Pathological Belly Pain

A stomach ache is an alarm signal sent by the body, a request for help to warn that some metabolic mechanism has gone haywire.

Pathological abdominal pain

The pathological stomachache is distinguished by its common form due to the danger of the disorder, the intensity of pain and the "satellite" (accompanying) symptoms.

While the common stomach ache is often self-resolvable, without necessarily intervening with drugs or medical treatments, the pathological form requires specific and more complex diagnostic tests, and pharmacological or surgical therapies.

When the stomach ache is subordinated to serious pathologies, such as appendicitis, the promptness of intervention (surgical, in this specific case) heavily affects the patient's prognosis, or rather the final outcome: an untreated appendicitis can generate peritonitis until death.

Diagnosis

A "suspicious" abdominal pain requires a thorough investigation (to be performed as soon as possible) by means of diagnostic tests such as: blood, urine and faeces analysis, computed tomography, colonoscopy or sigmoidoscopy *, addminal ultrasound, abdominal radiography and barium enema **.

To understand...

* Sigmoidoscopy: diagnostic test aimed at visually exploring the anus, rectum and sigmoid colon using a flexible probe introduced through the anal orifice

** Clisma opaque: radiological test of the large intestine, favored by the rectal introduction of a contrast medium

Causes

But what can cause "pathological" stomach pain?

There are many and varied disorders that are hidden under a "simple" stomach ache. Below are the most common diseases related to pathological belly pain:

  • APPENDICITIS : abdominal pain caused by appendicitis is distinguished by the particular intensity and ferocity with which it manifests itself. The pain is well localized in the right lower abdominal quadrant and the patient perceives an abnormal "abdominal" pain. Thermal alteration is another symptom that always accompanies appendicitis: in particular, fever measured via the anal canal appears much higher than the temperature measured in the armpit. Appendicitis can also cause diarrhea, bloating and abdominal bloating.
  • KIDNEY-CALCULATIONS / CALCULATIONS AT THE CISTIFELLEA : belly-ache, always fierce, spastic and acute, is accentuated during urination, inter alia hampered by the passage of any stones through the ureter. Abdominal pain is often accompanied by hematuria (blood in the urine), fever, hypotension, intense sweating, nausea and vomiting.
  • COLECISTITE (inflammation of the gallbladder) : abdominal pain due to cholecystitis is circumscribed to the upper right region of the abdomen and worsens with palpation (for this reason, differential diagnosis with appendicitis is required). Abdominal pain is, in this case, accompanied by fever, jaundice, loss of appetite, vomiting and sweating.
  • DIVERTICOLITIS : stomach ache is a constant in the forms of diverticulitis at an advanced stage. Precisely, the stomach ache is cramped and is accompanied by diarrheal discharges or constipation and fever. The differential diagnosis between a diverticulitis and a appendicitis-dependent tummy or cholecystitis is relatively simple, since the pain - although intense and fierce - is concentrated in the lower left abdominal quadrant.
  • INFARTO : sometimes, a very particular stomach ache can anticipate a heart attack. In these cases, a stomach ache spreads even higher, causing stomach pain and chest pain. The heart attack can appear under different clothes; therefore, those who are predisposed to it should respect all possible precautions to prevent such a serious pathology.
  • INFECTIONS OF URINARY TRACKS (eg cystitis): in such circumstances, pathological abdominal pain embodies the burning in the urinary tract accompanied by the difficulty in expelling urine. More than a characteristic symptom, abdominal pain is, in this case, a reflection of the urinary stimulus, hindered by the infection in progress. Targeted antibiotic therapy is necessary to effectively prevent infection and related symptoms.
  • INTESTINAL INFLAMMATORY DISEASES (Crohn's disease, ulcerative rectal colitis, ischemic colitis, etc.): abdominal pain is quite generalized, and often involves the stomach. Inflammatory bowel diseases associate abdominal pain with secondary symptoms such as vomiting, diarrhea, bloody stools, rectal tenesmus, loss of appetite and mucorrhea (presence of mucus in the stool). The stomach ache dependent on these pathologies is a vague and generic symptom, difficult to be associated (at least immediately) with a precise disease.
  • INTESTINAL OBSTRUCTION : abdominal pain caused by an intestinal block, which is typically accentuated even more by palpation, is accompanied by other secondary symptoms, such as fever, nausea, vomiting, diarrhea, abdominal cramps and profuse abdominal pain. This form of pathological stomach ache requires timely medical intervention, to avoid necrosis (death) of intestinal tissues, which can perforate and lead to peritonitis.
  • PANCREATITIS (inflammation of the pancreas): more than with a stomach ache, pancreatitis begins with a violent abdominal pain, at the site where the pancreatic gland is located. However, abdominal pain does not remain localized in the stomach, rather it tends to extend even lower (in the belly area) and along the back. Abdominal pain tends to be accentuated after meals and with deep breaths.
  • IRRITABLE COLON SYNDROME : abdominal pain assumes a typically cramp-shaped connotation and is accompanied by symptoms such as aerophagia, meteorism, flatulence, hard stools, mucorrhea and rectal tenesmus.
  • Colorectal tumors, pancreatic cancer, liver neoplasia etc .: tummy-related abdominal pain does not normally manifest itself in acute form and the pain is not particularly aggressive. Tumors are infamous and terrible pathologies, which do not always manifest their symptoms, especially at an early stage. The "oncological" abdominal pain - which (we specify) may or may not appear - is a generalized, chronic pain, which can be intermittent or constant, and hardly leads immediately to an ongoing cancer. The therapy must be aimed at eliminating the tumor mass: in the case of a positive prognosis, the stomach ache disappears completely.

