Why Does My Stomach Hurt?

2/13/2018

From time to time, almost everyone will experience a stomachache. Most causes of abdominal pain are nothing to worry about, and will either pass on their own or be easily diagnosed and treated. But sometimes, stomach pain is a sign of a more serious illness. Learn which symptoms to watch out for, and use these tips to prepare for a successful visit with your doctor.

“Stomach pain is both quite common AND notoriously difficult to diagnose,” Shuja Yousuf, MD said. "There are literally hundreds of potential causes for pain and discomfort in the abdominal area. The more a patient can share about the nature, origin and severity of the pain, the easier it will be to diagnose and prescribe for relief.”

The more structural causes of abdominal pain fall into three categories:

• Inflammation – conditions such as appendicitis, diverticulitis and colitis
• Stretching or distention of an organ – for example, obstruction of the intestine, blockage of a bile duct by gallstones or swelling of the liver from hepatitis
• Loss of blood supply to an organ – as in ischemic colitis

However, abdominal pain can also occur for reasons that are quite unclear, and in the absence of the above conditions. This is called functional pain, because no visible cause for the pain can be found. One of the most common conditions in this category is irritable bowel syndrome (IBS). Characterized by abdominal pain and discomfort combined with dysfunctional bowel habits – diarrhea or constipation, or both – it’s estimated that between 25 and 45 million people in the U.S. are suffering from IBS.

If your abdominal pain or bowel symptoms are severe, paired with fever or vomiting, or last more than 24-48 hours, it is likely time to see the doctor. Note that, if your symptoms follow a recent injury or trauma to your abdomen, call 911 or go directly to the nearest emergency facility. If the symptoms are chronic, or gradually worsening, schedule time with your primary care physician or a gastroenterologist to help you track down the cause and create a treatment plan. Prepare a list of symptoms you are concerned about, along with a general description of your diet and a list of all prescriptions, over the counter medicines, and supplements you are taking. Then, arm yourself with as much of the following information as possible to maximize your time in the office:

• Origin of the pain. When does the pain occur? Is it constant or intermittent? How long does it last? Does it occur after eating/eating certain foods? Worse in the morning or at night? Before/during/after menstruation? Try keeping a log in the days before your appointment to help you track the details of when, why, and how bad.
• Location and characteristics of the pain. Where exactly is the pain located? Try to break your abdomen into quadrants – upper right, lower left, etc. Does the pain move, or is the location static? Try to describe the pain – is it sharp and sudden, dull and aching, crampy? Do you notice any ‘sounds’ coming from your abdomen? Does pain travel to your back or legs?
• Aggravation and relief. What makes the pain better or worse? Does movement or use of muscles make it worse, or does laying down make it better? Does the pain worsen if you apply pressure, or after you eat? What do you do to find relief? Antacids or gas relief medications? Anti-inflammatories? Does a heating pad or bed rest make you feel better? Keep a log of how you feel at different times of the day, and what you did before, during and after that may be related.
• Bowel habits and changes. Be prepared to speak freely about your current and historical bowel habits, and any recent changes. Details such as frequency, size and texture are relevant, as is any pain you may be having related to bowel movements or urination. Be sure to note any feelings of pressure or nausea, any incidences of vomiting, and any presence of blood in the toilet bowl or on the tissue.

Once you’ve consulted with your doctor on the symptoms and any other health concerns or history, you should expect him or her to do a physical examination. This may include examination of your abdomen for swelling or tenderness, a check of your lungs and blood pressure, listening for sounds in your digestive system, blood work and urine and stool samples. From there, if the diagnosis isn’t clear or the labs reveal any concerns, you may be asked to proceed to some imaging or diagnostic procedures.

“While it’s likely your pain is not caused by colon cancer, colonoscopy screenings are still a critical diagnostic tool for those with digestive problems,” Dr. Yousuf said. "Dealing with chronic conditions such as IBS, Crohn’s or inflammatory bowel disease increases your risk factors for polyps and colon cancer down the line. Survival rates keep getting better, simply because we are now catching these issues in their early stages.”

There is seldom any good reason to just live with chronic abdominal distress. If your stomach issues have been on your mind for more than 30 days, reach out to your primary care physician and start a conversation and diagnostic plan. To schedule an appointment with Dr. Yousuf, call (601) 825-5000.

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