Abdominal pain and vomiting is a symptom of the disease

Everyone is probably familiar with painful sensations in the abdominal area, accompanied by productive vomiting. These manifestations are observed in the clinical picture of diseases of many organs, mainly those located in the abdominal cavity and directly involved in the digestion process. Abdominal pain and vomiting also manifest pathological changes in organs located close to the abdominal area, or these manifestations may not be related to organic disorders at all.

Often, such symptoms require immediate medical attention - abdominal pain and vomiting are part of the symptom complex of "acute abdomen". Let's try to figure out what to do when this kind of malaise befalls you or someone close to you.

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Causes abdominal pain and vomiting

When talking about abdominal pain, they usually mean sensations coming from the internal organs located directly in the abdomen, and not the soreness of the skin or the underlying muscle layer. Vomiting signals, in most cases, the body's desire to cleanse itself, to get rid of the contents that irritate the walls of the stomach. The occurrence of antiperistaltic (reverse to the normal flow of food) movement begins when the intensity of irritation has exceeded the permissible threshold.

Abdominal pain and vomiting can be caused by inflammatory processes of infectious and non-infectious origin, significant deformation (stretching) or ischemia of almost any organ in the abdominal region or retroperitoneal space.

Risk factors for the appearance of such symptoms are viral diseases, bacterial infections (food poisoning), allergic reactions, appendicitis, diverticulitis, hepatitis, pancreatitis, nephritis, acute gastritis, exacerbation of peptic ulcer disease, toxic effects of poisonous substances, the presence of parasites, etc.

Pain during stretching of the digestive organs, ischemic processes in their membrane appears under the influence of such factors as blockage or compression of the lumen by calculous formations, neoplasms, intestinal volvulus. The closer to the stomach the obstruction develops, the stronger the gagging urge and the more intense the vomiting.

Abdominal pain and vomiting can also appear with a mysterious disease - irritable bowel syndrome, when the patient has these symptoms, but there are no organic disorders.

Gynecological diseases in the acute stage can be accompanied not only by pain, but also by vomiting caused by pain syndrome.

Sometimes the appearance of such symptoms accompanies neuroses and other disorders of the nervous system, for example, acute reactions to strong shocks, unpleasant stimuli, stressful situations. First of all, nausea, vomiting and pain sensations accompanying the gagging urge are caused by vasovagal reactions, when the immediate cause is a temporary disruption of the blood supply to the brain caused by dysfunction of the heart muscle due to intense stimulation of the sensory fibers of the vagus nerve. Irritation of the phrenic nerve is also a stimulus for the appearance of the gag reflex.

Abdominal pain and vomiting may be observed in a diabetic due to impaired glucose metabolism or gastroparesis.

Pain radiating to the abdominal region in combination with vomiting is sometimes present in the clinical picture of myocardial infarction, pneumonia or bronchitis.

These symptoms are often observed during treatment with certain drugs (corticosteroids, cytostatics, non-steroidal anti-inflammatory drugs), during a course of X-ray therapy, and in septic conditions.

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Symptoms

Pathological conditions, when the first signs of ill health are expressed by abdominal pain and vomiting, almost always require immediate examination of the patient, since such manifestations are observed in many diseases. Some of them are related to the "acute abdomen" syndrome and, although not rare conditions, nevertheless require emergency measures to save the patient's life.

When an adult has a stomach ache and vomiting, it is necessary to establish what other symptoms the person is complaining of. Quite often, this condition occurs with food poisoning. The presence of vomiting indicates the body's attempts to get rid of the contents of the stomach, which irritates its walls. In case of poisoning with poor-quality food products or toxic substances, vomiting occurs quite often, in addition to these symptoms, fever, rumbling in the intestines and frequent diarrhea are characteristic.

Abdominal pain, vomiting and fever that suddenly appear may indicate the development of acute appendicitis. Vomiting in adults with inflammation of the cecum, as a rule, does not recur more than twice at the beginning of the attack, then other symptoms prevail - a shift in pain to the lower quadrant of the abdomen on the right, fever, loss of appetite. One of the important signs is difficulty passing gases, the pain is felt constantly, it can be moderate in strength, its intensity can increase, with the development of suppuration it can acquire a paroxysmal character.