Even gastritis can cause abdominal pain: in this case, however, rather than a stomach ache, it would be appropriate to speak of stomach pain, given that gastritis is an inflammation of the gastric mucosa.

Interpret a stomach ache

It is essential to be able to distinguish a minor tummy ache from its pathological variant. For this reason, it is essential to recognize which spy signals require immediate medical intervention. Unfortunately, the two forms of bellyache (common and pathological) are not always able to be simply differentiated, given that the causes of origin are very variable among them. According to this, it is easy to understand how a thorough investigative investigation is needed through specific diagnostic tests (eg blood tests, x-rays, faeces and urine tests, etc.).

A single episode of abdominal pain, as well as an abdominal pain that regularly begins near the menstrual cycle or after a particularly abundant meal, must not alarm and must be interpreted as a passing and completely reversible phenomenon.

Considering that a stomach ache is a multi-faceted disorder, here are some general examples, useful for directing the patient towards a first and approximate diagnosis. We emphasize, however, that the opinion of the doctor is in any case unavoidable.

  • Case 1: abdominal pain is generalized (the precise point from which it originates cannot be identified), accompanied by diarrhea and vomiting → typical pain due to gastro-intestinal viral infections, indigestion or intake of deteriorated food
  • Case 2: abdominal pain is spastic / crampy and the patient suffers from constipation and abdominal distension → typical abdominal pain due to intestinal obstruction
  • Case 3: the stomach ache is bearable, but accompanied by flatulence, meteorism and / or diarrhea → probably, the origin of the stomach ache depends on a particularly abundant meal or the introduction of food to which one is intolerant
  • Case 4: Abdominal pain is severe and well localized in a specific area of ​​the abdomen → abdominal pain can be an indicator light of appendicitis, gall bladder or cholecystitis
  • Case 5: abdominal pain occurs during the cycle and is effectively relieved by taking analgesic drugs - painkillers or natural remedies → bellyache is a typical symptom of dysmenorrhea
  • Case 6: the stomach ache is intermittent and accompanied by colic. It appears suddenly, and then progressively regresses → the stomach ache depends on renal or biliary colic

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