stomach pain
and Carola Felchner, science journalistHanna Rutkowski is a freelance writer for the medical team.
More about the expertsCarola Felchner is a freelance writer in the medical department and a certified training and nutrition advisor. She worked for various specialist magazines and online portals before becoming a freelance journalist in 2015. Before starting her internship, she studied translation and interpreting in Kempten and Munich.
More about the experts All content is checked by medical journalists.Everyone has probably had abdominal pain before: oppressive intestinal cramps, pinching stomach pain left or right, sometimes in combination with nausea, vomiting and indigestion. They often appear after a large meal or as an upset stomach after a meal. Usually the cause is not of concern. But abdominal pain can also be dangerous and must then be treated immediately! Find out here which are the signs of harmless stomach cramps and which you shouldn't ignore.
Brief overview
- Description: Pressing, stabbing, rumbling or cramping of varying severity in the abdominal area, continuous or wave-like. The source of pain is often difficult to pinpoint clearly.
- Causes: often harmless (e.g. too large a meal), sometimes also diseases such as gastrointestinal flu, gastric mucosal inflammation, gastric ulcer, heartburn, reflux disease, appendicitis, diverticulitis, intestinal obstruction, gallstones, hernia, heart attack, pneumonia, etc.
- When to the doctor If you have very severe or worsening abdominal pain, a hard, bloated abdominal wall, blood in your stool, vomiting, high fever or fainting.
- Diagnostics: Talk to the patient, palpation and listening of the abdomen, if necessary additional examinations depending on the suspicion, e.g. blood test, ultrasound, gastroscopy, laparoscopy, hydrogen breath test
- Treatment: depending on the cause, e.g. B. with home remedies (tea, hot water bottle, relaxation, etc.), medication, sometimes with surgery
Abdominal pain: description
Pulling, cramping, grumbling - abdominal pain manifests itself in different ways. Sometimes they are the only symptom, but most often they are accompanied by nausea, vomiting, fever, diarrhea, constipation and / or gas.
Abdominal pain can have both harmless and serious causes. A large meal or menstruation can cause abdominal pain as well as damage to or disease of internal organs: the stomach (medical abdomen) houses other organs in addition to the stomach and intestines, all of which can cause complaints. First and foremost, there is something wrong with the digestive organs when there is abdominal pain.
Abdominal pain: causes and diseases
As different as abdominal pain can express itself, the causes are just as varied. Depending on where the pain is noticeable (upper abdomen, lower abdomen, entire abdomen), the cause can be narrowed down.
Upper abdominal pain
Pain in the upper abdomen can originate from one of the organs located there. These include the stomach, duodenum, liver (right), gall bladder (on the underside of the liver), spleen (left behind the stomach) and pancreas (more centrally behind the stomach). Other organs such as the heart or lungs can also trigger upper abdominal pain. The main causes of upper abdominal pain are:
- Heartburn, reflux disease: Burning, ascending pain behind the breastbone, in the upper abdomen and possibly up to the neck, as well as occasional acid regurgitation are the main symptoms. Most often, they appear after a large, high-fat meal. Repeated contact with the aggressive stomach acid can inflame the lining of the esophagus (reflux esophagitis), which causes further pain.
- Irritable stomach: The digestive problems appear as cramp-like abdominal pain and independently of the food.Often there are also feelings of fullness, gas and loss of appetite.
- Inflammation of the stomach lining: Common signs of gastritis are bloating, pain in the upper abdomen, poor appetite, nausea, vomiting, heartburn, belching, and bad breath.
- Gastric ulcer (Ulcus ventriculi): Typical are severe upper abdominal pain in the middle or on the left side and usually immediately after eating. Over time, the symptoms subside (often until the next meal).
- Duodenal ulcer (Ulcus duodeni): Characteristic of this ulcer is fasting pain that suddenly occurs at night or a few hours after a meal in the middle upper abdomen and is relieved by eating.
- Gallstones: Depending on the location and size of the stones, abdominal pain of varying intensity occurs, usually on the right side of the upper abdomen and after a high-fat meal. In the worst case, biliary colic develops with sudden, severe pain in the upper abdomen, which can radiate into the shoulder and back. In addition, there is often a fever, chills and vomiting.
- Liver disease: Liver damage often manifests itself in the form of tenderness under the right costal arch or epigastric cramps. In the case of hepatitis and cirrhosis of the liver, the abdominal pain cannot be precisely localized. In addition to the pain, jaundice, decreased performance, fatigue and loss of appetite can occur.
