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Discomfort in the abdominal area with bloating, fever, nausea, after eating: causes and what to do
Medical expert of the article
Last reviewed: 23.04.2024
Absence of comfort in the abdominal area means a variety of sensations from mild nausea and belching to considerable severity and pain. They can occur after eating or, conversely, on an empty stomach, at different times of the day or pestering with enviable constancy. And there can be many reasons for this. Discomfort in the abdomen, especially permanent, can signal the development of a pathological process, and the most reasonable decision in this case is to seek medical help, especially if the obvious reason for overeating or eating poor quality food does not lie on the surface.
Epidemiology
One of the causes of discomfort in epigastrium is functional dyspepsia. Symptomatic digestive disorders are observed in more than a third of the population of our planet. Similar complaints cause about 5% of all requests for medical help. According to medical statistics, only 40% of those applying to the doctor are diagnosed with organic causes of this symptomatology, while the larger part is found within the criteria of functional dyspepsia. As a result, its prevalence is estimated at 15-20% and has a clear tendency to increase.
Irritable bowel syndrome is also considered a very common disease, the frequency of its occurrence in the population is estimated at 15-30%. Female patients with such a diagnosis are doubled, if not quadrupled, more than males. Almost all of them belong to the age group from 25 to 40 years.
Causes of the discomfort in the abdomen
Most often, uncomfortable sensations in the abdominal region arise on the basis of the lack of a diet. Long and uneven intervals between meals result in a person who is fairly hungry for a working day, compensates for this dense dinner, combined with lunch.
Malnutrition, for example, a sharp transition to a hard diet can also provoke discomfort in the abdomen.
Dyspeptic disorders can occur on the background of alcohol abuse, containing caffeine or carbonated drinks, certain types of food (fatty or causing intense gas formation), in heavy smokers, and also as a result of eating poor-quality food and a number of medications.
Provoke digestive disorders can depletion of the nervous system due to stress and mental overexertion, fear and intense excitement in the lead-up to any significant event.
To cause discomfort, and even severe painful spasms, can be food allergens.
This grief is not difficult to help - by analyzing their habits, lifestyle and changing them in a qualitative way.
More serious risk factors for discomfort in the abdomen are infectious and inflammatory diseases of the digestive organs (hepatitis, pancreatitis, gastritis, appendicitis, helminthic invasions and others), genito-urinary organs, neoplasms. In the upper part of the abdomen, there may be an irradiating pain with gastrilagic myocardial infarction. The list of diseases can be continued, as in this and nearby zone there are a lot of vital organs. And if discomfort in the abdominal area worries more than one day, it is recommended to go to a medical institution for a survey and identify its cause.
The pathogenesis of discomfort in the abdomen depends on the cause that caused it. The mechanism of development of unpleasant sensations in the detection of the organic causes of their appearance (gastric and duodenal ulcer, chronic forms of liver and pancreas diseases, neoplasms, the consequences of drug therapy, etc.) corresponds to diseases.
If the patient does not have these diseases, nevertheless, there are complaints of unpleasant sensations in the stomach, then they speak of functional dyspepsia. Its pathogenesis is considered from the point of view of violation of acid formation, gastroduodenal dissotorics and changes in the susceptibility of the internal organs of the peritoneum. The increased acidity of gastric juice and its insufficient neutralization in the antrum is the main role in the occurrence of epigastric pain. Violations of the motor functions of the stomach and intestines, manifested in the inability of adequate muscle relaxation, tachigastria, bradygastria leads to accelerated or delayed food movement and cause stretching of the walls of the stomach, a feeling of overflow and heaviness. A significant role is given to the hypersensitivity of the receptors of the gastric and duodenum shells to extension. Currently, the violation of the duodenal sensitivity of not only increased acid production, but also to fat-rich food is taken into account. Risk factors for functional dyspepsia: heredity, gastrointestinal infections in history, including Helicobacter pylori, stress and other psychosocial causes, smoking and inaccuracies in nutrition.
Functional disruption of the intestinal tract, which is uncomfortable under the navel and associated with a change in the frequency of bowel evacuation and the consistency of feces or other symptoms of defecation, are classified as irritable bowel syndrome. The reasons leading to this are not fully understood, however, there are a number of pathogenetic links that cause this condition: hereditary predisposition (dyspepsia in family history), imbalance, low stress resistance, emotionality. Factors that are the impetus to the development of the syndrome - a sharp change in the habitual specificity of nutrition; preference for any type of food with insufficient fiber (fatty, protein, carbohydrate); sedentary lifestyle; diseases of the urogenital system; dysbacteriosis of the intestines caused by infection or medication, in particular antibiotics; fluctuations of the hormonal background associated with post- and menopause; diabetes mellitus; diseases of the thyroid gland; overweight and other reasons.
