Intestinal pain - causes, diagnosis and therapy

Pain in the gut - causes and therapies

Everyone has already experienced mild intestinal pain. In many cases, short-term digestive complaints such as flatulence or constipation are responsible for the pain symptom. Occasionally, however, serious health problems are behind the pain in the intestines. A particular complication in assessing the severity of such disorders is the precise location of the pain source.

contents

• Pain in the gut - causes and therapies
• How do you get intestinal pain??
• Indigestion as the main cause
• Intestinal pain caused by intestinal diseases
• Poisoning as a cause of intestinal pain
• Nervous load
• Intestinal pain in case of allergy or intolerance
• Associated symptoms
• diagnosis
• Treatment of intestinal pain
• nutritional intervention
• Medication
• Operative treatment
• home remedies
• Medicinal plant measures
• Diseases that cause intestinal pain

How do you get intestinal pain??

In the medical sense, intestinal pain is one of the intestinal pain, the so-called visceral pain or visceral pain. The term roughly describes a very wide range of pain symptoms of various kinds that occur in the area of ​​the abdominal organs, including

• the pancreas,
• the liver,
• the kidneys,
• the uterus,
• the stomach
• and the intestine itself.

Causes of visceral pain are usually special irritation in said organs, which cause the nerves located there to send pain signals. Corresponding pain stimuli, for example, are already provoked by harmless flatulence or by the female period. However, even serious inflammatory processes or other tissue damage in the organs can cause visceral pain, which is why in case of persistent symptoms necessarily a medical examination is required.

Bowel pain can have a variety of causes. (Image: Adiano / fotolia.com)

An important role in the development of intestinal pain often plays the so-called intestinal peristalsis. It describes the interplay of the intestinal muscles, which make the digestive process through routine muscle contractions. Very often there is pain in the intestine, if this peristalsis of the intestinal musculature is disturbed in any way. The muscles then send out mostly uncontrolled contractions, which also involves the surrounding nerves and thus leads to pain symptoms. This is also referred to as an intestinal colic, as long as the pain has a spasmodic character.

Due to the anatomical proximity and the concomitant supply of blood and nerve vessels from abdominal organs, the causes of visceral pain in general and of bowel pain in particular can often not be clearly localized immediately. Sometimes these are just radiation pain from adjacent organs, but they are so severe that intestinal pain is suspected. Especially with a pain event in the stomach or the uterus a clear determination of the pain symptoms is often very difficult. In addition, due to the many possible sources of pain in the intestinal area, the actual cause may be masked at the beginning.

For actual pain in the intestine itself, one of the following causes is usually responsible:

• inflammation,
• infectious diseases,
• Food intolerances,
• nervous stress such as stress,
• Tumor diseases or cancer,
• or indigestion.

Indigestion as the main cause

In the vast majority of cases, bowel pain is a temporary condition and is due to temporary digestive problems. It is sufficient, eaten immature or strongly bloating foods such as beans, peas or onions and thereby flatulence (Flatulence) provoked to have provoked. These develop in the intestine when gut bacteria responsible for digestion produce too much gas, which happens only too easily, for example, with the high sulfur content of onions. It thus accumulates air in the stomach. Usually, however, the intensity of the intestinal pain here is limited, since the gas accumulations in the intestine are a one-off thing, do not turn out to be too rich and the resulting irritation of the intestinal walls, muscles and nerves is limited. But there are also special cases in which the pain becomes unbearable due to flatulence. We are talking about chronic bloat, or bloating (Meteorism).

Legumes such as beans and peas can cause flatulence and associated intestinal pain. (Image: piyaset / fotolia.com)

Often she is also associated with certain dietary habits, such as a high-fiber diet, which in itself is not a problem. Because fiber, as well as many flatulent foods are in and of themselves very healthy, even if they provoke the increased gas emissions of intestinal bacteria. But occasionally, bloating is also due to chronic bowel disease and is no longer considered a harmless sequelae of nutrition.

Pain intensity and duration of pain decide even with constipation (Constipation) not infrequently about whether the complaint is harmless or questionable. In most cases, the pain symptoms are based on too hasty food, which puts the digestion under pressure in the short term. The porridge subsequently accumulates in the intestine because the intestinal peristalsis do not follow the necessary muscle contractions for digestion. It is also conceivable that too many stuffing foods, for example white flour products such as bread rolls or pasta were consumed, which then hinder a trouble-free digestion. Inadequate hydration may also promote bowel pain through constipation. Once and taken alone, intestinal pain, as well as the constipation itself, are not a health problem. Should a corresponding nutritional behavior manifest permanently, health complications may arise.