The most common complication of acute appendicitis is perforation of the inflamed appendix and development of peritonitis. Inflammation of the peritoneum is characterized by the development of general symptoms - weakness, increased heart rate, hyperthermia, hypotension, in addition, there is severe pain in the abdomen, accumulation of gases that have not found an outlet, tension of the abdominal muscles, vomiting of bile may occur. Intoxication increases and the inflammation spreads, capturing an ever larger space. The patient increasingly loses strength, his facial features become sharper, there is sweat on the forehead, consciousness is confused, moments of excitement alternate with periodic inhibition and even loss of consciousness. Abdominal pain and vomiting are observed constantly. Peritonitis complicates any advanced inflammation of the peritoneum and retroperitoneal space. In most cases, it does not occur suddenly. The patient should have already experienced discomfort in the abdominal area. Such patients need emergency surgical care.

Acute pancreatitis is accompanied by a triad of main symptoms - girdle pain and pain radiating to the neck and shoulder, vomiting and abdominal distension. Temperature fluctuates from above subfebrile to loss of strength, fluctuations are frequent and debilitating.

Acute cholecystitis and acute nephritis, renal colic also occur with symptoms such as abdominal pain and vomiting. The same symptoms may accompany a broken ectopic pregnancy, ovarian cyst apoplexy. Vomiting often occurs as a reaction to severe pain. In such cases, the pain does not subside, vomiting recurs and the patient's condition quickly worsens. In such cases, urgent medical care is needed.

The presence of a high temperature is a sign of an acute process, however, one should not relax if the patient’s body temperature is normal or even a loss of strength is observed.

Stomach pain, vomiting, no fever in most cases with gynecological problems related to acute abdomen syndrome - ruptured ectopic pregnancy, ovarian apoplexy or torsion of the ovarian cyst stalk. Inflammatory diseases of the peritoneum organs are not accompanied by a rise in temperature in all patients, at least in their initial stages, but if in case of viral hepatitis the speed of seeking help will not greatly affect the outcome of the disease, then in case of acute pancreatitis, appendicitis, intestinal volvulus or ectopic pregnancy, the timeliness of medical intervention significantly affects the scope of the operation, postoperative therapy and the prognosis of the disease.

The condition described by the patient as "stomach ache, nausea, weakness" may simply pass by itself and, at the same time, be present in many pathologies of various organs. If such symptoms have been felt for a long time, bother periodically, then it is worth contacting a gastroenterologist, since they may indicate the presence of gastritis, peptic ulcer, irritable bowel syndrome; a gynecologist, if the pain is localized above the pubis, on the side in the lower abdomen and radiates to the lumbar region; a nephrologist or urologist. If the stomach hurts suddenly and severely, and then nausea and malaise appear, then you should not wait for further developments for a long time. It is better to consult a doctor, especially if there is no improvement.

Abdominal pain, diarrhea and vomiting in most episodes of diseases with such symptoms accompany intestinal infections, food poisoning. The occurrence of such symptoms is usually associated with the oral ingestion of pathogenic microorganisms - bacteria, viruses, parasites, causing inflammation of its mucous membrane in some area - the stomach, duodenum, small or large intestine. Additional signs indicating an intestinal infection are weakness, headache, rumbling in the area below the navel, bloating. The temperature can vary - from normal or subfebrile to very high, in addition, some infections have specific symptoms that help diagnose the disease. Vomiting in intestinal infections usually brings temporary relief to the patient, its appearance usually precedes diarrhea or these symptoms appear simultaneously. It is the presence of diarrhea that suggests intestinal infection, however, examination is necessary, since, for example, with irritable bowel syndrome, all these symptoms may be present, but infection and organic pathologies are not detected.

