Complaints about abdominal pain just as common as headache. Patients say “my stomach hurts”, “the stomach is twisted” or “grabbed”, “the lower abdomen is pulling”, “the stomach hurts”.

When we say that the stomach hurts, we mean a fairly large area - down from the chest and all the way to the groin. In this area there are various organs, primarily the digestive and genitourinary systems. The first includes the stomach, liver, gallbladder, pancreas, intestines. To the second - kidneys, bladder, in women - the ovaries, uterus, in men - the prostate gland. And any of these organs can hurt.

Pain comes in different forms. It is useful to distinguish exactly where and how your stomach hurts. This will allow you to more accurately describe the problem at a doctor’s appointment, and a little earlier - to separate pain caused by an accidental factor (for example, poor-quality food) from something truly alarming. The appearance of pain in the abdominal area (often in combination with other symptoms) can be a sign of a serious, dangerous disease.

The causes of abdominal pain in children are collected in a separate article (). The present one is more general.

What is abdominal pain like?

Pain can be acute or chronic.

Acute pain can be paroxysmal, or it can be constant. It can occur sharply, suddenly (in this case they sometimes say “stomach grip”), or it can be weak at first and gradually intensify. Chronic abdominal pain, as a rule, is weaker, passes, but always returns. Increased chronic pain can be caused, for example, by eating.

Force pain does not always correspond to the severity of the disease. An attack of severe pain can be caused by a banal accumulation of gases (due to overeating or specific foods) or viral infection, which does not pose a serious danger. Whereas habitual chronic pain can be a consequence, for example, of colon cancer.

Sometimes the pain is localized (the patient can clearly point to the place where it hurts), and sometimes it is distributed (a significant part of the abdomen hurts).

Causes of abdominal pain

Cramping abdominal pain (colic) caused by irritation of the nerve receptors on the inner surface of the hollow organs. In this case, a spasm of smooth muscles occurs - muscle tissue lining the corresponding organ. Such pains are usually very strong, painful, but do not last long - a few minutes, after which they pass. Attacks can follow one after another, the pain first increases, then decreases...

Attacks can be caused by the movement of stones (in the kidneys, in the gallbladder or duct, in the ureters), inflammatory diseases, and poisoning. One of the common reasons is a violation of the diet (too spicy, salty, fatty foods, excessive eating).

Attacks of pain can be combined with other symptoms - fever, chills (typical of infections and blockage of the bile ducts), changes in the color of urine and stool (with blockage of the bile ducts, the urine darkens and the stool becomes lighter).

Pain may be caused stretching of hollow organs or tension of their ligamentous apparatus(for example, due to injury). It is usually aching or drawing and may not have a clear localization.

Pain may be caused local circulatory disorders(congestion in the vessels of the abdominal cavity), the so-called “abdominal toad” is an attack of pain at the moment of greatest functional activity of the digestive organs.

Acute pain occurs when pathological structural changes or damage internal organs - inflammation, tumor growth, ulceration, rupture (perforation), transition of the inflammatory process to the peritoneal tissue (peritonitis).

Pain in the abdominal area is not always associated with diseases of the organs located there. Quite common referred pain. In this case, they say that the pain radiates: its source is elsewhere, but the patient feels pain in the abdominal area. This is possible with heart disease, pleurisy, diseases of the esophagus and in some other cases.

Abdominal pain may also psychogenic origin. Stress, emotional tension, and fear can lead to pain, in some cases quite severe.

Localization of abdominal pain: in which disease where does it hurt

Epigastric (epigastric) region

The epigastrium (epigastric region) is located in the center of the body between the costal arches, below the sternum. Pain in this area is associated mainly with diseases of the stomach (, duodenitis,). Similar pains occur after eating sour or spicy foods. With a stomach ulcer, painful sensations are possible during long breaks in eating (for example, at night). The pain is usually dull, aching, less often sharp. Painful sensations in the epigastric region can also be caused by occasional digestive problems (indigestion, heartburn). In the same area, radiating pain is possible in case of heart disease.

