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Different types of stomach pains
call for different treatment methods

By: James Rogers, M.D.

Abdominal distress, stomach pain, bellyache, a sore tummy, a tender abdomen we have lots of ways to describe discomfort in our midsection. Most of us experience stomach pain occasionally when we overindulge, catch a bug, or have a certain food disagree with us. Fortunately, most abdominal problems are minor and home treatment is all that is needed. In certain cases, however, stomach pain can be the symptom of a serious condition and medical attention is required. There are numerous conditions that can cause stomach discomfort.

Indigestion
Indigestion is a general term that describes symptoms of stomach upset including generalized pain, bloating, belching, nausea and loss of appetite. It is normal for most people to experience indigestion from time to time. It can be treated with over-the-counter medications or by avoiding the foods that cause it. If you experience chronic indigestion, a visit to your health professional is warranted.

Stomach flu
Gastroenteritis, or the stomach flu, can be caused by bacteria, a virus, or some poisons. It occurs when the stomach and intestines become inflamed. Symptoms include nausea, vomiting, abdominal cramps, diarrhea, fever and weight loss. Stomach flu usually goes away within a day or two without medical treatment. Home treatment should include comfort measures to relieve discomfort and prevent illness-related problems such as dehydration.

Food poisoning
Food poisoning occurs when you ingest food contaminated by viral, bacterial or chemical agents. In general, symptoms include mild to moderate pain, cramping, diarrhea, and vomiting. They can start from one hour to four days after eating the tainted food. Additional symptoms of headache, fever and chills beginning from 12 to 48 hours after eating indicate viral food poisoning. Symptoms of chemical food poisoning include sweating, dizziness, excessive salivation and mental confusion occurring about 30 minutes after eating contaminated food. Finally, in botulism, a rare, but serious form of bacterial food poisoning, people experience partial loss of speech or vision, muscle weakness, difficulty swallowing, dry mouth and muscle paralysis.

Most food poisoning resolves on its own with home treatment. However, seek medical attention if you recognize the symptoms of chemical food poisoning or botulism or if your symptoms are severe and last for more than two days.

Medications
Some medications irritate the stomach lining, cause pain and heartburn-like symptoms. These include aspirin, ibuprofen, naproxen sodium, corticosteroids (such as prednisone) and alcohol. Other medications can cause cramping, diarrhea and constipation. These include antidiarrheals, laxatives, antibiotics and iron supplements. If you suspect that you are experiencing abdominal discomfort due to a medication you are taking, your health professional may be able to help you find a way to take your medication so that it doesn't cause pain, or prescribe other medication to alleviate your symptoms.

Peptic ulcers
Peptic ulcers develop when the digestive liquids in the stomach erode the lining of the digestive tract. They may form in the lining of the stomach or in the small intestine near the stomach. A person with a peptic ulcer often experiences burning or aching pain between the navel and breastbone that is relieved by eating or taking antacids. Other symptoms include bloating, nausea or vomiting after eating, lack of appetite, weight loss and black tarry stools. Treatment from a medical professional is needed to correctly diagnose a peptic ulcer. Medications are often used to effectively treat and relieve symptoms. In serious cases, a hole may develop in the stomach or intestine or an ulcer may cause substantial bleeding in the digestive tract. When this occurs, surgery may be needed.

Bowel obstruction
A bowel obstruction is a blockage of the intestines that prevents gas, fluids and solids from moving through the intestines. Symptoms include severe cramping abdominal pain, nausea, vomiting, bloating and inability to have a bowel movement or pass gas. A suspected bowel obstruction is serious and requires the attention of a medical professional. Surgery may be needed.

Perforation
A perforation is a hole within the wall of the digestive tract. It can be caused by an ulcer, infection or a swallowed object that causes a puncture in the digestive tract. Symptoms include severe pain and bleeding. Material from the digestive tract can leak through the perforation and cause a serious infection. A perforation requires immediate medical attention and possibly surgery.

Kidney stones
Kidney stones build up over time as salts and minerals in the urine stick together to form masses that can be as small as a grain of sand or as large as a golf ball. Severe pain can occur when a kidney stone moves from the kidney to the narrow ureters that carry urine as it exits the body. Pain is typically on one side of the back, just below the rib cage, and can spread to the lower stomach, groin and genital area. Other symptoms include frequent urination, blood in the urine, nausea and vomiting. Some kidney stones pass on their own without medical treatment. If you experience severe pain, however, it is best to seek advice and treatment from your physician who will often prescribe increased fluids and medication to relieve the pain until the stone has passed. In some cases, treatment to break up a large stone may be warranted. In extreme cases, surgery may be needed.

Gallstones
Like kidney stones, gallstones build up over time and can be as small as a grain of sand or as big as a golf ball. Gallstones are common and do not typically cause problems until they enter a duct leading from the gallbladder to other organs. The major symptom involves pain, often severe, in the upper abdomen. Gallstones that cause pain require medical attention. They are typically treated with surgery to remove the gallbladder.

Appendicitis
The appendix is a small sac that is attached to the large intestine. Occasionally this sac becomes infected and swollen, causing appendicitis. Pain caused by appendicitis begins as mild to moderate in intensity around the belly button becoming generalized throughout the abdomen. This pain increases in severity and moves below the navel on the right side and becomes worse when a person walks or coughs. Other symptoms include nausea, vomiting, lack of hunger, constipation, back pain and low-grade fever. Appendicitis requires medical attention to remove the appendix before it ruptures.

Stomach pain is a common condition that most of us experience from time to time. In general, most discomfort is mild and can be treated at home. Most home treatments include rest, drinking fluids to prevent dehydration, avoiding carbonated beverages, eating small amounts of mild foods such as rice, dry toast, crackers or bananas, avoiding fatty and spicy foods, avoiding caffeine and alcohol and avoiding medications that can increase stomach pain.

If your pain is severe, comes on suddenly or gets progressively worse over time it may be a symptom of a serious condition that requires medical attention. Your health care provider can help you map out a plan of care to decrease pain and help you -- and your stomach -- get back on the right track to good health.

Dr. Rogers is a board certified family practice physician at Raiter Clinic.