Conversely, bowel pain may also be part of diarrhea (Diarrhea) arise. Here, however, there is already a disturbed digestion, which ultimately provokes the diarrhea. Basically, in this case, the absorption of liquid from the porridge is hampered, so the stool is highly liquefied. The intestinal pain associated with this in most cases often has a spasm character and indicates extreme irritation of the intestinal walls, including the intestinal musculature and intestinal nerves located there. As a cause, for example, a food poisoning or an intestinal infection is conceivable, which is why persistent diarrhea is always a case for the doctor. The same applies to the dehydration of the body resulting from permanent diarrhea, which can lead to dangerous dehydration and therefore requires the quickest possible treatment of indigestion.

If diarrhea is associated with abdominal pain, care must be taken to balance the fluid balance. (Image: Rosalie P./fotolia.com)

It can be seen that indigestion, as well as the associated intestinal pain is not always as safe as it first appears. This is especially true for nausea and vomiting, two digestive problems that are also often associated with a dull feeling and pain in the intestinal area. As evidence of an existing gastrointestinal disease or food intolerance, bowel pain in combination with nausea and vomiting may be a clear indication of a doctor's visit.

Intestinal pain caused by intestinal diseases

Serious indigestion often arise from underlying intestinal diseases. And also intestinal pain can be repeatedly attributed to inflammation or infections in the intestine. The pain arises here by an irritation of the intestinal mucous membrane, which penetrates in the later course of disease into the intestinal walls and thus to the intestinal muscles and nerves. Since this often leads to spasmodic muscle contractions, when the intestinal muscles irritated react to the inflammatory or infection events, any pain expresses at least in advanced disease often as intestinal colic.

The reasons for inflammation or infection in the intestines are versatile. On the one hand, such diseases can be triggered by classic pathogens such as

• Coli bacteria such as Escherichia coli (enterohaemorrhagic colitis),
• salmonellae (Salmonellosis),
• Candida mushrooms (Candidiasis)
• or intestinal parasites (Tapeworm)

If it comes in this regard to a faulty colonization of the intestine with the corresponding pathogens, so first gets the intestinal flora out of balance, which leads to general digestive problems. Gradually, the pathogen populations then attack the intestinal tissue and provoke inflammatory processes and tissue damage.

An intestinal inflammation, for example, by Escherichia coli, is a possible cause of intestinal pain. (Image: Antonioguillem / fotolia.com)

On the other hand, nutritional aspects often play an important role in intestinal inflammations. For example, those who regularly eat very spicy or acidic foods risk weakening their intestinal mucosa, which can then develop into painful intestinal wall inflammations. Likewise, radiation damage (radiation colitis) as the cause of the inflammation-related pain can not be excluded. In addition, poisoning by chemicals and substance abuse, such as alcohol, come as an author of painful intestinal inflammation in question. As intestinal diseases, which lead to intestinal pain in this way, apply

• enteritis (Enteritis),
• Colitis (Colitis),
• chronic colitis (Ulcerative colitis),
• Gastrointestinal inflammation / gastrointestinal flu (Gastroenteritis),
• Irritable bowel syndrome (RDS),
• Colon cancer and metastases in the intestinal area,
• bowel obstruction (Ileus)

Poisoning as a cause of intestinal pain

If abdominal pain suddenly appears in the intestine after eating, it may also be due to food poisoning. Whether foods were previously insufficiently cleaned or were already bad at the time of consumption, in both cases, more bacterial germs reach the intestine and multiply rapidly there. Since the bacteria like to secrete toxic gases as decomposition products, they almost always cause food poisoning, which is characterized by diarrhea, nausea and vomiting, but also by severe intestinal pain to intestinal cramps.

Excessive use of alcohol is a potential trigger for intestinal pain. (Image: motortion / fotolia.com)

Now, however, poisoning does not necessarily have to be based on spoiled or contaminated food. Sometimes chemical toxins are also responsible for the intestinal pain. Clairaudient in this regard should be especially parents of toddlers. Again and again children complain about apparently harmless abdominal pain, if they have accidentally sipped on toxic cleaning agents. And even environmental pollutants in the air or in drinking water provoke pain symptoms in the gastrointestinal tract in case of persistent pollution of the organism.

