguinal region.
Often joins bloating, nausea and vomiting, constipation, urination becomes more frequent. There may be an increase in temperature.
The skin is pale, cold, moist.
Behavior during such an attack of colic is restless, it is impossible to find a comfortable position, so the patient rushes about in bed.
Perforation of a stomach or duodenal ulcer
Occurs against the background of an existing peptic ulcer or may be its first sign. The duodenum is more often affected (85%).
The maximum perforation occurs in autumn or spring.
Before the perforation of the ulcer, there are often precursors - increased pain, chills, subfebrile temperature, nausea.
Sudden severe dagger pain in the region of the stomach or in the right hypochondrium, which then spreads to the right lower abdomen, and later throughout the abdomen.
The pain radiates to the right shoulder, collarbone or right shoulder blade.
There may be vomiting with an admixture of blood.
The skin is pale or ash-gray, damp, cold sweat.
The abdomen does not participate in breathing, it is very tense.
The patient occupies a forced immobile position lying on the right side with legs bent and brought to the stomach.
After the first attack, the dagger pain may subside for 3-6 hours, the condition improves, but then everything returns again, because. peritonitis occurs; vomiting appears, sometimes with blood, the temperature rises, the pulse quickens, the pressure drops. Waiting for a period of improvement after the first symptoms of perforation is a direct threat to life.
Peritonitis (inflammation of the peritoneum)
Peritonitis, as a rule, is the result of a complication of other diseases of the abdominal organs (appendicitis, acute cholecystitis, ruptured abdominal aortic aneurysm, perforated gastric ulcer, acute pancreatitis). The main signs of peritonitis underlie the concept of "acute abdomen".
The strongest unbearable pain in the abdomen, which increases with movement, coughing and even breathing with tension in the muscles of the anterior abdominal wall.
The pain first occurs at the location of the organ where the disaster occurred, and then spreads to the entire abdomen.
At various diseases pain can radiate to different places:
- In diseases of the liver and gallbladder - in the right shoulder.
- In case of damage to the spleen - in left shoulder.
- In diseases of the pancreas - in the back.
- In diseases of the kidneys and urinary tract - in the lower abdomen.
Heat.
Severe bloating, signs of intestinal obstruction.
Vomiting, blood in stool,
Severe general condition: pallor, cold sweat, tachycardia, there may be shock.
Dissecting aneurysm of the abdominal aorta with its rupture
tear of the inner layer of the aorta with blood flowing between the layers of the walls of the aorta and subsequent dissection.
Sudden, tearing, stretching or burning pain in the navel.
The pain is very intense from the very beginning and continues continuously, spreading along the course of the dissection, often radiating to the lower back.
Slight tension in the muscles of the anterior abdominal wall, but there are no symptoms of peritoneal irritation.
More often develops in the morning.
Mostly men after 55 years of age with a hereditary predisposition are ill.
Develops against the background of severe atherosclerosis, hypertension, rheumatism or syphilis. The risk also increases during pregnancy.
If, during dissection, all 3 layers of the aortic wall break through, then internal bleeding occurs with rapid blood loss, which is later joined by symptoms of peritoneal irritation, i.e. "acute abdomen"
Great tension in the muscles of the abdominal wall, with inability to move or touch the abdomen.
Dizziness, pallor, cold sweat, pressure drop with collapse, tachycardia, loss of consciousness.
There may be vomiting.
Thrombosis, embolism, spasm of mesenteric (mesenteric) vessels
The mesenteric vessels supply the intestines with blood.
These three conditions have a similar clinical picture, as they and spasm, and thrombosis, and embolism of the mesenteric vessels lead to circulatory disorders in the intestinal wall, oxygen starvation and the development of intestinal infarction.
With spasm of the mesenteric vessels, the pain is periodic, acute, intermittent, spreads throughout the abdomen and lasts about 3-4 minutes.
Taking antispasmodics (papaverine, no-shpa, nitroglycerin) with spasm of the mesenteric vessels eliminates pain.