Right hypochondrium (stomach pain on the right side above the navel)

Left hypochondrium (stomach pain on the left side above the navel)

The stomach is not directly in the center of the body, but is shifted to the left, so pain in the left hypochondrium can also be of gastric origin (gastritis, stomach ulcer). The pancreas is also located on the left side, so pain in this area can occur with. The cause of pain can also be diseases of the spleen. Heart pain can also radiate to this area.

Periumbilical region

The intestines (small intestine) make themselves known in this area. Pain can be caused by reasons such as lack of enzymes (problems with digesting food), intestinal infection, serious inflammatory diseases (Crohn's disease, ulcerative colitis). It can also hurt here.

Left and right lateral abdominal areas

Pain displaced to one side of the mid-abdomen may be caused by problems with the urinary system. The cause may be inflammation of the urinary tract. However, with kidney disease, pain is still more often localized in the lumbar region. Pain on the side of the abdomen can be caused by constipation and gas in the colon (). The left side is more often the area where intestinal diseases take their toll. Pain here can also be a manifestation of colitis or diverticulosis.

Right iliac region (stomach hurts below the navel and on the right)

In this area, in most people, the appendix is ​​located - the vermiform appendix of the cecum. Inflammation of the appendix - appendicitis - is a dangerous disease. The development of appendicitis is usually characterized by sudden and sharp pain, but in some cases the pain may increase gradually. Sometimes the pain is initially felt in the umbilical region and only then moves to the right iliac region. There are people whose appendix is ​​located higher, and accordingly, the pain with appendicitis will have a different localization.

Pain in the lower abdomen

Pain in the lower abdomen is typical with diseases of the urinary system, and in women with gynecological diseases. It can be caused by kidney stones, inflammation of the kidneys (), prolapse of the ureter, gynecological problems: acute and subsequent adhesions, tumors and ectopic pregnancy. Depending on the location of the problem, the pain may be concentrated in the left or right iliac region or in the center (suprapubic region). Another possible cause is varicose veins of the small pelvis (more typical for women). In this case, discomfort in the lower abdomen occurs from time to time, intensifying after physical activity, shortly before menstruation or after sexual intercourse.

Also, pain in the lower abdomen, especially in the left iliac region, can be caused by intestinal diseases: inflammation of the sigmoid colon (sigmoiditis), irritable bowel syndrome, worms, colitis, intestinal dysbiosis and some other diseases.

What to do if your stomach hurts?

Be sure to consult a doctor, If:

• pain occurred for the first time;
• the feeling of discomfort in the abdomen persists for a considerable time (more than a week). If we are not talking about discomfort, but already pain, do not wait more than 1-2 days;
• bloating (flatulence) does not go away within 2 days;
• the pain is accompanied by a burning sensation when urinating (or);
• the stool is upset for more than 5 days;
• pain is accompanied elevated temperature;
• pain radiates to the chest, neck and shoulders.

If you are pregnant, the appearance of abdominal pain is a serious reason to consult a doctor.

Conditions of serious concern(emergency medical attention required):

• sudden and/or very severe pain;
• change in behavior (a person becomes lethargic, apathetic);
• painful sensations are accompanied by;
• lack of stool;
• refusal to eat;
• increased heart rate, cold sweat, pale skin;
• heat;
• tense state of the abdominal wall.

Which doctor should I contact for abdominal pain?

For outpatient treatment of abdominal pain, you should consult a doctor:

• if you suspect gastrointestinal diseases(this may be indicated by a connection between attacks of pain and food intake) – to;
• if you suspect a disease of the urinary system - to;
• for women with suspected gynecological diseases - to;
• for pain in the groin area - to or;
• in other cases - to

Many people complain of abdominal pain, but do not seek medical help. Some people don’t like doctors and hospitals, others avoid them diagnostic procedures. Some are even afraid to find out about a far-fetched, terrible diagnosis and therefore put off going to the doctor for a long time. What diseases and disorders can cause discomfort or pain in the abdomen?

