Stomach pain

Stomach pain is a common problem.

Abdominal pain can be caused by inflammation of an organ (e.g. appendicitis, diverticulitis and colitis), by distention and oedema of an organ (e.g. intestinal disorders, obstruction of the bile duct by gallstones, hepatitis) or by a disturbance in the blood supply to an organ, etc.

The cause of abdominal pain is not always in the abdomen – it can also be caused by, for example, pneumonia or problems in the pelvic area.

At the same time.

Stomach pain can also occur without inflammation, oedema or problems with blood supply. Irritable bowel syndrome, stress and psychological experiences can also cause them.

Only 20 to 25% of abdominal pain is due to a serious condition such as acute appendicitis, acute pancreatitis, rupture of a gastric ulcer, intestinal obstruction, etc., and the cause of the pain is often not clear.

Most cases of stomach pain are caused by indigestion, especially if it occurs immediately or about 30 to 60 minutes after eating.

Here’s everything you need to know about stomach pain, its possible causes and when to seek emergency medical attention.

Common causes and symptoms of stomach pain

Stomach pain can be caused by a variety of reasons.

A 2023 study found that the most common causes of non-traumatic abdominal pain lasting less than 7 days are:

1. Gastroenteritis.
2. Non-specific abdominal pain (meaning the doctor has not identified the cause of the pain).
3. Gallstones.
4. Kidney stones.
5. Diverticulitis.
6. Appendicitis.

1 Gastroenteritis

Gastroenteritis (also called stomach flu) can be caused by viruses, bacteria and parasites.

In this case, abdominal pain is often accompanied by nausea, vomiting and watery diarrhoea. Viral gastroenteritis can also sometimes cause fever and dehydration.

2 Gallstones

Gallstones can form if:

• Too much bilirubin or cholesterol in the bile, or not enough bile salts.
• The gall bladder does not empty fully or does not empty often enough (for example, if you lose weight too quickly).

If stones do not block the bile ducts and bile does not accumulate in the gallbladder, a person usually does not experience any symptoms.

But.

If gallstones block the bile ducts – you may have pain in the right side of your upper abdomen. This abdominal pain can last for several hours.

3 Kidney stones

Kidney stones can form in one or both kidneys if the urine contains high levels of calcium, oxalate or phosphorus.

Seek medical help immediately if you experience any of these symptoms:

• Sharp pain in the lower abdomen, side, back or groin.
• Blood in the urine (pink, red or brown).
• The constant need to urinate.
• Pain when urinating.
• Inability to urinate or only urinating small amounts.
• Urine is cloudy or has a foul smell.

Kidney stones can also cause:

• Nausea.
• Vomiting.
• Fever or chills.

4 Diverticulitis

Diverticulitis is inflammation of the diverticula (irregular bulges in the colon in the form of sacs). It can cause abdominal pain, usually in the left lower abdomen.

Other symptoms of diverticulitis include:

• Diarrhoea or constipation.
• Nausea.
• Vomiting.
• Chills or fever.

5 Appendicitis

Appendicitis is inflammation of the appendix. It can cause abdominal pain, which can:

• Start at the navel and move lower and to the right.
• Start suddenly, may even wake up someone asleep.
• Get worse during movement, deep breathing, sneezing or coughing.
• Be severe and different from any pain you have felt before.
• Appear before other symptoms and worsen within a few hours.

Other symptoms of appendicitis may include:

• Fever.
• Loss of appetite.
• Nausea.
• Vomiting.
• Bloating.
• Intestinal upset (diarrhoea, constipation, inability to pass gas, etc.).

If you suspect you or someone else has appendicitis, call the emergency immediately.

6 Trapped gases

Gas in the stomach is caused when bacteria in the small intestine break down foods that the body finds intolerant or when people swallow more air than usual while eating.

Gas in the stomach can cause bloating and abdominal pain.

7 Irritable bowel syndrome

It is still not known exactly what causes irritable bowel syndrome, but abdominal pain is the main symptom of the condition in many people. It often occurs alongside bowel movements and can manifest as constipation or diarrhoea.

Other common symptoms include:

• Bloating.
• Feeling that the bowel movement is incomplete (feeling that you have not completely emptied the stool).
• Mucus in the stool.

8 Gastroesophageal reflux or regurgitation

Gastroesophageal reflux (acid reflux) or regurgitation is the expulsion of stomach acid into the oesophagus and/or pharynx.

It most often occurs briefly, after eating, and causes burning pain behind the breastbone.

Acid reflux can also cause:

• Abdominal pain.
• Difficulty swallowing.
• Bloating.
• Nausea.
• Belching.

