WITH UNPLEASANT FEELINGS IN THE ABDOMINAL IS KNOWN TO EVERYONE , but many experience pain so often that they have learned to ignore it or drown it with some pain reliever. What this is fraught with, we find out from specialists: doctor of medical sciences, obstetrician-gynecologist, member of the Association of Gynecologists-Endocrinologists of Russia, the Association “Quantum Medicine” and the Russian Association of Obstetricians and Gynecologists Eliso Jobava, therapist, nutritionist- parasitologist of the VMBUZ “Polyclinic No. 6” Tamara Urusova and expert of the Center for Molecular Diagnostics (CMD) of the Central Research Institute of Epidemiology of Rospotrebnadzor Elena Tivanova.
What is abdominal pain
This is any pain in the abdomen, which is caused by a variety of reasons – from inflammation in individual organs to malfunctions in the work of entire systems: the digestive, biliary, urogenital. Different organs hurt in different ways. But, according to experts, in 60% of cases of visiting a doctor, abdominal discomfort is associated with spasm. The latter is a painful contraction of the smooth muscles of the abdominal cavity (this is associated with increased pressure, tension or impaired blood circulation in the organs).
For example, in the case of a spasm of the uterus, the pain may be pulsating, like “grabbed and let go.” A strong spasm is characterized by severe discomfort. For example, burning pain is a common symptom of acute stomach ulcers, and bursting pain is a symptom of bowel problems, including intestinal flu. With inflammation in the organs of the reproductive system, aching pain most often occurs. Ovulation usually “hurts” from the sides – pain occurs on the side where the follicle is located, and menstrual pain bothers the lower abdomen and often radiates to the lower back.
At the same time, the doctor Eliso Jobava draws attention to the fact that it is impossible to determine the problem only by the type of pain. In addition, the assessment of sensations is subjective: everyone can describe the pain syndrome in their own way. According to Jobava, there is even a diagnosis of acute abdomen, after which several specialists – a surgeon, a gynecologist, a urologist – study the intestines, reproductive organs and urinary tract. Therapist Tamara Urusova adds that sometimes the discomfort is not related to abdominal problems. So, pain in the abdomen can occur with myocardial infarction or pneumonia.
Why women have stomach pain more often than men
According to Eliso Jobava, this is due to the anatomical features of the female body – the presence of reproductive organs and cyclic processes in them. Menstrual syndrome is the main cause of abdominal pain in women. Discomfort before menstruation or on the first day of the cycle is usually caused by a spasm of the uterus and tension in its ligamentous apparatus, which allows the organ to remain mobile. Normally, this spasm is associated with the release of menstrual blood.
In most cases, pain on the first day of menstruation is considered a deviation (there is a diagnosis of dysmenorrhea, suggesting painful menstruation). In rare cases, we are talking about primary dysmenorrhea, when all menstruation is painful, starting from the very first. In fact, this is due to individual physiology, but it still does not cancel the examination by a gynecologist. There are also pathological causes of such pain: fibroids, endometriosis, various inflammatory processes. If the pain syndrome occurs in the middle of the cycle, it is likely that the cause of the discomfort is ovulation. With ovulatory pain, a small amount of fluid from the ruptured follicle enters the abdominal cavity. This discomfort is not caused by spasm, but by a local reaction to the fluid. If there is a lot of fluid, the pain can be strong and prolonged, if not, the stomach hurts for 1.5-2 hours and then goes away.
In second place are chronic abdominal pain associated with frequent stress, as well as bowel problems such as intestinal cramps. The latter usually occurs with irritable bowel syndrome with bloating, constipation or diarrhea, or due to improper diet: the use of fatty, fried or large amounts of sugary foods, alcohol, as well as fasting or overeating. The third common cause is biliary and urinary tract problems and infections. Tamara Urusova notes that in this case it is important to exclude gallstones, cystitis and the presence of gastritis or gastric ulcer caused by the bacterium Helicobacter pylori.