Abdominal pain without diarrhea and vomiting is more typical for ruptures, stretches, twists or compressions of the peritoneal organs and extraperitoneal space. The pain itself indicates trouble, its intensity is a signal for urgent diagnostics. Localization can tell where to look for pathology, however, abdominal pain itself is not the only diagnostic sign of any disease.

Diarrhea, vomiting, fever and abdominal pain – if the symptoms are described in order of their significance, then it is most likely that the patient has consumed poor-quality food or contracted an intestinal infection. When frequent vomiting and diarrhea are combined, severe water and electrolyte losses pose a great danger, even death. There are about thirty common intestinal infections, many of which are so-called food poisonings. Depending on the massiveness of the invasion, the type of pathogen and the patient's immunity, some of them are milder, for example, abdominal pain and diarrhea without fever can go away on their own within a day. Often, they are accompanied by severe symptoms with signs of general intoxication – loss of strength, headache, fever. High temperature (39-40 ℃), abdominal pain and diarrhea combined with nausea and vomiting are also present in severe food poisonings.

The presence of the above symptoms cannot be ruled out in acute appendicitis, diverticulitis, pancreatitis, and hepatitis. Although diarrhea in this case is not a typical symptom. Nausea, vomiting, and abdominal pain are more typical for inflammatory diseases, ischemic pathologies, and obstructions of hollow organs. Moreover, the leading symptom is pain, and nausea and vomiting, especially in the initial stages of the disease, appear due to severe pain syndrome.

Vomiting, abdominal pain and chills can be observed as a result of food poisoning, and during exacerbation of gastritis or cholecystitis. In this case, gynecological inflammations, acute appendicitis and hepatitis cannot be ruled out. Chills can accompany an increase in body temperature, fever, sweating and trembling of the limbs can be manifestations of extreme weakness as a result of intoxication or severe pain, for example, with a ruptured ovary or fallopian tube during an ectopic pregnancy. The same manifestations can be hysterical in nature, appear as a consequence of severe stress or overwork.

Abdominal pain and vomiting of bile, first of all, make us remember about the possibility of chronic liver pathologies, bile reflux, gallstones or gallbladder ducts. In such cases, biliary colic is observed after eating non-dietary food (fatty, spicy, fried, freshly baked pastries), after feasts with abundant libations. Moreover, such attacks are usually observed periodically after gastronomic excesses. In this case, it is imperative to visit a gastroenterologist and undergo an examination.

The sudden appearance of such symptoms may be a sign of acute pancreatitis, small intestinal obstruction, acute appendicitis and hepatitis, damage to the central nervous system. Vomiting of bile is also observed with peritonitis.

It is necessary to pay attention to the nature of the pain. Strong, sharp pain in the abdomen and vomiting, mainly indicates an acute development of the process - inflammatory or destructive. Although the concept of pain intensity is very individual. Everyone perceives pain at a level accessible to him, there are many cases when people with acute appendicitis came to the doctor's appointment on foot, not considering their pain to be strong enough.

Sharp abdominal pain and vomiting may be psychogenic. They are usually diffuse, without a specific localization, vomiting is preceded by nausea. These symptoms are accompanied by feverish excitement or, conversely, loss of strength.

Cutting pain in the abdomen and vomiting are most often an alarming symptom, an occasional spasm or colic rarely has this character. Often they indicate conditions of "acute abdomen" requiring emergency surgical care - appendicitis, peritonitis, pancreatitis, ulcer perforation, ectopic pregnancy.

During exacerbations of gastritis, the consequences of eating unsuitable food can also be cutting pains in the abdomen and vomiting, preceded by nausea, heartburn, and belching.

Pain of the same nature can be caused by cholecystitis, parasitic infestations, severe inflammation of the pelvic organs, and intestinal infections.

The localization of pain will help to suggest which organ should be examined first. For diseases of the liver, gallbladder, right-sided sections of the intestine, normally located appendix (lower right), right kidney or paired genitals (the pain often radiates to the lower back) abdominal pain on the right and vomiting are characteristic. Slightly to the left of the central line at the level of the lower edge of the stomach, the pancreas hurts (often the pain is of a girdle nature). In the left middle and lower part of the abdomen, pains associated with problems in the intestinal sections, left kidney, appendages are localized. The abdomen above the pubis hurts with processes in the uterus and bladder, lower sections of the intestine. With an abnormal location of the appendix, the localization of pain can be different.

