Stomach aches are not diseases?
People often say "stomachache is not a disease, it will be fine in a moment", is this really the case?
The stomach is medically said to be the abdomen, which has many tissues and organs, no matter which part of the problem will cause stomach pain, and even sometimes it is not a problem with the organs in the stomach, such as some heart attack will also make people feel that it is stomach pain.
So stomach pain is a symptom, and there are many, many causes and diseases that can have this symptom.
At the same time, stomach pain is an imprecise statement, because the area of the stomach is relatively large, sometimes it is part of the pain, such as the upper left pain, the right lower abdominal pain, etc., sometimes the whole abdomen is painful, most of the cases are not caused by a disease.
If you want to know if there is a stomachache, then find the cause of the stomach pain, see if it needs to be treated urgently, or take some medicine, or observe it.
Some common diseases of stomach pain
1. Acute appendicitis:
Appendicitis should be the first thing everyone thinks of stomach pain, generally the appendix grows at the end of the cecum, in the right lower abdomen of the human body, so the right lower abdominal pain, everyone thinks of appendicitis.
However, when most patients start with the disease, it is not the right lower abdominal pain at the beginning, but the persistent vague pain in the middle and upper abdomen, and then the abdominal pain metastasizes to the right lower abdomen after a few hours, showing persistent vague pain, accompanied by paroxysmal exacerbation. A small number of patients feel right lower quadrant pain at the onset of the disease.
Therefore, in the medical records of hospital doctors, it is often written that "metastatic right lower abdominal pain for several hours", when there is such a description, it can basically be determined that it is appendicitis.
Such abdominal pain can also be accompanied by nausea, vomiting, or diarrhea, and in severe cases, fever, fatigue, and mental difficulties. The right lower quadrant fixes the tender point. Blood white blood cell count is elevated and neutrophils are elevated during the test. Color ultrasound may reveal swelling of the appendix or a fluid dark area around the appendix.
If acute appendicitis is diagnosed, it is impossible to observe, first apply antibiotics, fast water, conservative treatment to improve and continue to use drugs for a period of time. If conservative does not work, and even some suppuration or perforation, surgery is required.
2. Acute gastroenteritis
This is probably the most common cause of tummy pain, which is predominantly abdominal pain above the abdomen and around the umbilicus, often with persistent pain with paroxysmal exacerbation and slight hyperintestinal sounds. There is often a history of unclean diet before the onset of the disease, often accompanied by nausea, vomiting, diarrhea, and fever. Laboratory tests: routine stool tests may be abnormal.
Most of this abdominal pain can be relieved by fasting for a day or two, most do not require special treatment, if the abdominal pain is not relieved, there is severe vomiting and diarrhea, and it is necessary to seek medical rehydration and oral antibiotics.
3. Acute cholecystitis
Abdominal pain caused by this disease is also common, and stomach pain caused by cholecystitis is characterized by persistent pain in the right upper quadrant, radiating to the right shoulder, and often accompanied by fever, nausea, and vomiting.
Abdominal pain caused by acute cholecystitis is mostly gallbladder stones, often occurring after a fatty meal, with significant tenderness in the right upper quadrant, sometimes palpable swollen sac, and jaundice in patients with biliary obstruction.
Blood white blood cell count is elevated, neutrophils are elevated. Color ultrasound may reveal a large gallbladder, swollen cyst wall, wall thickness or exudation around it, and is the preferred test.
Antibiotics are also used first in the treatment of acute cholecystitis, and emergency surgery is often required if not relieved.
4. Acute pancreatitis
It often occurs suddenly after overeating or alcoholism, and people with a history of gallstones are more likely to occur.
The site of pain is in the epigastric region, persistent pain, radiating to the lower back, nausea and vomiting, abdominal pain in severe patients spread rapidly to the whole abdomen, often fever, and early appearance of shock or multiple organ dysfunction syndrome. above
Blood white blood cell count is elevated, neutrophils are elevated. Blood and urine amylase may be markedly elevated, and CT and ultrasound may reveal pancreatic enlargement, loss of the peripanimal layer of fat, and peripanicreatic or peritoneal effusions.
5. Abdominal pain specific to women
(1) Acute pelvic inflammatory disease
Presents with persistent or diffuse abdominal pain in the lower abdomen. Most occur during menstruation or when menstruation has just stopped, and there is often a history of pelvic inflammation or a history of preterm birth, induction of labour, miscarriage, gynaecological examination procedures, or a history of unclean sex.
It may be accompanied by nausea, vomiting, frequent urination, urgency, dysuria, and in severe cases, chills and fever. Gynecological examination: vaginal discharge, cervical swing pain, lifting pain. Blood white blood cell count is elevated, neutrophils are elevated. Cervical smear and bacterial culture are helpful in diagnosis. Gynecological ultrasound examination may reveal pelvic effusions or fallopian tubes and ovarian cysts.
(2) Ectopic pregnancy rupture
Women of childbearing age who have menopause for more than 6 weeks or months have sudden severe pain in the lower abdomen, often with persistent pain and a small amount of vaginal bleeding. Shock is common, intraperitoneal puncture draws out non-clotting blood, and intraperitoneal blood chorionic gonadotropin (HCG) measurements are significantly elevated.
Pregnancy tests are positive, and the diagnosis can be confirmed by ultrasound examination and CT test.
6. Acute intestinal obstruction
Children are mostly caused by intestinal ascariasis and intussusception; adults are mostly caused by hernia incarceration or intestinal adhesions; and the elderly are caused by intestinal tumors.
Abdominal pain in small bowel obstruction is mostly around the umbilicus and presents as paroxysmal colic, with nausea, vomiting, bloating, and cessation of defecation and defecation.
