Causes of Stomach Pain and How to Stop them

1. Peptic Ulcer Disease 

Epigastric pain is the most common symptom of ulcers in the lining of the lower esophagus, the stomach, and the first part of the small intestine. An ulcer in the stomach is known as gastric ulcer whereas an ulcer of the first section of the small intestine is called a duodenal ulcer. Together these disorders are known as peptic ulcer disease (PUD).

The epigastric pain of PUD is characterized by a gnawing or burning sensation and occurs after meals, classically, shortly after meals with gastric ulcer and 2-3 hours afterward with duodenal ulcer

Antacids can provide rapid pain relief by neutralizing existing stomach acid. However, they are not considered useful enough to promote healing.

2. Gallstones

Abdominal pain caused by gallstones is called biliary colic.

Bile is a liquid that helps to digest fats. It is produced by the liver and stored in the gallbladder. When we eat, bile passes from the gallbladder through the bile ducts into the small intestine, where it mixes with partially digested food.

Biliary colic is a steady or intermittent ache usually located in the right upper quadrant of the abdomen. Sometimes the pain spreads backward to the right shoulder blade.

Biliary colic is usually caused by gallstones blocking the normal flow of bile from the gallbladder.  A tumor can also block bile flow and cause biliary colic. The worst pain of biliary colic usually lasts for 30 minutes to an hour but may continue at a lower intensity for several more hours. The pain stops when the gallstone breaks free of the bile duct and passes into the intestine.

 

 

3. Intestinal Obstruction

Intestinal obstruction is a blockage that keeps food or liquid from passing through the small or large intestine.

There may be several underlying causes including fibrous bands of tissue (adhesions) in the abdomen that form after surgery, inflammatory bowel disease (IBD), diverticulitis, twisting of the colon (volvulus), impacted feces, hernias, and cancer.

The symptoms include crampy abdominal pain that comes and goes in waves, loss of appetite, swelling of the abdomen, vomiting, and inability to have a bowel movement or pass gas.

Treatment of intestinal obstruction depends on the underlying cause.

4. Acute Cholecystitis

Acute cholecystitis is an inflammation of the gallbladder. In most cases, gallstones blocking the transport of bile from the gallbladder are the underlying cause of cholecystitis.

Usually, patients with acute cholecystitis experience steady, severe upper right quadrant or epigastric pain. Nausea and vomiting are sometimes present.

Usually, there is associated fever and elevated leucocyte (white blood cells) count in the blood suggesting inflammation.

Palpation of the abdomen usually reveals tenderness in the right upper quadrant of the abdomen. Murphy’s sign is typically present.

Hospitalization is usually necessary. Treatment is based on fasting, pain medication, antibiotics if an infection is present, and cholecystectomy.

5. Acute Cholangitis

Acute cholangitis occurs when gallstones become impacted in the biliary ducts resulting in blockage of bile flow and dilatation of the ducts leading to a bacterial superinfection.
Acute cholangitis is characterized by fever, jaundice, and abdominal pain, known as Charcot’s triad.

Jaundice is a term used to describe yellowing of the skin and the whites of the eyes. It is caused by the build-up of a substance called bilirubin in the blood and tissues of the body.
Bilirubin is excreted in the bile.

Blockage of bile flow in cholangitis cause accumulation of bilirubin in the body, leading to jaundice.
Cholangitis is a serious medical condition.

Treatment includes fasting, and intravenous fluids need to be administered. The infection is treated with broad-spectrum antibiotics.

 

6. Sphincter of Oddi Dysfunction

A sphincter is a muscle that can open and close. The sphincter of Oddi is a muscular valve that controls the flow of bile and pancreatic juice through ducts from the liver and pancreas into the first part of the small intestine (duodenum).

When it’s working properly, the sphincter of Oddi opens to allow bile and pancreatic juice to flow through and then closes again.

When sphincter of Oddi dysfunction is present, the sphincter muscle does not open when it should. This prevents the bile and pancreatic juice from flowing through, causing bouts of severe pain in the right upper quadrant of the abdomen. Nausea, vomiting, fever, chills, and diarrhea may sometimes be present as well.

7. Gastritis

Gastritis is an inflammatory process affecting the lining of the stomach.

Gastritis, similar to stomach ulcer is sometimes caused by an underlying infection with H pylori. 
The symptoms of gastritis include a gnawing or burning ache or pain in the epigastrium. Sometimes there is nausea and vomiting.

Common over the counter pain relievers, such as aspirin, ibuprofen (Advil, Motrin IB, others), and naproxen (Aleve, Anaprox) can cause gastritis. Stress and excessive alcohol consumption are also common underlying causes.

If left untreated, gastritis may cause stomach ulcers and stomach bleedings.
Medical treatment is essentially same as that of peptic ulcer disease and GERD.

 

8. Pancreatitis

Pancreatitis is an inflammation of the pancreas. It can be both acute and chronic.

The main symptoms of acute pancreatitis are abdominal pain, nausea, vomiting, and sometimes diarrhea.

The pain is characteristically dull, boring, and steady; usually sudden in onset and gradually becoming more severe until reaching a constant ache; most often located in the upper abdomen and may radiate directly through to the back.
Gallstones and binge alcohol consumption are the most common underlying causes of acute pancreatitis.

Serum levels of amylase and lipase are typically elevated in acute pancreatitis.

9. Disorders of the Spleen

Left upper quadrant pain is sometimes related to diseases of the spleen.

Enlargement of the spleen (splenomegaly) may cause pain or discomfort in the upper left upper quadrant of the abdomen, sometimes radiating to the left shoulder.

Splenic infarction may cause severe left upper quadrant pain.