Abdominal pain and vomiting with blood indicate bleeding. Most often - gastric or intestinal, sometimes from the vessels of the pharynx or esophagus. Significant admixtures of blood are characteristic of ulcerative bleeding. With cirrhosis of the liver, bleeding occurs from dilated vessels in the esophagus. Erosive gastritis can manifest itself as vomiting with bloody streaks. With hemorrhagic phenomena in the digestive tract, black feces or feces with black areas are usually observed.

Headache, vomiting and abdominal pain may accompany migraine, hypertension (especially with predominant kidney damage), tumors and consequences of brain injuries. With any organ damage, such a combination of symptoms with hyperthermia is possible, which often causes headache.

Vomiting and pain in the back and abdomen often indicate acute pancreatitis. Renal pain is given to the back. Painful sensations during inflammatory processes in the genitals in patients of any sex are often localized in the back and lower abdomen, strangulation of the inguinal hernia and atypical location of the appendix, neoplasms can manifest themselves as pain in this localization.

Lower abdominal pain and vomiting are typical signs of inflammatory bowel disease - the patient experiences diarrhea and rumbling in the abdomen. Severe lower abdominal pain and vomiting as a result of pain syndrome are possible with acute diseases of the pelvic organs, appendicitis (on the right), diverticulitis (on the left).

The time of vomiting is a diagnostic criterion. The occurrence of vomiting in the morning hours allows us to assume its alcoholic etiology; without preliminary nausea, sudden morning vomiting may indicate brain diseases.

Abdominal pain and vomiting after eating most often occurs with gastritis and peptic ulcers; vomiting towards evening occurs with diseases that contribute to the disruption of the process of passage of the food bolus through the digestive tract.

The smell of vomit can also indicate its origin. A sour smell indicates excessive production of hydrochloric acid, a rotten smell indicates indigestion, and a fecal smell indicates partial or complete obstruction. In case of poisoning with chemical substances, the vomit will emit a corresponding smell. In the case of kidney failure, the vomit has a pronounced ammonia smell, and the vomit of a diabetic has the smell of acetone.

We will talk separately about pregnant women, for whom abdominal pain and vomiting, usually in the morning, are quite normal in the first months of pregnancy. However, if the abdominal pain is strong enough and vomiting is frequent, it is necessary, at a minimum, to inform the gynecologist who is monitoring the pregnancy. In addition, pregnancy can become an impetus for the exacerbation of chronic diseases; pregnant women are also not insured against organic catastrophes in the abdominal cavity.

Read also: Vomiting and abdominal pain in a child

Diagnostics abdominal pain and vomiting

Abdominal pain and vomiting are not specific symptoms and the need to call an ambulance is determined by the patient's condition. With the "acute abdomen" syndrome, the pain is usually intense. With a sudden attack, the patient tries to take a comfortable position to reduce the pain. Often, any movements, coughing and deep breathing are accompanied by increased pain. Associated symptoms can be different, depending on the pathology that has arisen, vomiting is one of them. Other pathologies that do not require emergency surgical intervention can be masked under the clinical picture of "acute abdomen", however, only a specialist can distinguish one disease from another using tests and instrumental methods.

Diagnostics includes an express examination that will confirm the need for urgent surgery or allow observation and further examination of the patient for pathologies that do not require emergency surgical measures.

The main diagnostic measures are questioning the patient, superficial palpation of the abdomen with checking for symptoms of peritoneal irritation, tapping and listening to sounds of organ function, general blood and urine tests, as well as ultrasound examination of the peritoneum, retroperitoneal space and pelvis. Endoscopic examination of the gastrointestinal tract may be necessary. Other instrumental diagnostics are also prescribed - tomography, radiography, laparotomy.