Common causes of colon obstruction are colon cancer, intussusception, and volvulus, often with bloating and cessation of defecation.
Blood white blood cell count is elevated, neutrophils are elevated. Plain x-ray abdominal examination may reveal intestinal lumen inflation with fluid-gas levels and closed bowel tubes.
7. Perforation of gastric and duodenal ulcers
Stomach and duodenal ulcers tend to occur in young and middle-aged people, mainly middle and upper abdominal pain, mostly persistent pain, mostly on an empty stomach, and can be relieved after eating or taking antacids.
When an ulcer is acutely perforated, sudden severe pain in the epigastric region, such as a knife cut, persistent, and rapidly spreads to the entire abdomen in a short period of time, with nausea, vomiting, and fever. May be accompanied by hematemesis or melaena.
After perforation, full abdominal tenderness can occur, abdominal muscle tension is "plank-like rigidity", rebound pain, and intestinal sounds disappear.
Plain x-rays of the abdomen may reveal diaphragm-free gas and abdominal puncture to aid in the diagnosis.
It should be noted that gastrointestinal fluid can flow along the ascending paracolonal groove to the right lower abdomen in patients with gastric and duodenal ulcer perforation, which can present as metastatic abdominal pain and should be distinguished from acute appendicitis.
8. Other common abdominal pain
(1) Rupture of abdominal organs: often abdominal trauma leads to spleen rupture, liver rupture, kidney rupture, pancreas rupture, etc., liver cancer lesions can rupture due to external force or spontaneous rupture. Onset is sudden, and persistent abdominal pain often involves the entire abdomen, often with shock.
(2) Bile duct stones and cholangitis: there is often a history of repeated attacks of right upper quadrant pain. Abdominal pain, chills, high fever and jaundice. May be accompanied by nausea and vomiting. Ultrasound, CT, MRCP, etc. are all helpful in diagnosis.
9. Unbearable abdominal pain: urinary tract stones
Abdominal pain often occurs suddenly, mostly in the left or right abdomen, with paroxysmal colic, unbearable, radiating to the perineum, often accompanied by low back pain.
There is no significant tenderness in the abdomen, or tenderness at the upper and middle ureteral points only, or percussion pain in the renal area. Urine red blood cells are positive, but bacteria and proteinuria may also be detected.
Plain x-ray of the abdomen may show positive stones that do not show x-rays, intravenous pyelography can visualize stones and their blocked sites, and renal pelvis on the obstructive side of the stone tends to delay development. Urinary ultrasound or magnetic resonance imaging confirms the diagnosis.
10. Fatal abdominal pain
(1) Acute myocardial infarction: Some symptoms of acute myocardial infarction and acute pericarditis are manifested as sudden pain in the epigastric region, but are more common in middle-aged and elderly people. Because the site of myocardial infarction, such as in the diaphragm, especially in large areas, there is more epigastric pain. This pain occurs suddenly after exertion, tension, or a full meal, is persistent, and radiates to the left shoulder or the inside of both arms. Often accompanied by nausea and may be in shock. EcG or myocardial enzyme profile may confirm the diagnosis.
(2) Rupture of abdominal aortic aneurysms: mostly persistent severe pain in the abdomen and lower back, pulsatile masses can be reached in the abdomen, hypotension or shock. Diagnosis can be made on ultrasound examination, abdominal enhancement CT, angiography, or abdominal magnetic resonance imaging, and it is difficult for patients with ruptured abdominal aortic aneurysms to survive.
(3) Mesenteric vascular embolism or thrombosis
Sudden severe pain in the abdomen, accompanied by nausea and vomiting. At the beginning of the disease, the degree of abdominal pain is disproportionate to the abdominal signs, the abdominal tenderness is light, the bowel sounds are active, and as the lesion progresses, the bloating gradually increases, the signs of peritonitis appear, the bowel sounds disappear, there may be bloody stools, and shock is rapid. Plain x-ray abdominal film may show intestinal dilation and gas-fluid level, but plain x-ray abdominal film may also be found without abnormalities. Color Doppler examination, magnetic resonance angiography, or angiography confirm the diagnosis. Patients who are not treated in time will have small bowel necrosis and there is no hope of survival.
11. Others:
For example, lead poisoning is characterized by paroxysmal abdominal cramps. Usually the onset of abdominal pain is sudden, mostly around the umbilicus.
For example, diabetic ketoacidosis is mostly epigastric pain, which is not fixed and relieved with the correction of acidosis.
Abdominal pain, such as gastrointestinal cramps, is also common and can mostly be relieved in a few moments.
When abdominal pain requires medical attention
Some people think that abdominal pain is okay, it is good to stand up, some people think that as long as it is painful, you have to go to the hospital to see it, so what kind of abdominal pain needs to be treated?
1. Unbearable abdominal pain should be treated immediately, because such abdominal pain often needs to be treated immediately, such as mesenteric vascular thrombosis, and most of the blocked blood vessels can be re-passed by rapid diagnosis and treatment.
2. Abdominal pain within a few hours of shock, that is, cold sweat, pulse is not clear, cold hands and feet must be consulted. This condition often indicates heavy bleeding, and if the bleeding is not stopped in time, the transfusion and rehydration fluid may be fatal. For example, liver rupture, ectopic pregnancy, etc.
3. Abdominal pain is not very serious, but it lasts for several days without relief and also needs to seek medical treatment, such as intestinal obstruction has not been defecated and deflated, gastroenteritis has not been alleviated, etc.
4. People with cardiovascular and cerebrovascular underlying diseases have abdominal pain, and such people are best to seek medical treatment, because it may be caused by heart causes.
5, if the abdominal pain is not serious, a few hours can be relieved, most can be observed, but in a few days or weeks will appear again, it is also recommended to go to the gastroenterology department for a comprehensive examination.