In this part of the world, when people talk about having ‘stomach pain’, they are referring to pain that is related to the gastro-intestinal tract known as the alimentary canal, not just one part of it.
The stomach, of course, is just one organ. Typically speaking, perceived ‘stomach pain’ that occurs in the part of the abdomen nearer to the ribs involves the upper gastro-intestinal tract, which includes the oesophagus, stomach and small intestine. Pain occurring in the lower abdomen tends to be related to the lower GI tract, which comprises the large intestine (colon), rectum and anus.
Upper abdominal pain is a major reason children and adults visit the hospital, hence the need for a pragmatic approach to its management. On the other hand, ‘stomach pain’ is a common symptom seen on daily basis in our consulting rooms. In most cases, it is clearly related to something eaten, caught or experienced routinely. If this happens and the symptoms are severe, persistent, or worsening, one will need to see a doctor to investigate the cause.
Stomach pain, described as burning, stabbing, aching, biting, and peppery, is sometimes associated with other symptoms, such as nausea, belching, vomiting, excessive gas, indigestion, etc. This information is very helpful to doctors when working to make a diagnosis.
Peptic Ulcer: This is a term used to describe an open sore in the stomach or duodenum. The symptoms can vary, but often it includes a gnawing or burning pain, indigestion, nausea, vomiting and excessive gas. Most peptic ulcers are caused by either the bacterium Helicobacter pylori (H. pylori) or the use of nonsteroidal anti-inflammatory, which may irritate and alter the protective mucosal layer of the digestive tract.
Gastritis: Gastritis is the medical term for an inflammation in the lining of the stomach. Gastritis is a far-ranging condition caused by everything from alcohol to nonsteroidal anti-inflammatory drug use to infection with the bacteria H. pylori. In some cases, the condition will be idiopathic (meaning no cause is ever found). Besides pain in the upper belly, which ranges from a dull ache to an intensely sharp or burning pain, other symptoms of gastritis include feeling bloated, early satiety, decreased appetite, nausea and vomiting.
Oesophagitis: This is the tube that carries food from the mouth to the stomach. Oesophagitis refers to irritation and inflammation of the lining of the oesophagus, which may occur for many reasons, including infections like Candida or the Herpes Simplex Virus and certain medications (for example, the antibiotic clindamycin or aspirin).
Besides heartburn and pain in the upper belly, a person with oesophagitis may experience difficulty in swallowing and/or pain with swallowing.
Gastroesophageal Reflux Disease: Also known as acid reflux, this is a condition in which stomach acid leaks into the eosophagus, thereby causing a burning sensation in the chest or throat. Besides heartburn, some other symptoms of GERD include regurgitation, trouble swallowing, stomach pain, hoarseness, cough, or feeling as if there is a lump in the throat.
Gallstones: Gallstones are caused by the crystallisation of bile in the gallbladder. This may lead to the formation of jagged, little stones that block the bile duct and cause severe, sharp pain by in the upper right abdomen (a condition called acute cholecystitis).There are many complications of gallstones, like acute cholangitis or pancreatitis that may worsen your pain and/or cause other symptoms.
Pancreatitis: This refers to inflammation of the pancreas, a small gland that releases insulin to regulate your blood sugar levels and also aids in the digestion of fat. Alcohol and gallstone disease are the two most common causes of pancreatitis. Most people with acute pancreatitis develop severe, constant pain in their upper belly.
Lactose Intolerance: It is a condition in which a person lacks the enzyme needed to digest the sugars found in dairy products. People with lactose intolerance typically experience diarrhea, gas, and/or bloating soon after eating foods like milk or cheese.
Cancer: While less common, upper and lower abdominal pain may be a sign of cancer. Be sure to see your doctor if your pain is persistent and/or you are experiencing other unusual symptoms like a change in bowel habits, blood in your stool or urine, excessive fatigue, or unexplained weight loss.
There are other causes, such gastro-enteritis, diarrhea and food poisoning, which may also cause upper abdominal pain.
When to see a doctor
If you ever have sudden and severe stomach pain, seek immediate medical attention. Other symptoms that warrant getting medical attention right away include chest pain; vomiting up blood or dark-coloured flecks; having black, maroon, or bloody stools; dizziness and/or feeling faint; inability to keep down food or fluids
This depends on the cause. Some may require antacids, antibiotics, anti-ulcer drugs, while others require surgical interventions or a change of lifestyle and dietary modifications.
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