Main causes of abdominal pain

Gallstones and cholecystitis

To diagnose gallbladder diseases, it is prescribed ultrasonography, as well as blood tests.

Inflammation of the pancreas causes severe, burning pain in the middle or upper abdomen. Sometimes the pain radiates to the back and chest. A person experiences nausea, vomiting, and fever. Among the main reasons for the development of pancreatitis are alcohol addiction, as well as the formation of gallstones. Pancreatitis often requires hospitalization.

As with gallbladder diseases, if pancreatitis is suspected, blood tests and an ultrasound of the abdominal organs should be performed. To prescribe appropriate studies, make an appointment with.

Inflammatory bowel disease can lead to scarring, abdominal abscesses (peritonitis), and intestinal obstruction. These serious changes manifest as abdominal pain along with diarrhea and rectal bleeding. Symptoms of IBD are chronic, but appear in cycles: they flare up and then fade away. For this reason, diagnosing the disease can be difficult.

IBD must be constantly monitored, because it leads to very serious consequences. Advanced stages of inflammatory bowel disease can lead to cancer.

Appendicitis

Inflammation of appendicitis is manifested by sudden pain in the center of the abdomen, which moves to its lower right side. Appendicitis mainly affects children and young people. Ignoring inflammation of the appendix is ​​extremely dangerous, because it can burst and cause peritonitis.

If you notice symptoms of appendicitis in yourself or your loved ones, call an ambulance immediately!

Oncological disease

This disease can affect any of the abdominal organs - liver, pancreas, stomach, gall bladder, ovaries. Pain usually appears in later stages. Other symptoms include loss of appetite and weight, persistent vomiting, and bloating.

• Diarrhea
• Nausea and vomiting
• Bloating
• Stool with blood and mucus
• Rash or itching around the rectum or vulva
• Feeling tired
• Weight loss

Lactose intolerance

Millions of people suffer from this type of food intolerance. Among its symptoms:

• Moderate abdominal pain
• Flatulence
• Belching
• Diarrhea

There is only one solution - complete or partial refusal of dairy products.

Intolerancegluten free

Gluten is a protein found in wheat, barley and rye. In people with intolerance, this protein damages the walls small intestine. As a result, its ability to absorb nutrients received from food is lost.

A person with intolerance has a stomach ache, flatulence and a feeling of fatigue. The most severe form of gluten intolerance is called celiac disease.

Spinal diseases

Up to 62% of patients with spinal diseases suffer from abdominal pain, bloating, constipation, and hemorrhoids. Such data were provided by American specialists from the University of Medicine in 2012.

Some patients who do not suffer from diseases of the gastrointestinal tract complain of abdominal pain due to orthopedic problems. If you fall into this category of people, an experienced one will do everything possible to improve the health of your spine. Perhaps it is problems with the spine that cause pain in the abdominal area.

Stress and depression

Constant stress can also cause abdominal pain. If a person develops depression, their chances of experiencing irritable bowel syndrome increase.

When to seek medical help:

• Abdominal discomfort lasting 1 week or longer
• Abdominal pain that does not subside within 24-48 hours or gets worse
• Pain with nausea and vomiting
• Bloating for more than two days
• A burning sensation during urination or frequent trips to the toilet
• Diarrhea that lasts several days
• Pain in the abdominal area with increased temperature
• Prolonged vaginal bleeding
• Unexplained weight loss

In what cases should you call your doctor immediately:

• A person suffers from cancer and his stomach hurt
• Constipation accompanied by vomiting
• Vomiting blood or blood in the stool
• Black or tarry stools
• Sudden, sharp abdominal pain
• Pain between the shoulder blades accompanied by nausea
• The abdomen is sensitive and painful to touch, or vice versa – the abdomen is hard and hard to the touch
• Abdominal pain during pregnancy
• Recent abdominal trauma

Why is it important to seek help as early as possible?

Almost each of the diseases discussed does not just cause pain and unnecessary worries.

If you don't receive it on time medical care, serious and sometimes life-threatening complications can develop. Don’t wait, make an appointment through or call the numbers listed at the top of the site.

