Pain in the stomach develops with functional digestive disorders, intestinal infections, gastritis and peptic ulcer. The symptom occurs with foreign bodies and neoplasms of the stomach, pyloric stenosis, NSAID gastropathy. To diagnose the causes of abdominal pain syndrome, instrumental methods are used - ultrasound, EFGDS, X-ray examination, intragastric pH-metry. To eliminate pain, medications are used: drugs that reduce gastric secretion, antacids, antispasmodics and prokinetics. In acute conditions, gastric lavage, sorbents, antidotes are prescribed.
The most common cause of stomach pain in young and middle-aged people. It is 2 times more common in men than in women. Unpleasant aching sensations in the epigastric zone are characteristic, which can turn into sharp pain. The pain syndrome is changeable, appears periodically. Accompanied by belching, nausea, heartburn. Symptoms are provoked by the use of spicy food, fast food, dry food.
The defeat of the stomach is more typical for food poisoning, infection with staphylococci. A few hours after eating stale food, severe pain in the epigastric region, nausea and repeated vomiting begin. Often the symptoms are associated with watery diarrhea. Pain throughout the abdomen, including in the stomach, occurs with salmonellosis, escherichiosis.
The nature of the pain depends on the type of inflammation. For hyperacid gastritis, intense pain on an empty stomach is specific. They resemble an attack of peptic ulcer, accompanied by heartburn and sour belching. With hypoacid gastritis, dull pain that occurs after eating is disturbing. It is aggravated by nausea, heaviness in the stomach, loss of appetite.
An ulcerative defect of the gastric mucosa is characterized by pain in the epigastrium. With damage to the antrum and body of the stomach, pain is observed to the left of the central line of the body, and with a defect in the pyloric section, to the right. Pain is often given to the shoulder blade, spine, or to the left side of the chest, simulating pain in the heart.
With gastric ulcer, the appearance of soreness is typical 30-6 minutes after eating. The higher the defect is localized, the earlier pain is felt. When the duodenum is involved in the pathological process, "hungry" and night pains predominate. They decrease at the end of the meal. The patient's condition improves after vomiting, when a heating pad is applied to the stomach area.
With a complicated course of peptic ulcer, the nature of the symptoms changes. The perforation of the ulcer is indicated by a strong "dagger" pain in the stomach, which sometimes causes fainting against the background of pain shock. If the perforation is accompanied by bleeding, the pain decreases. General symptoms are steadily increasing: there is a protective tension of the abdominal muscles, severe weakness, pallor, tachycardia.
In the compensated stage of pyloric stenosis, there is a dull pain in the abdomen, which is aggravated after eating. As a rule, patients are relieved by vomiting. Decompensation of the process is manifested by severity, severe pain in the epigastrium. After each meal, vomiting opens, vomit often contains foods eaten many hours ago. Patients quickly lose weight, complain of constant weakness and drowsiness.
In this disease, pain is more often localized behind the sternum, but can be located in the projection of the stomach. Pain sensations are very intense, irradiation to the interscapular region is characteristic. Pain is disturbed after eating, physical activity, when bending the torso forward. Symptoms are relieved by taking a deep breath, drinking water. The second specific symptom of a diaphragmatic hernia is dysphagia, which is more common when eating liquid or semi-liquid food.
For benign polyps of the stomach, mild pain is typical, which usually rarely disturbs. Most people do not attach importance to them. The clinical picture is complemented by discomfort after eating, belching. If the formation on the leg is infringed by the pylorus, acute cramping pains appear. First, they are localized in the epigastrium, then spread throughout the abdominal cavity.
Stomach cancer is characterized by constant moderate pain in the epigastric zone. Discomfort intensifies at the end of a meal. There is also heaviness in the abdomen, decreased appetite and weight loss. A pathognomonic symptom is a sudden change in taste preferences, an aversion to meat food. As the process progresses, the pain becomes very strong, not stopped by standard analgesics.
Unpleasant sensations are caused by both swallowed objects (buttons, bone fragments, dentures) and stones formed in the body (gallstones, gastric bezoars). With a large foreign body, the patient experiences constant aching or dull pain in the stomach. Symptoms are aggravated after eating: worried about the feeling of heaviness and fullness in the epigastrium.
Pain in the stomach area is often caused by diseases of adjacent organs - the liver and gallbladder, pancreas, and intestines. For cholecystitis, localization of pain in the epigastrium and right hypochondrium, the presence of nausea and vomiting after taking fatty food are typical. Pancreatitis causes girdle pain in the upper abdomen, which usually radiates to the back.
Pain in the epigastrium is felt in the abdominal form of a heart attack. A person complains of sudden, severe pain with frequent irradiation to the arm and left half of the body. The attack resembles an exacerbation of peptic ulcer or pancreatitis. There is nausea, reflex vomiting. Pain in the stomach is aggravated by severe weakness, increased heart rate. The skin is covered with cold sweat.
Most often, pain occurs due to uncontrolled intake of anti-inflammatory drugs, leading to the development of NSAID-gastropathy. It is characterized by moderate pain that occurs at night or on an empty stomach. The symptom is combined with heaviness in the abdomen, nausea, flatulence. Pathology is dangerous because in 50% of people it is asymptomatic, and then it can manifest itself as gastric bleeding. In addition to NSAIDs, stomach discomfort is provoked by glucocorticoids, antihypertensive drugs.
At the initial appointment, the gastroenterologist collects complaints and an anamnesis of the disease, conducts a physical examination of the digestive system: superficial and deep palpation of the abdomen, checking for peritoneal symptoms. Diagnostic search is aimed at finding out the causes of pain in the stomach. For this, laboratory and instrumental diagnostic methods are prescribed:
With moderate pain in the stomach, non-drug treatment is indicated. To reduce the burden on the digestive tract, fried, spicy, fatty foods are excluded from the diet. To reduce irritation of the mucosa, you should give up strong coffee, spices, carbonated drinks. It is necessary to eat in small portions 5 times a day, carefully chew each piece.
In acute gastritis caused by poisoning, it is required to rinse the stomach as soon as possible. To bind and remove the remaining toxins, sorbents based on activated carbon, silicon dioxide, and silica gel are used. If a person has very severe pain, vomiting with streaks of blood, tarry stools, you should immediately consult a doctor.
Most cases of stomach pain are associated with organic pathology, which requires individually selected etiotropic and pathogenetic therapy. With medical lesions of the gastric mucosa, it is necessary to cancel the drug that causes unpleasant symptoms. For the treatment of the underlying disease and relief of symptoms, the following is prescribed:
If the pain in the stomach is not provoked by the pathology of the gastrointestinal tract, the patient is selected for treatment by doctors of the relevant specialties - a cardiologist, a neuropathologist, a psychiatrist. Taking into account the disease, such patients are shown taking antianginal and antiarrhythmic drugs, sedatives, antidepressants.
Operations are recommended for malignant neoplasms, decompensated or therapeutically resistant forms of gastrointestinal diseases. The choice of surgical method is determined by the underlying disease. Patients can undergo organ-preserving operations (vagotomy, gastrostomy or gastroanastomosis, pyloromyotomy or pyloroplasty, removal of polyps, bezoars), various types of resections, gastrectomy.