Stomach hurts: How to cope with the most frequent complaint
Everybody is familiar with unpleasant sensations in the stomach., but many people so often experience pain that they have learned to ignore it or drown it with some kind of painkillers. What is fraught with, we find out from the specialists: doctor of medical sciences, obstetrician-gynecologist, member of the Association of gynecologists-endocrinologists of Russia, the Quantum Medicine Association and the Russian Association of Obstetricians and Gynecologists Eliso Jobava, therapist, parasitologist and nutritionist of the MBUZ Polyclinic No. 6 "Tamary Uru" Polyclinic No. 6 " and Elena Tivanova, expert of the Center for Molecular Diagnostics (CMD), Central Research Institute for Epidemiology of Rospotrebnadzor.
What is abdominal pain
This is any pain in the abdomen, which is caused by a variety of reasons - from inflammation in individual organs to malfunctioning of the entire systems: digestive, biliary, urinary. Different organs hurt differently. But, according to experts, in 60% of cases of going to a doctor, abdominal discomfort is associated with spasm. The latter is a painful contraction of the smooth muscles of the abdominal cavity (this is due to an increase in pressure, tension or impaired blood circulation in the organs).
For example, in the case of a spasm of the uterus, the pain can be pulsating, like “grabbed - let go”. Severe spasm is characterized by severe discomfort. For example, burning pain is a frequent symptom of acute gastric ulcer, and arching is a problem with the intestines, including the intestinal flu. When inflammation in the organs of the reproductive system often occurs aching pain. Ovulation usually "hurts" from the sides - pain occurs on the side where the follicle is located, and menstrual pain worries the lower abdomen and often gives to the lower back.
At the same time, doctor Eliso Jobava notes that it is impossible to determine the problem only by the type of pain. In addition, the assessment of sensations is subjective: everyone can describe pain syndrome in his own way. According to Jobava, there is even such a diagnosis “acute abdomen”, after which several specialists, such as a surgeon, a gynecologist, and a urologist, study the intestines, reproductive organs and urinary tract. The therapist Tamara Urusova adds that sometimes discomfort is not associated with abdominal problems. So, pain in the abdomen can occur with myocardial infarction or pneumonia.
Why women have a stomach ache more often than men
According to Eliso Jobava, this is due to the anatomical features of the female body - the presence of reproductive organs and cyclic processes in them. Menstrual syndrome is the main cause of abdominal pain in women. Discomfort before menstruation or on the first day of the cycle is usually caused by a spasm of the uterus and the tension of its ligamentous apparatus, which allows the organ to remain mobile. Normally, such a spasm is associated with the process of release of menstrual blood.
In most cases, pain on the first day of menstruation is considered a deviation (there is a diagnosis of "dysmenorrhea" that involves painful menstruation). In rare cases, we are talking about primary dysmenorrhea, when all menstruation is painful, starting with the very first. In fact, this is due to individual physiology, but still does not cancel the examination by the gynecologist. There are also pathological causes of such pain: fibroids, endometriosis, various inflammatory processes. If pain occurs in the middle of a cycle, ovulation is probably the cause of the discomfort. With ovulatory pain, a small amount of fluid from a bursting follicle enters the abdominal cavity. Such discomfort causes not a spasm, but a local reaction to the liquid. If there are many fluids, the pain can be severe and prolonged, if not - the stomach hurts for 1.5-2 hours and then passes.
In second place are chronic abdominal pains associated with frequent stress, as well as intestinal problems, such as intestinal spasms. The latter usually occur in irritable bowel syndrome with bloating, constipation, or diarrhea, or as a result of malnutrition: eating fatty, fried, or large amounts of sugary foods, alcohol, and fasting or overeating. A third common cause is biliary and urinary problems and infections. Tamara Urusova notes that in this case it is important to exclude gallstones, cystitis and the presence of gastritis or gastric ulcer caused by the bacterium Helicobacter pylori.