- Inflammation of the pancreas (pancreatitis): Inflammation of the pancreas causes very severe, colicky abdominal pain, which often runs in a belt-shaped manner around the upper abdomen. Usually there are other symptoms such as vomiting, loss of appetite, nausea, bloating, fever or jaundice.
- Heart diseases: Both chest pain (angina pectoris) and heart attack can cause pain in the abdomen as well as chest pain. A heart attack can manifest itself in severe abdominal pain, especially in women. Other signs of such heart problems include shortness of breath and shortness of breath. Then call the emergency doctor immediately!
- Pneumonia: Due to the anatomical proximity to the chest, upper abdominal pain can also be a sign of pneumonia.
- Vertebral problems: Problems in the area of the spine (such as a blockage of the thoracic vertebrae or a vertebral body fracture) sometimes also cause discomfort that radiates into the abdomen and can be felt as upper abdominal pain.
- Abdominal aortic aneurysm: This is a pathological bulging of the main artery (aorta) in the abdominal area. Such an aneurysm sometimes causes pain centrally or across the entire abdomen. Above a certain size, it can also press on neighboring nerves, which, in addition to radiating pain in the upper abdomen, can cause discomfort in the legs. Caution: The aneurysm can suddenly rupture - then there is a mortal danger!
- Cancer: Tumors (such as stomach cancer, liver cancer) can also cause pain or a feeling of pressure in the upper abdomen. Usually other symptoms such as bloating, loss of appetite, weight loss or fatigue occur.
- Porphyria: This term covers a group of metabolic diseases in which the structure of the red blood pigment "heme" is disturbed. Instead, toxic intermediate products are created that damage the liver, among other things. Those affected often suffer from severe cramp-like abdominal pain in episodes.
Pelvic pain
Abdominal pain below the navel often emanates from the intestines. Urinary tract diseases and gynecological problems can also be responsible for pelvic pain.
- Appendicitis (appendicitis): It usually begins with sudden, severe abdominal pain in the navel area, which then extends to the right lower abdomen. The pain increases when jumping, walking, sneezing and coughing, the abdominal wall is tense and very sensitive to pressure. This is often accompanied by fever, loss of appetite, nausea and vomiting.
- Chronic inflammatory bowel disease: Ulcerative colitis manifests itself as bloody diarrhea with simultaneous cramping abdominal pain. With Crohn's disease, painful cramps occur again and again, especially in the area of the lower right abdomen, but also over the entire area. Diarrhea, fever and weight loss also occur.
- Urinary tract infections: A urinary tract infection can also be the cause of pelvic pain. Often the symptoms are dull, but in the case of a bladder infection they tend to be cramp-like and in the case of ureteric colic or a stone loss caused by it, they appear in waves.
- Renal colic: Both kidney stones and pelvic inflammation can cause colic-like pain in the lower abdomen. These sometimes radiate into the flanks and back. Sometimes they are so strong that nausea and vomiting result.
- Inguinal hernia: It is mostly men in whom the intestine breaks through into the inguinal canal. A sign of this is a drawing pain in the groin with a visible and / or palpable swelling in the groin area.
- Diverticulitis: This disease is characterized by inflamed protuberances on the intestinal wall. Typical symptoms are dull pain, mostly in the left lower abdomen. Often there are digestive problems such as constipation, diarrhea or flatulence.
- Gynecological problems: pelvic pain in women can also originate from the genital organs. In addition to menstrual bleeding, diseases such as fallopian tube inflammation, endometriosis and ectopic pregnancy can cause pain in the abdomen.
- Inflammation of the prostate: Inflammation of the prostate (prostatitis) can cause abdominal pain in the abdomen, which sometimes extends to the back. Pain or pressure in the perineal area and discomfort when urinating are also possible.
Pain all over the abdomen
Abdominal pain can rarely be precisely located - it usually spreads over the entire stomach. Even ordinary constipation can cause abdominal pain. But other factors and diseases can also be behind pain in the entire abdomen.
- Stress: Often the psyche and a fast, hectic lifestyle hit the stomach - it comes to gastrointestinal cramps and digestive disorders.
- Gastrointestinal infection: Diarrhea with abdominal cramps all over the abdomen, vomiting and nausea, sometimes also fever and general weakness and fatigue are typical for gastrointestinal infections and light food poisoning.