Nervous load

The stomach and intestines are known to be among the first to respond to stress and worry. So it is not surprising that intestinal pain, as well as some intestinal inflammation are favored by prolonged nervous stress. The exact mechanism of inflammation is not yet fully understood, but at least the intestinal pain can be reasonably explained by the fact that nervous tension also leads to a disturbed and painful contraction behavior of the intestinal muscles. Anyone who suffers from pain in the intestines for no apparent reason, that may fight with

• anxiety,
• depressions,
• inner restlessness,
• Fear of exams or stage fright,
• nervousness,
• panic attacks,
• mental trauma,
• a stressful everyday life
• or stress at work.

Intestinal pain in case of allergy or intolerance

It is also conceivable that intestinal pain may occur as an allergic reaction. This applies in particular to food or food allergies, since these lead to irritant reactions in the digestive tract immediately after consumption of a critical food.

The reason for the pain in existing allergies is that the immune system in such a case misinterprets certain food components as foreign bodies to be controlled. There are therefore formed antibodies that are sent to ward off the alleged hazardous substances in the intestine. The transmission of pain signals together with other typical allergic symptoms such as diarrhea or vomiting is part of the body's defense reaction. While the vomiting or diarrhea should ensure that the foreign bodies are removed from the digestive tract as quickly as possible, the pain is an erroneous warning signal to the body.

Whether the cause of intestinal pain is a food intolerance, should be clarified by the specialist. (Image: Antonioguillem / fotolia.com)

In this context, food intolerance should be distinguished from food allergy. There is no malfunction of the body against food, but there is a fundamental inability of the body to digest certain food components, thus provoking indigestion and pain. A good example is lactose intolerance, better known as lactose intolerance. Often falsely referred to as food allergy, this is actually a relatively natural intolerance of the human body. Because young people and adults still tolerate milk after weaning, is primarily due to the introduction of dairy farming in the last millennium. It is particularly widespread in Europe, ensuring that the enzyme lactase necessary for the breakdown of lactose is still produced by our organism well beyond infancy. In other parts of the world, where dairy products do not occupy such an essential position in the daily diet, lactose intolerance is still present. After eating milk to get intestinal pain, because the digestive tract irritated to the lactose reacts, is therefore completely normal in said regions.

Far from the distinction between food allergy and food intolerance, however, just about all foods can contribute to both variants of defense. Foods that cause the most common problems include:

• certain vegetables such as celery, soy or mustard,
• gluten-containing cereals, especially wheat and barley ,
• Sea animals such as fish, crabs or clams ,
• Dairy products, especially lactose-containing cow's milk products,
• and nuts such as peanuts, hazelnuts or walnuts.

In addition, food additives and chemical sprays in under-washed foods should not be underestimated as the cause of allergic bowel pain.

Associated symptoms

The abdominal and pelvic organs have some anatomical features:

• They are very space-saving distributed in the abdominal area.
• They are supplied by numerous nerve and blood vessel networks.
• For their protection, they are made of a kind of network of connective tissue (Peritoneum) surround.

These three factors mean that intestinal pain can only be classified as such in very rare cases. As a rule, these visceral pains are perceived as diffuse, dull and difficult to localize. In some cases, they may even progress colick-like at intervals or be perceived as unbearable persistent pain.

Also, the intensification of pain in food intake can be very different. In part, the pain can be moderated temporarily in their intensity, in part they are enhanced by food and beverage intake but also.

Vomiting may be an accompanying symptom of bowel pain, depending on the cause. (Image: metamorworks / fotolia.com)

In addition to the actual intestinal pain, there are some accompanying symptoms that may occur depending on the particular pain cause. For example, gastrointestinal infections are known to cause diarrhea, nausea and / or vomiting in addition to convulsive bowel pain. In addition, food allergies often result from other allergic reactions, such as narrowing of the esophagus due to swelling of the mucous membranes (especially with peanut allergy), Dizziness or redness on. Overall, the following symptoms may be considered as concomitant symptoms in intestinal pain:

• Nausea and vomiting,
• Fever and fatigue,
• sweats,
• Diarrhea or constipation (Constipation),
• Discomfort when urinating,
• erythema,
• Skin and mucous membrane swelling
• as well as sensory disturbances in the intestinal area.