With blockage (thrombosis) of the mesenteric vessels by a blood clot or their embolism, signs of peritonitis and intestinal obstruction are observed:
Pain with thrombosis of the mesenteric vessels is constant, strong, cutting, begins suddenly and is accompanied by severe bloating.
The localization of pain depends on the location of the vascular lesion: in the navel, in the right or left iliac region, or spreads throughout the abdomen.
The pain is aggravated by the slightest movement, so the patients lie motionless on their backs, bending their knees.
Nausea and indomitable vomiting are observed from the very beginning of the disease.
Retention of stool and bloating.
Sometimes it can be frequent at the beginning liquid stool mixed with blood.
The condition is severe, characterized by pallor, cold sweat, dry tongue, tachycardia, sometimes shock.
There is tension in the muscles of the abdominal wall.
Thrombosis of mesenteric vessels most often occurs in patients with atrial fibrillation, atherosclerosis and myocardial infarction.
Rupture of an ovarian cyst
The provoking factor is physical activity, trauma, sexual intercourse.
It manifests itself as a sudden pain in the lower abdomen, first the pain is local on the right or left, then it becomes diffuse.
Torsion of an ovarian cyst
The pain is associated with ovarian ischemia and is manifested suddenly by acute pain in the lower abdomen on the right or left. There is an increase in pain during probing and there are symptoms of irritation of the peritoneum.
Often a woman knows that she has a cyst.
Spontaneous (spontaneous) abortion
Pain in the abdomen is acute, severe, cramping, sudden. Occurs in the suprapubic region.
Accompanied by uterine bleeding.
It often occurs after physical effort, heavy lifting, trauma, sexual intercourse.
Rupture of the fallopian (uterine) tubes in ectopic pregnancy
An ectopic pregnancy is accompanied by moderate pain and a delay in menstruation, there may be minor bloody issues from the vagina. If a complication occurs in the form of a rupture of the tube, the pain suddenly intensifies, becomes diffuse, the bleeding becomes severe, leading to fainting. The lower abdomen is very painful when palpated, symptoms of peritoneal irritation appear.
This condition is often associated with physical activity, heavy lifting, sexual intercourse.
Tumor diseases of the abdominal organs
Pain in malignant tumors is very rarely the first sign of the disease, and its appearance indicates a far advanced process.
Almost always, pain is preceded by a “precancerous disease”, for example, long-term and improperly treated chronic atrophic gastritis or peptic ulcer, intestinal polyps. Therefore, pain in tumors at first has the character of the disease against which they develop, but later the nature of the pain changes, its dependence on food and other symptoms familiar to the patient.
It is necessary to be attentive to the appearance of new symptoms or the change in the nature of old and familiar signs. It is at this stage that the treatment gives good results. But "acute abdomen" with tumors is a sign that speaks of a far-reaching process. Don't wait for threatening symptoms.
Always to be considered heredity through parents, brothers and sisters.
Signs of neoplasms at the onset of the disease are nonspecific and may resemble other diseases. This is bloating, nausea, heartburn, discomfort in the stomach, loss of appetite, constipation, diarrhea, etc.
However, regardless of which organ is affected, there are a number of signs that
allow to suspect the presence of a tumor in the abdominal cavity:
Anemia of unknown nature
Unreasonable weight loss and loss of appetite,
Abdominal pain that occurs at night
If the disease began after 50 years;
Fever of unknown origin
Causeless general failure weakness, depression, apathy
Persistent constipation that does not respond to medical treatment,
The appearance of blood and mucus in the stool,
Pale earthy skin tone
sudden appearance of jaundice,
The tumor may be palpable.
Spleen infarction
The reason for the development of this pathology is thrombosis or embolism of the spleen vessels, which occur with certain heart defects, increased pressure in the vena cava, bacterial endocarditis, rheumatism, coronary artery disease, leukemia.
If the infarction is small-focal, it may be asymptomatic or with minor pain in the left hypochondrium.