- Intestinal obstruction (ileus): This acute emergency begins with colic and causes increasing pain as it progresses. In addition, stool retention or vomiting, sometimes stool, can occur. Call the emergency doctor immediately!
- Peritonitis: Abdominal pain and fever are common symptoms of peritonitis. Possible triggers are an intestinal obstruction, the rupture of a stomach ulcer or an inflamed appendix, gallstones and infected surgical scars. The same applies here: Call the emergency doctor immediately!
- Intestinal infarction (mesenteric infarction): It occurs as a result of the acute closure of an intestinal artery and begins with severe, knife-pricked abdominal pain, often accompanied by diarrhea and vomiting. The symptoms subside after a few hours, but this is deceptive. At this point in time, the section of the intestine that has been cut off from the oxygen supply is already severely damaged and even dead. In severe cases there is a risk of circulatory failure and mortal danger! If there are any signs of an intestinal infarction, see a doctor immediately!
Acute abdomen (acute abdomen)
Various of the above-mentioned causes of abdominal pain can lead to an "acute abdomen" (acute abdomen) if the course is severe. An acute abdomen is always a medical emergency! Possible causes of an acute abdomen are, for example, intestinal infarction, intestinal obstruction, rupture of the fallopian tubes in an ectopic pregnancy, peritonitis and the rupture of a gastrointestinal ulcer or an inflamed appendix.
Abdominal pain in children
Children are usually only able to tell exactly where they are in pain from primary school age. Small children in particular cannot yet correctly locate pain and point to the stomach as the cause of sore throat or ear pain, for example. To be on the safe side, parents should have their child clarify recurring abdominal pain from a doctor. There may be a disease to be treated or a food intolerance behind it.
Sudden, severe abdominal cramps and accompanying symptoms such as fever, sweating, anxiety, vomiting and diarrhea should be seen as warning signs. Then take your child to the doctor right away.
Abdominal pain during pregnancy
Many women experience pelvic pain and cramps, especially at the beginning of pregnancy. This is because as the fetus grows, the uterus and the surrounding tissue expand - usually noticeable as a strong pull. In addition, kicks or lying on their back often cause abdominal discomfort. In addition, many pregnant women suffer from digestive problems such as constipation. In such cases, a hot water bottle, digestive teas and taking a comfortable position can often help to alleviate the abdominal pain.
However, a visit to a doctor is advisable in the following cases:
- when the pain does not subside
- if the pain is worse than usual
- if the pain is accompanied by other symptoms such as fever, vomiting, nausea or bleeding
Sometimes the cause of the symptoms is harmless, for example a simple bladder infection or kidney stones. However, serious complications such as premature birth, miscarriage or ectopic pregnancy can also hide behind the symptoms.
Abdominal pain: when should you see a doctor?
Abdominal pain that expresses itself differently than usual and that goes beyond the usual pinching after a little gluttony or a glass of wine should be taken seriously in any case. Suddenly severe abdominal pain, which gets worse as the disease progresses, is always a warning sign. The sick person then usually takes a crouched position lying down, since he has the fewest complaints. That alone is a reason to see a doctor immediately. If the following symptoms also occur, you should call an emergency doctor immediately:
- hard, bloated stomach (so-called defensive tension)
- severe vomiting
- Vomiting of blood (vomit that turns red or black), vomiting of stools
- Blood in your stool or bloody diarrhea (red or black stool)
- Stool retention or urinary retention
- high fever
- Blood in the urine, severe back pain
- Fainting, cold sweat, shock
Abdominal pain: what does the doctor do?
Whether harmless or life-threatening - the doctor must find the source of the abdominal pain as quickly as possible. To do this, he will first collect the patient's medical history (anamnesis) in conversation with the patient. Questions about nutrition, digestion and lifestyle habits are just as important as a precise description of the location and characteristics of the abdominal pain and any other symptoms. The information often provides the doctor with information on the possible cause of the complaints. For example, blood in the stool indicates a source of bleeding in the intestinal tract, and colorless or light-colored stools can be signs of liver problems or biliary disorders.
During the physical examination, the doctor palpates the abdomen looking for painful areas, swellings or hardening. In addition, the doctor will listen to the stomach for intestinal noises with a stethoscope.
This can be followed by further examinations, for example:
- Laboratory tests: blood values can show which organ is no longer working properly and whether there is inflammation. Stool and urine are examined for blood, pathogens, and signs of inflammation.