As the causative disorder progresses, the intensity of the pain usually increases. This can sometimes develop a symptom complex, which is referred to in medical parlance as an acute abdomen or acute abdomen and may become acute to a life-threatening state of shock. It may be an indication of internal bleeding, perforation, occlusion or inflammation. Typical, alarming symptoms of an acute abdomen include:

• Strong, acute abdominal pain.
• Abdominal tension of the abdominal muscles, noticeable by an exciting abdominal wall, which gives way from the outside when palpated.
• Decompensation of the circulatory situation to shock, which is characterized by hypotension, tachycardia, tachypnea and cold sweat.

An acute abdomen may also lead to the following concomitant symptoms:

• Vomiting, even in the fasted state,
• Vomiting of stool (Miserere),
• Teerstuhlabgänge or black chair,
• Stool excretions with obvious or hidden blood admixtures,
• fever,
• and change the bowel sounds.

diagnosis

As bowel pain is often very diffuse with few specific symptoms, the initial visit to the doctor often involves many different diagnostic procedures until the treating physicians can make a conclusive diagnosis. Depending on the acuteness of the event, the different examination measures sometimes take place in a very fast sequence, in order to be able to obtain a quick focus on the acute abdomen, for example. Even with suspected poisoning or in the context of allergic reactions with very severe symptoms must be acted quickly. The diagnosis is therefore based on a systematic step-by-step procedure.

A detailed history can narrow down the cause of the intestinal pain. (Image: Lumina Images / fotolia.com)

1. Anamnesis

During the anamnesis, the physician first attempts to collect first indications of a possible cause by means of specific questioning of the patient. For example, it asks about the duration, frequency and intensity of the pain in the bowels, as well as the situations in which the pain occurs. Also information about the last meal, existing underlying diseases and the general health of the patient should be discussed in depth, for example to check for the possibility of an allergy, infection or acute stress.

2. Physical examination

In the subsequent physical examination, the doctor will be mainly on the palpation (Palpate) Concentrate on the abdominal area, with concrete suspicion, however, other body regions may move into the focus of investigation. For example, a look at the skin may reveal signs of allergic skin reactions. A rectal examination, in turn, is able to provide evidence of rectal bleeding or ulcers, for example in the context of a tumor disease.

3. Laboratory chemical investigations

The doctor has various methods available for laboratory chemical diagnostics. These focus significantly on the examination of different body fluids for the evaluation of certain health values:

• Blood test:
  In the blood, inflammatory parameters, liver values, kidney values, electrolytes, tumor markers and antibodies can be determined. If inflammation is considered, it is also possible to create blood cultures that unmask the suspected bacterial strains and enable appropriate antibiotic therapy.
• Examination of gastric juice:
  Here, the concentration of gastric acid, the pH, the presence of pathogenic bacteria, such as Helicobacter pylori or tuberculosis bacteria, and large amounts of blood can be determined.
• stool samples
  Stool examinations allow conclusions about internal bleeding (Hemoccult). The colonization of the intestinal mucosa with pathogenic bacteria and viruses, such as Clostridium difficile, norovirus or Salmonella, is also evident and inflammatory processes become visible in a study of stool samples.

4. Imaging procedures

In imaging diagnostics, many procedures are now available to the attending physicians to be able to confine the diagnoses in question safely. Depending on the severity and presumed focus, the following procedures may be used:

• Sonography, Duplex sonography,
• Computed Tomography,
• magnetic resonance imaging
• and endoscopic procedures (Gastroscopy, colonoscopy, ERCP) for sighting and sampling.

In the diagnosis of intestinal pain also imaging techniques can be used, such as a computed tomography. (Image: Werner / fotolia.com)

Although the technicians now allow the treating physicians a very detailed view through the closed abdominal wall, there are cases in which all diagnostics do not provide sufficient treatment focus. After careful consideration of the benefits and risks, a diagnostic laparoscopy can be carried out here (Laparoscopy) be another step to the diagnosis assurance. Instruments are introduced into the abdominal cavity through small incisions in the abdominal wall in order to be able to inspect the abdominal organs from the outside. This can, for example, the peritoneum (Peritoneum) to be examined.

Treatment of intestinal pain

Of course, the therapy for intestinal pain based on the underlying cause. For example, medicines for the treatment of infections, nutritional measures or those that counteract allergic reactions are eligible. Finally, a short overview:

nutritional intervention

If one-off flatulence, constipation or diarrhea is responsible for the intestinal pain, it may help to relieve the intestine by light diet. We are happy to resort to vegetable broths and teas. In case of constipation the light diet causes a softening of the stool and thus a suppression of intestinal peristalsis. In diarrhea, in turn, the electrolyte balance can be replenished by the liquid food and thus prevent dehydration. Overall, one should resort to painful digestive problems, as well as intestinal infections and inflammation on easily digestible foods that do not contain too many additives and enforce the intestine neither by sharpness nor a high acid content. Some recommendations include brown rice, porridge and semolina pudding.