Sources:

1. 18 Reasons Why Your Stomach Hurts, Health.com,
2. 5 Reasons Your Stomach May Hurt, The Johns Hopkins Hospital,
3. Abdominal Pain, U.S. National Library of Medicine,
4. Abdominal Pain, Patient.info,
5. Irritable Bowel Syndrome, U.S. National Library of Medicine,
6. Symptoms & Causes of Diverticulosis and Diverticulitis, The National Institute of Diabetes and Digestive and Kidney Diseases,
7. Endometriosis, Mayo Clinic,
8. E. Ebert, Gastrointestinal Involvement in Spinal Cord Injury: A Clinical Perspective, University of Medicine and Dentistry New Jersey, Robert Wood Johnson Medical School,
9. Intestinal parasites, University of Maryland Medical Center (UMMC).

Abdominal pain- one of the most common reasons for visiting doctors. Unpleasant and painful sensations can overtake each of us. And if in some cases the pain goes away after a short time and never returns, sometimes attacks of pain become unbearable and require urgent attention to a gastroenterologist. Let's look at the reasons for the appearance of pain in the abdominal area and our subsequent actions.

Why does my stomach hurt?

There are two main types of abdominal pain: visceral and parietal.

Visceral pain is caused by irritation nerve endings in the walls of internal organs caused by their stretching or spasm. Such pain is also called colic, and its intensity is variable. However, it is often difficult to determine where the source of pain is located.

Parietal pain occurs due to irritation of the abdominal wall. This happens, for example, when a stomach ulcer is perforated. In this case, the abdominal muscles become significantly tense. Such pain, most often sharp and cutting, has a clearly defined center and is constant.

Based on duration, abdominal pain is divided into chronic and acute. And if chronic ones can last a long time, then acute ones can last from several minutes to several hours. Acute pain indicates a sharp deterioration in health caused by various reasons. For example, this is how acute pancreatitis, cholecystitis and ulcers manifest themselves.

Where does it hurt?

Abdominal pain is divided into those that have a pronounced focus, and those that spread to large areas of the body. The possible cause of pain can be determined by its nature and location of the epicenter:

• Pain between navel and solar plexus. Occurs with diseases of the stomach (gastritis, ulcers, etc.), cholecystitis, inflammation of the duodenum or pancreas.
• Pain around and in the navel area. Often caused by intestinal disorder or inflammation of the appendix. The latter requires immediate hospitalization of the patient due to a direct threat to life.
• Pain below the navel. This is how problems with the intestines and, most often, with the rectum manifest themselves. In women, it can signal diseases of the genitourinary system. Pain of this localization also occurs during menstruation or pregnancy. In men, this is how diseases of the urinary system manifest themselves.
• Significant pain in the right upper abdomen indicates inflammation of the gallbladder. These are symptoms of inflammation of the pancreas and duodenum. With all these diseases, the pain can shift to the middle of the abdomen and even to the back.
• When there is pain in the left side of the abdomen, the stomach, pancreas or large intestine is not functioning normally.
• Pain in the lower right and left abdomen is a reason to examine the colon and rectum, respectively.

What to do if your stomach hurts

Regardless of the nature of the pain and the location of its source, if the pain appears regularly and continues for a considerable time or is acute, you should immediately seek help from a doctor. If you are in St. Petersburg, then you can always come for a consultation at our clinic. Experienced doctors, using modern equipment, will accurately determine the cause of abdominal pain and prescribe effective treatment.

What not to do for abdominal pain

There is a clear list of what you should never do if you have abdominal pain:

• You should not apply a hot heating pad to the source of pain or to your stomach in general, or try to warm up the sore spot in any other way. To alleviate the condition, try applying something cold on the contrary.
• Until the cause of the pain is determined and a doctor is consulted, you should not take painkillers. By taking them, you can change the symptoms of the disease in such a way that it will be impossible to make an accurate diagnosis of the gastrointestinal tract condition.
• Under no circumstances should acute or prolonged pain be tolerated, especially if it is accompanied by fever, prolonged (more than 2-3 times) vomiting, loss of consciousness, the presence of blood in the vomit, or the appearance of bloody stools. If any alarming symptom appears, you should immediately seek help from a doctor.