Do I need to be afraid of Helicobacter pylori
Helicobacter pylori is a bacterium that lives in the mucous membrane of the stomach and duodenum. In 2005, the Nobel Prize in Medicine was awarded for the discovery of the role of this microorganism in the development of gastritis. Now, according to Elena Tivanova, scientists blame Helicobacter pylori for the appearance of peptic ulcer and stomach cancer - the World Health Organization recognized the bacterium as a carcinogen of the first group. Under the microscope, Helicobacter pylori looks like an octopus: an oblong body with motor flagella, allowing bacteria to actively move in the thick gel of the gastric mucosa and attach to it, forming colonies. To survive in conditions of high acidity, the bacterium produces urease - an enzyme that breaks down urea to form ammonia. The latter neutralizes acidity, providing bacteria with comfortable living conditions. Over time, the enzymes of the microorganism dissolve the protective mucus of the stomach, which provokes inflammation.
Infection with Helicobacter pylori can be called "dirty hands disease". Infected products and water are also sources of infection. You can pick up the latter through a kiss - sometimes the bacterium lives in the oral mucosa. To confirm or deny the presence of Helicobacter pylori in the body allows gastroscopy with biopsy (taking a sample of mucus), but this method has contraindications. Elena Tivanova notes that there is another option - to take a 13C urea breath test in the laboratory. This method gives almost one hundred percent guarantee and is more delicate. If the presence of bacteria is confirmed, only the attending physician will be able to prescribe the appropriate therapy. According to Tivanova, Helicobacter pylori can form special biofilms that protect it from carrier immunity and antibiotic therapy, therefore several schemes have been developed for treating this infection with a combination of two or three key drugs.
What to do to relieve pain
Pain itself is stressful for the body, which means that it is harmful to endure it. Sometimes breathing exercises, diaphragmatic breathing (“belly breathing”), stretching exercises of the ligaments of the spine and abdomen help loosen or completely relieve discomfort in the abdomen - the meaning is that the muscles and ligaments of the lumbar spine and muscles that pass inside belly. But in most cases, medication is needed.
Analgesics (for example, on the basis of paracetamol, ibuprofen, metamizol), antispasmodics, as well as combination drugs with analgesic and antispasmodic action are popular painkillers that are sold over the counter in pharmacies. However, it is not safe to drink analgesics or combination medications for a spasm. Such tools do not take into account the nature of pain, but only mask the latter - they block the transmission of the pain signal, without affecting its cause. This can make diagnosis difficult and cause serious damage to health. In addition, if the pain is caused by diseases of the gastrointestinal tract, such as gastritis or an ulcer, taking an analgesic or a combination drug will irritate the mucous membrane, which will only worsen the condition.
For abdominal pain, experts advise that you first take an antispasmodic. It does not interfere with the mechanisms of pain sensitivity and does not "erase" the symptoms in acute surgical diseases. This drug can affect spasm in different ways: it affects receptors, blocks the pathways of substance transfer into the cell, and prevents the functioning of enzyme proteins. With spastic pain, it always has a targeted effect - by relaxing the muscles, it eliminates the pain syndrome. Some antispasmodics can affect only the muscle of the intestines, the intestines and uterus, or the intestines and biliary tract - a suitable option if the nature of the pain is known. If within a couple of hours after taking a spasmolytic pain does not go away, the cause of the discomfort is hardly associated with a spasm and the drug will be ineffective. In this case, you need to consult a doctor as soon as possible.
Medical consultation also requires regular pain, which is often a signal of irritable bowel syndrome, which needs full treatment, and not just relieve pain. Obstetrician-gynecologist Eliso Jobava notes that acute persistent abdominal pain is an alarming signal. Such discomfort can be associated with life-threatening situations: appendicitis, ectopic pregnancy (on the background of two or three days of delay), ovarian apoplexy with bleeding into the abdominal cavity (in the middle of the cycle during ovulation). If the pain first appeared, its intensity increases or it is accompanied by fever, nausea, vomiting, emergency medical care should be called.
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