Tip: If there is no lactose intolerance, probiotic yogurts can also help. They strengthen the intestinal flora and thus offer better protection against inflammatory processes in the intestine.

Allergy sufferers should of course refrain from those foods that are proven to be intolerable and supplement their diet with well-tolerated alternatives. For example, patients with lactose intolerance may switch to alternative dairy products, such as goat cheese or almond milk. However, people with gluten intolerance have to switch to gluten-free cereals such as amaranth, buckwheat, millet or Qinoa.

Medication

In the treatment of intestinal pain, depending on the underlying cause, various medications may be used. If inflammation is the cause, for example, a suitable antibiotic can combat the disease-causing bacterial strains. However, it should be noted that antibiotic therapies also destroy the good bacteria on the intestinal mucosa, which in turn increases the likelihood of further diarrheal diseases.

Antibiotics have a negative effect on intestinal flora and should only be used for intestinal pain if other therapies do not work. (Image: carballo / fotolia.com)

Chronic inflammatory processes, such as ulcerative colitis and Crohn's disease, also respond well to corticosteroid treatments. However, benefits and risks should be reviewed as long-term and repeated cortisone treatments can also cause many side effects, such as changes in blood sugar and lipid levels, weight gain, and blood pressure increase.

In intestinal pain due to indigestion, such as by lack of digestive enzymes, oral administration of the enzymes concerned can provide relief. For example, the missing enzyme lactase may be due to lactose intolerance or other missing digestive enzymes (Amylase, protease, lipase) be available in this way the body available pancreatic diseases present.

Operative treatment

More serious disease processes may require surgical intervention. Although one tries to be as invasive as possible and therefore carries out many procedures laparoscopically, but nevertheless a large abdominal surgery is sometimes unavoidable. For example, if there is a bowel obstruction or the supplying blood vessels are laid through a closure, the entire abdominal cavity must be opened in the sense of a life-sustaining operation. This is often followed by long recovery processes, which have both a good wound healing, as well as a regular diet to target.

home remedies

Affected with not acutely life-threatening intestinal pain, which have their cause in digestive and absorption disorders, such as in lactose intolerance, gluten intolerance or irritable bowel syndrome, the case can also be active and contribute to the relief.

For example, if you have diarrhea, people should be careful to at least drink enough fluids to avoid dehydration. As mentioned, particularly light broths and unsweetened teas or simply water are suitable here.

To relieve spasmodic discomfort in the abdominal area, externally applied heat treatments can bring relief. Well suited for this example, a hot water bottle, a grain pillow or a warm bath.

Since the intestine is closely intertwined with the psyche of humans, intestinal pain is not uncommon in stressful everyday situations. From exam stress to stress at the workplace to emotional problems, the pain can be an expression of a variety of occasions that disturb our psyche. Such a diagnosis does not always make it easy for sufferers in the sense of a cure, because there is no uniform treatment regime and in many cases different therapeutic measures have to be tried first.

Very often, patients help in addition to a conversation and behavioral therapy, however, measures that are conducive to inner relaxation. These include, for example, courses such as meditation, yoga, Qi Gong, progressive muscle relaxation or exercise therapy. Even private relaxation activities such as regular walks in the fresh air, massages, sound and aromatherapy are definitely worth a try.

Chamomile is bloating and antispasmodic. In addition, it is effective for intestinal inflammation. (Image: Africa Studio / fotolia.com)

Medicinal plant measures

Fortunately, herbalists are well aware of many herbal options, especially for complaints in the gastrointestinal area, which can help alleviate pain and indigestion. The general rule:

• Chamomile, fennel and anise have an antispasmodic effect.
• Flaxseed and coriander can be bloated.
• Myrrh and blueberries relieve diarrhea.
• Lavender, lemon balm and valerian help with nervousness.

The medicinal herbs can be used as tea, as an outer wrap in the abdominal region or in tablet form.

Diseases that cause intestinal pain

Enteritis, colitis, ulcerative colitis, gastrointestinal flu, irritable bowel syndrome, colon cancer, intestinal obstruction, food intolerance, food allergy, poisoning, stress, depression, anxiety. (Ma)