Remember that with the help of pain, the body signals us about the emergence of some kind of problem. The sooner the disease is identified and appropriate treatment is started, the faster you can achieve a full recovery and avoid possible complications. The doctors of our clinic in St. Petersburg will always help you with this.

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Abdominal pain (AP)- a symptom of many diseases that has a wide range of clinical significance: from functional disorders to conditions that threaten the patient's life.

Being a common symptom in outpatient practice, abdominal pain requires a rational diagnostic strategy, first of all, from the position of a doctor general practice, who is often the first to encounter such patients.

Rice. 20. Gastrointestinal tract

Pain impulses arising in the abdominal cavity are transmitted through the nerve fibers of the autonomic nervous system, as well as through the anterior and lateral spinothalamic tracts. Vegetative pain most often cannot be definitely localized by the patient; they are often diffuse in nature and localized in the middle part of the abdomen.

Pain transmitted through the anterior and lateral spinothalamic tracts is characterized by a clear localization and occurs when the parietal layer of the peritoneum is irritated. In this case, patients clearly indicate pain points with one, less often with two fingers. This pain is usually associated with intra-abdominal inflammatory process extending to the parietal peritoneum.

It should be noted that in diagnosis, differential diagnosis, determination of localization pain syndrome is quite important factor. When starting to examine the patient, the doctor must immediately mentally divide the abdominal area into three large sections: epigastric in the upper third, mesogastric or periumbilical and hypogastric, represented by the suprapubic part and the pelvic region (Fig. 21).

Rice. 21. Sections of the abdomen

The causes of abdominal pain can be surgical, gynecological, mental illness and many other internal diseases. Abdominal pain is an alarming symptom. It is practically important to distinguish between acute and chronic abdominal pain and their intensity. Acute intense abdominal pain may indicate dangerous disease, in which rapid assessment of the situation allows for life-saving emergency treatment measures.

It should be recalled that the current generally accepted rule is to abstain from the use of narcotics and other analgesics until a diagnosis has been established or a course of action has been determined.

Acute abdominal pain

The first thing to suspect when experiencing abdominal pain is acute diseases abdominal organs requiring emergency surgical intervention(acute stomach).

Need to know the most common reasons such pain. More often they occur with pathology of the abdominal organs, but they can also be of extra-abdominal origin.

The causes of abdominal pain are the following diseases:
1) involvement of the parietal peritoneum (appendicitis, cholecystitis, perforation of a gastric or duodenal ulcer);
2) mechanical obstruction of a hollow organ (intestine, biliary tract, ureter);
3) vascular disorders (thrombosis of mesenteric vessels);
4) pathology of the abdominal wall (trauma or infection of muscles, hernia);
5) acute inflammation of the gastrointestinal tract (salmonellosis, food intoxication).
Referred pain of extra-abdominal origin can occur with:
1) pleuropulmonary diseases;
2) myocardial infarction;
3) lesions of the spine.

The most common causes of acute abdominal pain in adults are acute appendicitis, as well as intestinal, renal and biliary colic; acute appendicitis, intestinal, renal and biliary colic, mesadenitis (inflammation lymph nodes intestines and mesentery). If abdominal pain occurs in elderly people who suffer from atherosclerosis, arrhythmia, or have recently suffered a myocardial infarction, acute circulatory disorders in the intestine should be suspected.

Pain in acute abdomen can be constant and paroxysmal.

Paroxysmal pain with a gradual increase and then complete disappearance is called colic. Colic is caused by a spasm of the smooth muscles of hollow internal organs (biliary tract and gallbladder, ureter, intestine, etc.), innervated by the autonomic nervous system. Depending on the location, intestinal, renal and biliary colic are distinguished.