- Ultrasound examination (sonography): With ultrasound, pathological changes in the abdomen can be recognized quickly and painlessly. The doctor can also perform a so-called endosonography. A flexible ultrasound probe is inserted into the digestive tract through the esophagus or anus. This ultrasound from the inside delivers even better images.
- Reflection of the stomach and intestines: In gastroscopy and colonoscopy, the digestive organs are examined from the inside with the aid of an optical device (tiny video camera). As part of the examination, the doctor can also take tissue samples (biopsy) and carry out minor surgical interventions.
- Laparoscopy: In a laparoscopy, the doctor inserts a tiny camera into the abdominal cavity through small incisions in the abdominal wall. In this way, he can detect diseases in the abdominal organs as well as carry out small surgical interventions without leaving large surgical scars.
- Hydrogen breath test: This can be used to clarify the suspicion of a food intolerance to carbohydrates such as fructose or lactose.
In order to confirm or rule out certain causes of the abdominal pain, examinations by specialists may also be necessary, for example by the gynecologist, urologist or cardiologist.
Treatment of abdominal pain depends on the cause. Sometimes taking medication is enough. In other cases, surgery is required (such as appendicitis).
Home remedies for stomach ache
You don't always have to go to the pharmacy or the doctor when your stomach is complaining. If the abdominal pain has a harmless cause such as large food or a slight gastrointestinal infection, you can often help yourself - with home remedies and natural medicine.
The following tips will help against abdominal pain:
- Artichokes, as juice or tablets, help prevent stomach pressure after a high-fat meal.
- In the case of a gastrointestinal infection with vomiting and diarrhea, the body loses fluids and salts. A water-salt-sugar mixture (homemade or from the pharmacy) compensates for the losses.
- Soda (baking powder) is supposed to help with stomach pain: A small tip of a knife is dissolved in lukewarm water and drunk.
- Reduce stress - too much work and a hectic lifestyle are often the trigger for stomach ache.
Tea for stomach ache
Herbal teas soothe the stomach and help against abdominal pain and flatulence. Are best suited
- anise
- Caraway seed
- fennel
- chamomile
- peppermint
- ginger
- Lemon balm
- Verbena
- Boldo
You can read how to prepare the tea correctly in the corresponding medicinal plants article.
Warmth for stomach ache
Warmth is a tried and tested home remedy for stomach cramps. A hot water bottle or a grain pillow (cherry stone pillow) alleviates the discomfort.
Potato wraps
A potato wrap gives off heat for a very long time - this relaxes, relieves pain and promotes blood circulation. To do this, boil the potatoes until soft, drain and let them evaporate. Place on a cloth and mash with a fork. Place an intermediate towel on your stomach, close the overlay to form a packet and place it on top. Fix with an outer cloth (e.g. towel) and let it work for 30 to 60 minutes. Then rest.
You can read more about this in the article Potato Wrap.
Belly pad with chamomile
A hot and humid belly pad with chamomile also helps against abdominal pain. To do this, pour half a liter of boiling water over one to two tablespoons of chamomile flowers and leave to stand for five minutes, covered. Strain off the plant parts.
Place a rolled-up inner cloth in a second cloth, roll the whole thing up to make a wrap. Let this soak through the hot tea with the ends hanging out and wring it out. Place the inner cloth around the stomach without creases. Wrap a dry cloth around it.
Remove the pad after 20 to 30 minutes. Then rest for half an hour. You should use a tummy pad a maximum of twice a day.
If the heat becomes uncomfortable, remove the wrap or pad immediately.
Rub in and massage
Other than tea and warmth, what you can do against stomach ache: Gently massage the stomach or rub essential oils.
Abdominal massage
A gentle stomach massage can stimulate the natural bowel movement, relieve tension and thus alleviate gastrointestinal complaints. To do this, stroke the stomach with both hands and gently pressure in a clockwise direction for several minutes.
This home remedy is particularly suitable for children.
Abdominal rubbing
A belly rub with diluted fennel, lemon balm, chamomile or caraway oil warms, relieves cramps and pain, calms and stimulates digestion. To do this, warm a few drops of oil in your hands and rub it gently into your stomach in a clockwise direction for a few minutes. Don't work with too much pressure.
Then rest well covered for about half an hour. The abdominal rubbing can be done several times a day if necessary.
Some essential oils can cause babies and young children to breathe easily. Therefore, always talk to the pediatrician before use.
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