Should you be afraid of Helicobacter pylori
Helicobacter pylori is a bacterium that lives in the lining of the stomach and duodenum. In 2005, the Nobel Prize in Medicine was awarded for the discovery of the role of this microorganism in the development of gastritis. Now, according to Elena Tivanova, scientists blame Helicobacter pylori for the appearance of peptic ulcer disease, as well as stomach cancer – the World Health Organization has recognized the bacterium as a carcinogen of the first group. Under the microscope, Helicobacter pylori looks like an octopus: an elongated body with motor flagella that allow bacteria to actively move in the thick gel of the gastric mucosa and attach to it, forming colonies. To survive in conditions of high acidity, the bacterium produces urease, an enzyme that breaks down urea to form ammonia. The latter neutralizes acidity, providing bacteria with a comfortable living environment. Over time, the enzymes of the microorganism dissolve the protective mucus of the stomach, which provokes inflammation.
Helicobacter pylori infection can be called “dirty hands disease”. Contaminated food and water are also sources of infection. You can pick up the latter through a kiss – sometimes the bacterium lives in the oral mucosa. Gastroscopy with biopsy (taking a sample of mucus) allows you to confirm or deny the presence of Helicobacter pylori in the body, but this method has contraindications. Elena Tivanova notes that there is another option – to undergo a 13C-urease breath test in the laboratory. This method gives almost one hundred percent guarantee and is more delicate. If the presence of the bacteria is confirmed, only the attending physician can prescribe a suitable therapy. According to Tivanova, Helicobacter pylori is able to form special biofilms that protect it from the host’s immunity and antibiotic therapy, therefore, several regimens have been developed to treat this infection with a combination of two or three key drugs.
What to do to relieve pain
Pain in itself is stress for the body, which means that it is harmful to endure it. Sometimes breathing exercises, diaphragmatic breathing (“belly breathing”), stretching exercises of the ligamentous apparatus of the spine and abdominal cavity help to weaken or completely relieve abdominal discomfort – the meaning is that in the process the muscles and ligaments of the lumbar spine and muscles that pass inside are stretched belly. But in most cases, a medication is required.
Analgesics (for example, based on paracetamol, ibuprofen, metamizole), antispasmodics, as well as combined drugs with analgesic and antispasmodic effects are popular pain relievers that are sold without a prescription in pharmacies. However, it is not safe to drink analgesics or combination drugs for spasms. Such means do not take into account the nature of the pain, but only mask the latter – they block the transmission of the pain signal without affecting its cause. This can make it difficult to make a diagnosis and cause serious damage to health. In addition, if the pain is caused by diseases of the gastrointestinal tract, such as gastritis or ulcers, taking an analgesic or a combination drug will irritate the mucous membrane, which will only worsen the condition.
For abdominal pain, experts advise taking an antispasmodic first. It does not interfere with the mechanisms of pain sensitivity and does not “erase” symptoms in acute surgical diseases. This drug can affect the spasm in different ways: act on receptors, block the pathways of transfer of substances into the cell, prevent the work of enzyme proteins. In case of spastic pain, it always has a targeted effect – relaxing the muscles, eliminates pain syndrome. Some antispasmodics work only on the muscle of the intestine, on the intestines and uterus, or on the intestines and biliary tract – an appropriate option if the nature of the pain is known. If the pain persists within a couple of hours after taking the antispasmodic, the cause of the discomfort is unlikely to be related to spasm, and the drug will be ineffective. In this case, you need to see a doctor as soon as possible.
Medical consultations also require regular pain, which is often a signal of irritable bowel syndrome, which needs full treatment, and not just pain relief. Obstetrician-gynecologist Eliso Jobava notes that acute persistent abdominal pain is an alarming signal. Such discomfort can be associated with life-threatening situations: appendicitis, ectopic pregnancy (against a background of two to three days of delay), ovarian apoplexy with bleeding into the abdominal cavity (in the middle of the cycle during ovulation). If the pain appears for the first time, its intensity increases or it is accompanied by an increase in temperature, nausea, vomiting, an ambulance should be called.