In the presence of acute intense abdominal pain, the general practitioner is faced with the task not so much of establishing a nosological diagnosis, but of immediately assessing the degree of urgency of the disease and the need for urgent surgical care. The solution to this issue is the prerogative of the surgeon, but an indicative conclusion is made by the general practitioner.

If the urgency of the situation is not obvious, it is necessary to establish a presumptive diagnosis, provide assistance and outline a plan for additional diagnostic measures, possible on an outpatient basis or in a hospital, judging by the patient’s condition (Figure 22).

Rice. 22. Determining the cause of acute abdominal pain

These issues should, first of all, be resolved on the basis of questioning and physical examination (Figure 23).

Rice. 23. Determining the cause of abdominal pain

When questioning the patient, the following questions should be asked:
1) when the pain occurred, its duration;
2) how the disease developed - suddenly or gradually;
3) what are the possible causes of pain - poor quality food, injury, medication, previous diseases of the abdominal organs, chest, spine;
4) what is the localization, irradiation and prevalence of pain (local, diffuse);
5) what is the intensity and nature of the pain: acute, dull, colicky, short-term, long-term, constant, etc.;
6) what are available associated symptoms: fever, vomiting, diarrhea, stool retention and flatus.

An objective examination should evaluate general state patient: position in bed and behavior, face, tongue, skin color, breathing and pulse rate, blood pressure; conduct auscultation of the lungs, heart, blood vessels. When examining the abdomen, it is necessary to determine its configuration, size, participation in the act of breathing, soreness, muscle tension, peritoneal symptoms, peristaltic sounds.

Soft, careful palpation should be used, using more rational techniques, for example, the Shchetkin-Blumberg symptom can be replaced by light percussion of the abdomen, and identification of muscle protection by coughing. Questioning and objective examination make it possible to distinguish visceral pain from diseases of the hollow organs, and somatic pain from irritation of the parietal peritoneum.

In all cases of acute intense abdominal pain that appeared without obvious external cause First of all, the presence of peritonitis or acute intestinal obstruction with or without phenomena of centralization of blood circulation, i.e., shock of varying severity and other life-threatening conditions should be excluded (see Table 36).

Table 36. Dangerous or life-threatening causes of abdominal pain

Cause of pain	Signs of illness	Key symptoms
Intestinal obstruction (due to adhesions, volvulus, duodenal edema, tumor)	Bloating, peritoneal irritation, persistent vomiting, vomiting fecal matter	Bloated belly, abnormal bowel sounds (gurgling, ringing)
Cancer (colon, pancreas)	Weight loss, loss of appetite, increased fatigue	Palpable tumor in the abdominal cavity, bleeding from the rectum. Anemia. Obstructive jaundice
Abdominal aortic aneurysm	Cutting or tearing pain radiating to the side (history of increased blood pressure)	Absence of femoral pulse, pulsatile abdominal mass, elevated blood pressure
Intestinal perforation	Pain, temperature	Absence of bowel sounds, abdominal muscle rigidity
Intestinal infarction (thrombosis of mesenteric vessels or ischemia)	Atrial fibrillation or severe atherosclerosis	Absence of bowel sounds, rectal bleeding, Fades Hyppocratica
Acute gastrointestinal bleeding	Dizziness, weakness, bloody vomiting, intestinal bleeding	Tachycardia, low blood pressure (in the early stages there may be a reflex increase in blood pressure), anemia, hematocrit
Diseases of the pelvic organs (ectopic pregnancy, inflammatory disease genitals, ovarian cysts)	Violation menstrual cycle, vaginal discharge or bleeding	Vaginal examination, pelvic ultrasound, pregnancy test

Peritoneal pain, usually constant, strictly limited, located directly above the inflamed organ, necessarily intensifies with palpation, coughing, movements, and is accompanied by muscle tension. A patient with peritonitis lies motionless, while a patient with colic constantly changes position.

With obstruction of a hollow organ, the pain is usually intermittent, colicky, although it can be constant, with periodic intensification. With obstruction of the small intestine, they are located in the peri- or supra-umbilical region, with colonic obstruction - often below the navel. Stool retention, gas passage, visible peristalsis, and bowel sounds are taken into account.