If the heart attack affects a large area, there is a strong, sudden pain in the left hypochondrium (sometimes spreads to the entire abdomen), which is aggravated by breathing, movement and coughing. The pain radiates under the left shoulder blade and in the lower back.
With an extensive infarction, a collapse may develop.
There is an increase in temperature, tachycardia, a drop in pressure, vomiting, and intestinal paresis are possible.
Muscle tension in the left hypochondrium is insignificant, palpation of the abdomen is painful.
More often, self-healing occurs.
Spleen rupture
Spleen rupture can occur in two situations: 1. Spontaneously, if the spleen is pathologically changed as a result of leukemia, mononucleosis, liver cirrhosis, etc., it is enlarged and its capsule is thinned. In this case, a rupture can occur even for no apparent reason or with the slightest injury to the abdomen. Therefore, with an enlarged spleen, great physical exertion and contact sports are contraindicated. 2. Rupture of a healthy spleen occurs during strong blows or injury. The presence of an injury to the trunk or a blow to the left side immediately before the disease is very important in the diagnosis.
The moment of rupture is most often manifested by fainting, and lasts several hours. Later, pain appears in the left hypochondrium, sometimes it covers the entire abdomen, sometimes it radiates to the left shoulder. The pain is sharp, but not as severe as with peritonitis.
Then there may be signs of irritation of the peritoneum with slight tension in the abdominal muscles. Shchetkin-Blumberg's symptom is not always positive.
During rupture of the spleen, large amounts of blood enter the abdominal cavity, causing all the signs of internal bleeding: a feeling of flashes of light before the eyes, cold, moist and pale skin, dizziness, cold sweat, weakness, rapid thready pulse, decreased pressure, lethargy, confusion . Shock does not always develop.
Patients take a position on the left side with legs bent to the stomach.
On palpation, pain is present, but muscle tension is weak.
A ruptured spleen always requires surgery.
Liver rupture
The reason is abdominal trauma.
Often occurs simultaneously with rupture of the spleen.
Signs of internal bleeding are mild, because. the liver does not bleed as much as the spleen, but the general condition is always worse when the liver ruptures, because. almost always accompanied by shock.
The pain is expressed more in the right hypochondrium.
When the liver ruptures, jaundice sometimes develops, because blood clots can clog the bile duct.
The prognosis for a ruptured liver is always worse than for a ruptured spleen.
Strangulated hernia
A hernia is a protrusion of organs located in the abdominal cavity with a parietal sheet of the peritoneum into the spaces between the muscles or under the skin through natural anatomical openings or acquired after trauma and surgery.
Most often there are inguinal, umbilical, postoperative hernias.
The cause of hernia is an increase in intra-abdominal pressure, which increases during severe physical activity, with constipation, difficult childbirth, prolonged strong cough.
A hernia can develop even after a single increase in intra-abdominal pressure, for example, when lifting heavy objects.
A hernia can be in a person for a long time and not disturb. But sometimes the hernial contents come out through the hernial opening and are not reduced. The result is abuse.
Infringement of the intestine is especially dangerous, because. plus, to the violation of blood circulation in it, intestinal obstruction with severe intoxication is added.
When a hernia is infringed, regardless of its location, the symptoms will be the same:
Acute pain with physical exertion and not decreasing after its cessation.
Severe pallor of the skin, tachycardia, drop in blood pressure, anxiety.
If you cough with your hand on the hernia, you can feel that the cough impulse is not transmitted to it.
There may be vomiting, sometimes with a fecal odor, bloating.
With infringement of the intestine, signs of intestinal obstruction develop.
In case of prolonged infringement, suppuration of the hernia occurs with high temperature, intoxication, severe swelling and redness in the area of the hernial protrusion.
Subsequently, peritonitis may develop.
At the location of the hernia, a dense rounded formation is determined.
Don't try to fix the hernia yourself! You can do it wrong and cause further complications. Urgently call an ambulance, and before it arrives, you need to lie on your back, put a container of ice on the area of \u200b\u200bthe hernial protrusion and drink an antispasmodic (baralgin or no-shpu).
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