Pain throughout the abdomen is observed with SIBO, intestinal infections and parasitic invasions, acute surgical pathology (peritonitis, intestinal obstruction, intestinal infarction). Less often, the symptom occurs in ketoacidosis, anaphylactic shock, and also as a complication of pharmacotherapy. The diagnostic plan for abdominal pain involves the implementation of ultrasound, x-ray, laparoscopic studies. Blood and stool tests are done. Treatment includes diet therapy, medicines - probiotics, enterosorbents, antibiotics. According to indications, surgical intervention is prescribed.
In domestic gastroenterology, the abbreviation SIBR is understood as intestinal dysbacteriosis. It is characterized by non-localized abdominal pain of moderate intensity, caused by the spread of the process throughout the intestine. Patients describe pain in different ways: cramping, cutting, aching or dull. Often there is arching pain associated with bloating. Typical diarrhea with fetid stools, nausea, rumbling in the intestines.
With lactase deficiency, symptoms develop 20-3 minutes after consuming dairy products. Patients feel cramping pain throughout the abdomen, which is accompanied by rumbling, flatulence, and repeated diarrhea. With isomaltase and sucrase deficiency, similar manifestations occur after eating potatoes, sweet vegetables and fruits, flour products and sweets.
Celiac disease (gluten enteropathy) is less common. If the diet prescribed by the gastroenterologist is not followed, constant pain and discomfort occur throughout the abdomen. Within an hour after taking the forbidden foods, sharp spasms begin, which gradually turn into dull or aching pain. Symptoms are complemented by repeated fetid stools, nausea and vomiting.
The appearance of diffuse pain is observed if the infectious agent has spread throughout the gastrointestinal tract. Patients are concerned about severe cramps and spasms associated with the use of poor-quality food and water. Usually the pain syndrome is paroxysmal in nature, its intensity decreases after defecation. In severe forms of infections, especially in dysentery, pain is felt constantly, supplemented by excruciating tenesmus.
Pain throughout the abdomen, disturbing the patient for several weeks, can be caused by helminthic invasions - ascariasis, trichinosis, teniasis. Often develops dull pain, which has no clear provoking factors. When moving helminths through the intestines, there are strong short-term colic in the abdomen. If the worms disrupt the passage of food throughout the gastrointestinal tract, the pain increases, accompanied by constipation.
In the initial period, pain is localized in the projection of the affected organ, but after a couple of hours the pain becomes diffuse. Painful sensations are very strong, they can radiate to the lower back, shoulder or supraclavicular area. To alleviate the condition, the person lies motionless on his back or side, pulling his legs to the body. When moving, pain throughout the abdomen is aggravated.
When feeling the anterior abdominal wall, the pain syndrome intensifies, due to hyperesthesia, even light touches on the stomach give a person discomfort. In addition to the pain syndrome, repeated vomiting, stool and gas retention are noted. If the patient is not given timely assistance, gradually the intensity of painful sensations decreases, which indicates the terminal phase of peritonitis.
Pain all over the abdomen
Characterized by sudden severe pain throughout the abdomen, accompanied by vomiting and constipation. With mechanical intestinal obstruction, abdominal pain has an undulating course: it intensifies to unbearable during the passage of a peristaltic wave, after which it subsides for a short time. During an attack, a person groans in pain, takes forced positions (squatting, on his side, knee-elbow).
For paralytic ileus, diffuse pains are typical, which are of lesser intensity. Their character does not depend on peristaltic waves. Patients complain of painful distension and bloating. With the spastic form of the disease, cramping pains are noted throughout the abdomen. Signs of intoxication and dehydration of the body, in contrast to mechanical obstruction, are absent.
Suddenly, against the background of full health, paroxysmal pains in the abdomen develop, which after a few hours turn into constant strong painful sensations. Patients experience unbearable pain, they can scream and moan, thrash around the bed in search of a more comfortable position. A distinctive feature is the absence of tension in the abdominal muscles - the abdomen is soft, with probing, there is no increase in pain.
Pain throughout the abdomen occurs not only in surgical and gastroenterological diseases. Sometimes they are caused by vascular pathologies and metabolic disorders. Usually such pains begin suddenly, their intensity quickly increases, the general condition sharply worsens. Most often with abdominal pain syndrome occur:
Sharp pain throughout the abdomen is typical for the manifest form of the disease. Painful sensations are colicky in nature. As a rule, they become unbearable, reminiscent of the clinical picture of "acute abdomen". In addition to pain, fever and high blood pressure are observed. There are pains in the lumbar region, accompanied by the release of urine of pink or red-brown color.
Discomfort and pain throughout the abdomen occur with drug-induced colitis provoked by taking antibiotics, laxatives, and some antihypertensive drugs. Patients complain of constant pain, rumbling throughout the large intestine, flatulence. Sometimes there are intense cramping pains in the left iliac region, tenesmus.
Mucositis occurs in cancer patients receiving radiation or chemotherapy. With the spread of the pathological process from the oral cavity to the underlying sections of the gastrointestinal tract, excruciating pains develop throughout the abdomen. Painful sensations are poorly stopped by analgesics. The pain syndrome is accompanied by diarrhea, there is a lot of mucus in the feces, streaks of blood are visible.
Depending on the intensity of pain and concomitant symptoms, a surgeon, gastroenterologist or infectious disease specialist may be involved in the examination of the patient. The doctor begins by taking a complaint and history, then performs a physical examination and checks for symptoms of peritoneal irritation. To establish the cause of the appearance of diffuse pains in the abdomen, the following laboratory and instrumental techniques are prescribed:
In practical gastroenterology, intestinoscopy is used, which is the “gold standard” for diagnosing SIBO. The diagnosis can be made if the growth of opportunistic microflora in an amount of more than 105 CFU is detected during culture of the contents of the small intestine. If vascular pathology is suspected, CT angiography of the mesenteric vessels, aortography is performed. To detect tumor processes, CT and MRI of the abdominal organs are shown.
Palpation of the abdomen
With a possible intestinal infection, it is necessary to wash the stomach, take sorbents, increase the amount of fluid you drink to prevent dehydration. With dysbacteriosis, which is caused by antibiotic therapy, it is recommended to add kefirs and yogurts to the diet, which contain many useful lactic acid bacteria. With intense diffuse pain in the abdomen, the patient requires emergency medical care.
Medications are prescribed after clarifying the causes of the pain syndrome. In uncomplicated forms of intestinal infection, oral rehydration and sorbents are sufficient; taking antibacterial agents is not advisable. To eliminate abdominal pain associated with enzyme deficiency, a diet is selected with the exclusion of foods that provoke symptoms.
In drug-induced colitis and SIBO, the first priority is to normalize the intestinal microflora with the help of probiotics and prebiotics. Medicines improve digestion, normalize stools, so discomfort and pain in the abdomen disappear. Antibiotics are indicated for severe intestinal infections, some surgical conditions for the prevention of complications.
Unbearable pain requires the use of narcotic analgesics to prevent the development of pain shock. In diseases of other organs and systems, manifested by abdominal pain, etiopathogenetic therapy of the underlying pathology is necessary. Suffering from ketoacidosis, correction of glucose levels, acid-base and electrolyte composition of the blood is performed. Emergency care for signs of anaphylactic shock includes the urgent administration of glucocorticoids and adrenomimetics.
Diseases such as peritonitis, intestinal infarction, intestinal obstruction require urgent surgical intervention. The operation is aimed at eliminating the pathological focus, restoring the integrity and continuity of the intestinal tube, sanitation of the abdominal cavity. In the postoperative period, massive antibiotic therapy and infusion therapy are prescribed.