9 Constipation

Constipation increases pressure on the large intestine, which can cause abdominal pain.

Constipation can occur for many reasons, the most common are:

• Too little fibre or fluid in the diet.
• Low levels of physical activity.
• Taking certain medications.
• Pregnancy.

Constipation can also be a sign of a neurological disorder or bowel obstruction, so if constipation is frequent or long-lasting – consult a doctor.

10 Food intolerances

Food intolerance is a condition where the body has difficulty digesting certain foods or food ingredients.

For example – Lactose (milk sugar) intolerance – where the body does not have enough Lactase enzyme and may have problems breaking down the sugars in dairy products.

Food intolerances can cause stomach pain and other symptoms such as:

• Bloating.
• Flatulence.
• Diarrhoea.

11 Food poisoning

Viral or bacterial food poisoning can cause abdominal pain, diarrhoea and vomiting.

Symptoms can start within minutes or a week or more after eating spoiled food. The duration of symptoms depends on the type of bacteria or virus ingested, but they often disappear on their own.

However.

If symptoms become severe or persist for several days – seek help in an emergency.

12 Peptic ulcers

Peptic ulcers are ulcers on the lining of the stomach, small intestine, or oesophagus.

Up to 70% of people with peptic ulcers do not notice any symptoms. The rest most often report the pain in the centre of the upper abdomen.

Other symptoms may include:

• Bloating.
• Expectoration.
• Feeling full too quickly when eating.
• Feeling uncomfortable or nauseous after eating.
• Vomiting.

The most common causes of stomach and peptic ulcers are Helicobacter pylori bacteria and excessive or prolonged use of non-steroidal anti-inflammatory drugs like ibuprofen.

13 Crohn’s disease

Crohn’s disease causes inflammation of the lining of the digestive tract and usually causes abdominal pain.

Other symptoms may include:

• Unexplained weight loss.
• Diarrhoea.

Symptoms may vary depending on the location and severity of the inflammation. Stress and certain foods can aggravate them, for example, spicy or caffeinated foods, alcoholic beverages, etc.

14 Coeliac disease

Coeliac disease occurs when a person is allergic to gluten (a protein found in grains). Coeliac disease causes damage to the small intestine, which in turn can cause abdominal pain.

Other symptoms may include:

• Chronic diarrhoea.
• Bloating.
• Flatulence.
• Lactose intolerance.
• Nausea.
• Vomiting.

15 Pulled or strained muscles

Abdominal muscles are involved in many everyday activities and sometimes their tightness or injury causes pain.

Abdominal pain can also occur as a result of physical exercise, for example as a result of doing more squats than usual, etc.

The best remedy in such cases is rest or, in the case of severe pain, ice packs. If the pain persists for 2-3 days, consult your doctor.

16 Menstrual cramps or endometriosis

Menstruation can cause inflammation and abdominal pain. Menstruation can also cause bloating, gas, cramps and constipation.

Endometriosis is a condition in which tissue that normally grows in the uterus develops in other parts of the body, typically in the pelvic area but sometimes elsewhere.

People with endometriosis may experience intense or mild abdominal or back pain during and between periods and, in some cases, severe menstrual cramps.

Other causes of abdominal pain

• Kidney infection.
• Hepatitis.
• Gastritis.
• Ectopic pregnancy.
• Infection or infarction of organs in the abdominal cavity (when an organ fails due to lack of blood supply).
• Heart problems such as atypical angina or heart failure.
• Cancer, in particular stomach, pancreatic or bowel cancer.
• Hernias.
• Cysts.

Stomach upset with no clear cause

You have stomach pain, feel bloated and/or overfed, are nauseous, have a squeezing or burning sensation in your abdomen…

The discomfort usually starts during a meal or maybe half an hour later.

If this happens often, you should consult your doctor.

If your doctor does not find any worrying symptoms – functional dyspepsia is the most likely diagnosis, which means recurring stomach upsets for no obvious cause.

Functional dyspepsia does not usually have a medical solution either.

But.

Here are some approaches that can be very effective:

Eat right

• Eat a complete and balanced diet, rich in fruit, vegetables, lean protein and whole grains.
• Avoid foods that trigger symptoms. Common culprits include caffeine, chocolate, alcohol and spicy, acidic or fatty foods.
• Eat less, but more often, so that the stomach does not expand and can empty quickly.
• Do not skip meals (especially breakfast).
• Eat slowly and chew your food completely.
• Drink enough water.
• Avoid activities that cause swallowing excess air, like eating quickly, chewing gum, drinking fizzy drinks and smoking.
• Avoid eating within two hours before going to bed.
• Maintain your weight at a healthy level.