With sudden obstruction of the gallbladder duct, pain, rather of a constant nature, occurs in the right upper quadrant of the abdomen with irradiation posteriorly to the lower back and under the scapula; when the common bile duct is stretched, pain can radiate to the epigastric and upper lumbar region. Similar pains also occur with obstruction of the pancreatic duct; they are aggravated by lying down and relieved by standing.

Pain during thromboembolism of mesenteric vessels is usually diffuse and severe, but without signs of peritonitis. Dissecting aortic aneurysm is characterized by pain radiating downwards and backwards. The presence of risk factors for these complications (age, heart disease, heart rhythm disturbances, thromboembolism in the past, etc.) is important.

Diffuse abdominal pain accompanied by gastrointestinal disorders (vomiting, diarrhea) and fever are usually a symptom of acute intestinal infection.

Referred pain is most often associated with diseases of the chest organs. This possibility should be considered in all cases of their localization in the upper abdomen. The causes of such pain can be pleurisy, pneumonia, pulmonary infarction, myocardial infarction, pericarditis, and sometimes esophageal diseases. To exclude them, appropriate questioning of the patient and systematic examination are required.

With referred pain, breathing and excursion of the chest are more disturbed than the abdomen. Muscle tension decreases with inspiration; upon palpation, the pain often does not intensify or even decreases. It should, however, be borne in mind that the detection of any intrathoracic pathology does not exclude simultaneous intra-abdominal pathology.

Pain in diseases of the spine, as a manifestation of secondary radicular syndrome, is accompanied by local soreness, dependence on movement, and cough.

When examining a patient, they should be used diagnostic methods, which would provide sufficient reliability, i.e., reliability of the results in terms of sensitivity and specificity of the method; low risk for the patient, low time consumption.

The latter is especially important in emergency situations. These requirements are met, first of all, by detailed questioning and objective research, which are considered more valuable than any instrumental and laboratory studies and, in most cases, decide the diagnosis or determine the tactics of patient management.

The main, most informative methods of additional examination of such patients are currently considered endoscopic (with possible biopsy), ultrasound and laboratory research. The latter include general analysis blood (leukocytosis!), blood for amylase, alkaline phosphatase, sugar, bilirubin.

X-ray studies often provide only probable data, and therefore it is better to use them for special indications: if mechanical ileus is suspected (sensitivity of the method is 98%), perforation of a hollow organ (60%), stones (64%) - only positive results are taken into account.

Based on the clinical examination of a patient with acute abdominal pain, 3 alternative solutions are possible:
- urgent hospitalization;
- planned hospitalization;
- outpatient monitoring and examination.

First of all, all patients with signs of peritonitis, intestinal obstruction or mesenteric thrombosis are subject to urgent hospitalization in the surgical department. This is followed by patients with severe, prolonged or recurrent pain, especially with signs of inflammation and/or cardiovascular disorders, including suspected acute appendicitis, cholecystitis, pancreatitis.

The remaining patients have a lesser degree of "urgency", are subject to planned hospitalization, usually in therapeutic departments, or, as with chronic pain, are examined on an outpatient basis. This group includes patients with cholelithiasis or urolithiasis, acute gastroenteritis, extra-abdominal diseases that may cause sharp pains, but not a sharp stomach.

G.I. Lysenko, V.I. Tkachenko

Abdominal pain is one of the most common complaints. Often we do not pay attention to this, drink a painkiller and forget about what can be a harbinger of serious illnesses. After all, no pain arises just like that... Today we will tell you what can cause various abdominal pains.

Grade

The human body is a complex mechanism. Every day hundreds of factors, including nutrition, environment and your emotions influence how it functions, shaping how you feel. For example, there are many causes of abdominal pain, which can explain cramping, bloating, sharp pains or other symptoms that bother you. First of all, it is necessary to determine the cause in order to get rid of the consequences as soon as possible.