If an infection is suspected, rapid antigen detection tests are performed using any method available at the medical facility – enzyme immunoassay, radioimmunological, or latex agglutination. The type of infectious agent is finally determined using polymerase chain reaction or serological methods. A longer period of time is required to isolate pathogens from vomit or feces cultures using the bacteriological method.

The tests ordered depend on the symptoms identified and the suspected pathology. These may include liver function tests, blood and urine biochemistry, and assessment of the degree of dehydration and electrolyte loss.

To differentiate pseudo-abdominal syndrome, echocardiography and electrocardiography, studies of the bronchopulmonary system, and X-rays of the pelvic region and chest may be prescribed.

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Differential diagnosis

Differentiation is made between surgical and therapeutic pathologies, and among surgical ones, acute appendicitis, cholecystitis, pancreatitis, perforated ulcer, acute and obstructive (caused by the presence of a tumor) intestinal obstruction, phlegmon of the intestine and stomach, diverticulitis, disrupted ectopic pregnancy, hemorrhage in the ovary, strangulated hernia, the presence of peritonitis and other diseases requiring immediate surgery are distinguished.

There are also pathologies of the peritoneum that are not subject to immediate surgical intervention - newly discovered uncomplicated cholecystitis and pancreatitis, exacerbation of peptic ulcer, Crohn's disease, cecal mobility syndrome, endometriosis and lipomatosis of the ileocecal valve, renal colic.

Surgical pathologies are distinguished from non-surgical ones – intestinal dyskinesia, acute gastritis, cyclic vomiting syndrome, parasitic invasions, intestinal infections (cholera, salmonellosis, dysentery, actinomycosis, food poisoning, etc.), irritable bowel syndrome, lead colic, acute gynecological inflammations without organ perforation and peritonitis, pseudo-abdominal syndrome (acute pleuropneumonia, cardiovascular pathologies, spinal diseases).

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Complications and consequences

The greatest danger is caused by delay when abdominal pain and vomiting are symptoms of conditions united by the term "acute abdomen". Uncomplicated inflammatory processes of the peritoneum organs are easily eliminated, which cannot be said about complicated ones, for example, perforation, when purulent contents of the inflamed organ and necrotic tissue fragments enter the abdominal cavity. Diffuse peritonitis occurs, which can be dealt with only in the initial stages of its development. The operation to cleanse the abdominal cavity can last several hours, then the patient undergoes a long course of inpatient treatment using detoxification and antibacterial therapy. Every fourth patient dies from diffuse peritonitis, so the cause of abdominal pain and vomiting must be established as soon as possible, at least diseases requiring immediate surgical intervention must be excluded - acute appendicitis, severe forms of acute cholecystitis and pancreatitis, perforated ulcer, intraperitoneal hemorrhage.

Abdominal pain and vomiting with diarrhea in intestinal infections are complicated by the development of dehydration, which can also lead to death. Dehydration occurs especially quickly in small children. In severe forms of intestinal infections, for example, salmonellosis, infectious toxic shock can develop with subsequent cerebral edema, renal or cardiovascular failure. Dysentery can be complicated by prolapse of the rectal mucosa.

It is entirely possible to avoid unwanted consequences by promptly seeking medical help and undergoing adequate treatment.

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Prevention

A huge role is played by proper nutrition, giving up bad habits and an active lifestyle - walks in the fresh air, feasible physical activity, hardening activities increase our resistance to stress and immune status.

Also, a measure that prevents the development of diseases that manifest themselves as abdominal pain and vomiting is compliance with basic sanitary and hygienic standards, as well as normalization of the rhythm and lifestyle, providing conditions that allow you to relax and relieve emotional stress, and cope with negative emotions if they arise.

You can use everything – autogenic training, yoga, other practices that cultivate a positive attitude in us.

If you have chronic diseases, undergo preventive examinations on time and follow the doctor’s recommendations to avoid exacerbations.

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Forecast

Serious consequences can be avoided by promptly seeking medical help, since almost all uncomplicated diseases that cause abdominal pain and vomiting are currently curable, if not by conservative, then by surgical methods.