Move

• Do 20 to 40 minutes of aerobic/cardio exercise three to five times a week – walking, jogging, cycling, swimming, dancing, mowing the lawn or any other activity that gets your heart beating faster.
• Do 20-30 minutes of strength training targeting all major muscle groups at least twice a week (lifting weights, exercises with resistance bands or your body weight such as push-ups, squats and lunges.
• Don’t forget to warm up to prepare your body for exercise and to cool down after exercise to help your body recover and prevent injury.
• Do a variety of exercises to avoid boredom and overuse injuries caused by repetitive movements.

Reduce stress

• To calm the nervous system, practice deep, slow breathing, such as diaphragmatic or 4-7-8 breathing.
• To reduce physical tension and promote relaxation, tense and then slowly release different muscle groups.
• Exercise – besides being good for overall health, it is a proven stress reliever.
• Use relaxation and meditation techniques to relieve stress, for example – focus on the present moment and observe your thoughts and feelings as if from the outside, or follow a recorded meditation guide that will lead you through a relaxation session.

Reduce fatigue

• Try to go to bed and get up at the same time every day.
• Prioritise – focus on the important tasks first and break them down into more manageable steps.
• Set boundaries – learn to say ‘no’ to avoid over-exertion and give yourself time to rest.
• Avoid caffeine after noon.

Home remedies for stomach pain

1 Ginger

Ginger has natural anti-inflammatory and antioxidant properties that can help to “calm” the digestive tract – make ginger tea or eat some candied ginger.

2 Peppermint

Peppermint oil can relax the muscles of the gastrointestinal tract, thus relieving spasms and pain – drink peppermint tea or take peppermint oil capsules.

3 Chamomile tea

Chamomile has anti-inflammatory properties and can help relax the digestive tract, relieving pain and cramps – brew chamomile tea and drink it warm.

4 Fennel seeds

Fennel seeds have carminative properties which can help reduce gas and bloating – chew fennel seeds after meals or drink fennel tea.

5 Probiotics

Probiotics can help balance the gut flora and improve digestion by reducing abdominal pain caused by dysbiosis – regularly eat foods rich in probiotics such as yoghurt, kefir, sauerkraut or other vegetables, etc.

6 BRAT diet

The BRAT diet (Bananas, Rice, Applesauce, Toast) is recommended to soothe the stomach, and relieve symptoms of diarrhoea and nausea – eat only bananas, rice, applesauce and toast for a few days.

But.

Remember that these foods do not provide your body with everything it needs.

So.

Follow this diet for no more than 2-3 days.

When should I call for medical help?

In most cases, abdominal pain is not long-lasting and does not have serious consequences.

However.

Several symptoms require medical attention:

• Abdominal pain that quickly gets worse.
• Abdominal pain or bloating that does not go away or keeps coming back.
• Abdominal pain and difficulty swallowing food.
• Unexplained weight loss.
• Sudden, unexplained need to urinate more or less often than usual.
• Sudden pain when urinating.
• Unusual vaginal discharge.
• Minor rectal bleeding or blood in stool.
• Diarrhoea or constipation does not go away after a few days.

Symptoms requiring emergency medical attention:

• Very sudden or severe abdominal pain.
• Severe abdominal pain if the pregnancy lasts less than 16 weeks.
• Pain on touching the abdomen.
• Vomiting with blood or vomit that looks like ground coffee.
• Bloody or black stools that are sticky and very foul-smelling.
• Inability to urinate.
• Inability to pass stool or gas.
• Difficulty breathing.
• Chest pain.
• Vomiting (in people with diabetes).
• Fainting or unconsciousness.

Key takeaways

Almost everyone has had a tummy ache.

In most cases, the abdominal pain is not long-lasting and serious.

However.

Severe or chronic abdominal pain may be a sign of a medical condition, so consult your doctor and try to find out the cause of the pain.

In case of sudden or severe abdominal pain, call an ambulance immediately.

Stomach problems can be temporary, appear and disappear, or appear only after eating. These are factors pointing to the cause of the problem.

If you suspect you are gluten or lactose intolerant – exclude products containing wheat, rye, and barley or dairy products from your diet for 2-3 weeks. If you feel better and get worse again when you start eating these products again, try to eliminate them from your diet.

Remember that only 20 to 25% of abdominal pain is caused by a serious illness.

In other words, 75 to 80% of abdominal pain is caused by your lifestyle and eating habits.

This is well illustrated by the feedback from my slimming challenges – starting to eat a balanced diet, the weight goes down, the blood pressure normalises, the cholesterol goes down, the well-being improves, the feeling of lightness appears…

I wish you the same.

Eat well, eat balanced, move and be healthy!