Abdominal pain can be classified depending on the specific area. Usually, abdomen is divided into four parts, although science identifies up to nine zones. Let's still divide the stomach into the upper right, upper left, lower right and lower left quadrants. Determining the location of the pain will help identify the cause. For example, pain in the left upper quadrant may indicate problems in the stomach, spleen, or part of the colon.

Most of us are not doctors, which means we don't understand human anatomy well enough to diagnose ourselves. Therefore, it is better not to self-medicate, but to consult a doctor, especially if abdominal pain causes you serious discomfort and is accompanied by other unpleasant symptoms.

Causes of abdominal pain

Lactose intolerance

Scientists say that most adults have. The body produces lactase to digest milk, but according to WebMD, 40 percent of us stop producing enough by age two. If you fall into this group of people, you may experience abdominal pain, bloating, gas, or diarrhea after consuming dairy products. This happens because your body can't break down the sugar in milk, which ends up in the colon (rather than in the bloodstream). Once in the colon, sugar begins to ferment, causing all these symptoms.

Stress

The enteric nervous system, located in the lining of the hollow organs of the gastrointestinal tract, is connected to your central nervous system. When you are under stress, the body takes blood from the intestines and sends it to the brain and limbs. This means digestion may slow down, which can lead to stomach problems.

Side effects of medication

According to Johns Hopkins Medicine, some medications can cause stomach problems. For example, abdominal pain may be the result of Other types of medications can cause constipation, which also leads to abdominal pain. Anti-inflammatory drugs (ibuprofen) damage the lining of the stomach, causing it to become inflamed. In other cases, the medicine may prevent food from reaching your stomach after you swallow it, increasing the chance of acid reflux.

Thyroid problems

The thyroid gland plays such an important role in the body that most people would be surprised to learn how much damage it can cause if it is not functioning properly. Research by Chris Sweet, Abhishek Sharma and George Lipscomb has found a link between abdominal pain, hypothyroidism, nausea and vomiting.

Gluten intolerance

Products labeled “gluten-free” are now increasingly found on store shelves, and for good reason. Gluten is a protein found primarily in wheat, barley and rye. And yes, it can indeed have a negative impact on your health. Some people may experience bloating, diarrhea, and constipation after eating gluten-containing foods. If this problem affects you, try reducing or eliminating gluten temporarily to monitor its effect on your body.

Urinary tract infection

The urinary tract begins at the kidneys and ends at the urethra, and UTIs can affect the tract at any point. This explains the connection between UTIs and abdominal pain, or pelvic pain in particular. Nausea is another common symptom of a UTI, which can cause stomach upset.

Stomach upset

Indigestion often causes pain in the upper abdomen. It is accompanied by an unnatural feeling of fullness, even at the beginning of the meal, as well as bloating. Although there may be an upset stomach side effect diseases of the digestive system. It usually goes away on its own without special medical care.

acid reflux

According to the Mayo Clinic, acid reflux occurs when the contents of your stomach begin to flow back up into your esophagus. This happens because the opening in the stomach does not work properly. The result is often heartburn. Although acid reflux is quite common, if it is accompanied by abdominal pain, you should definitely talk to your doctor.

Constipation

Constipation happens at least once in everyone's life and can be caused by various factors - stress or dehydration. Because constipation is often accompanied by bloating and a feeling of tension caused by trying to go to the toilet, abdominal pain is a common symptom.

PMS

Bowel movements are directly affected by hormones, which is why many women suffer from diarrhea in the days before and during the day. Add to that bloating, cramping and nausea, and you get the full picture of what's going on in your stomach at this time of the month.

gases

Gas is not only annoying and embarrassing—it can also be quite painful. The abdomen may look and even feel swollen, and touching it may be painful. Gases don't appear out of nowhere - there must be a reason. Possible reasons include: acid reflux, constipation, lactose or gluten intolerance.

food allergy

Food allergies occur when the body mistakes an ingredient, often a protein, as something dangerous. In response, your the immune system creates antibodies to fight it. Abdominal cramps and pain are common reactions to shellfish, nuts, milk, peanuts, eggs, fish and more.

And remember, if you feel unwell, be sure to consult a doctor!