The isolation of the main pathogenetic component in each patient suffering from functional digestive disorders is the determining tendency of the appointed therapeutic care.
Symptoms of the discomfort in the abdomen
Clinical signs of unpleasant sensations in the abdominal area can have a different origin, and they manifest themselves in different ways. Consider the most common of them, and the reasons that they can be caused.
For example, if you feel abdominal discomfort and swelling. This condition arose accidentally in the patient, and unpleasant sensations are expressed by short-term, but significant pains (colic), periodically passing, after the departure of the next portion of gases. The pain is wandering, their location is changing. The most likely causes of this condition can be:
- excessive consumption of carbonated beverages;
- ingestion of air during meals, especially hasty, so to speak "on the go" or accompanied by emotional communication;
- the use of a large amount of food containing in excess easily digestible carbohydrates, fiber or starch (fresh baking, black bread, legumes, sweets);
- Mixing incompatible food, for example, fruit, watermelon or melon after a dense dinner.
Such swelling, as a rule, can pass independently, delivering short-term inconveniences, as gases leave the healthy organism naturally quickly enough.
If bloating is a habitual and periodic symptom, accompanied by pain and the patient does not register previous food excesses, it is probably the first signs of any disease of the gastrointestinal tract. Regular flatulence after taking any food can be a symptom of chronic inflammation of the pancreas. Neoplasms, overlapping the lumen of the organ, cause partial obstruction of the gases and bloating. Not off-gases - one of the signs of inflammation of the peritoneum, not only digestive. Meteorism is observed in intestinal dysbiosis, lactase deficiency, celiac disease, irritable bowel syndrome, supplemented by other signs of dyspeptic disorders, in particular, rumbling.
Discomfort in the abdomen and rumbling periodically happens in everyone, and this condition is usually associated with a feeling of hunger. Grumbles in the stomach sometimes and in well-fed people with very delicious smells, and when overeating after a long interval (four hours or more) from the last meal. Body position, abundant libations in combination with carbonated drinks can cause rumbling in the abdomen and associated discomfort. In anticipation of exciting events in the abdomen, rumbling may begin, accompanied by diarrhea and nausea. To cause discomfort and rumbling in the stomach can also physiological causes, for example, violations of the vitamin-mineral balance or menstruation in women. In general, this is not a dangerous and quite natural symptom, which, however, can speak about more serious pathological processes in the body. Rumbles in the abdomen in combination with diarrhea and flatulence in food allergies and imbalance of microorganisms in the intestine, bacterial infection, lactase deficiency and irritable bowel syndrome.
Night rumbling in the stomach, can talk about too early dinner. Then eliminate this symptom will help a glass of yogurt or a light salad of fruits or vegetables for half an hour before bedtime. By night rumble can lead to colitis and pancreatitis, the same dysbiosis, which develops with various diseases, and if it starts to rumble in the stomach when turning to the left side - this can be a sign of gastritis.
If the sounds are localized on the right, then we can assume the presence of inflammation of the gallbladder or pancreatic, left - infectious gastroenteritis or alcohol (food, chemical) intoxication. This condition, as a rule, is accompanied by nausea and a loose stool.
The severity and discomfort in the abdomen are most often felt after eating and are caused by various inaccuracies in the regimen (eating twice a day instead of at least four, a plentiful dinner just before bed, snacks instead of a full meal) and a diet (preference for fried or flour dishes, semi-processed foods , fast food products).
Discomfort in the abdomen after eating almost immediately can be a signal about the presence of chronic gastritis. With excessive acid formation, abdominal discomfort and belching with acidic taste are combined with heartburn or abdominal discomfort and nausea - with belching of rotten eggs, swelling and heaviness in the stomach with reduced acid production. The stomach disease often recurs in the spring and autumn seasons. Ulcerative lesions of the stomach and gastroduodenitis also have similar symptoms and make themselves felt after eating, in some cases immediately, and sometimes in an hour and a half.
Feeling of weight on an empty stomach is provoked by smoking, frequent use of alcohol and carbonated drinks. This condition can arise due to nervous exhaustion, with functional dyspepsia and irritable bowel syndrome.
Discomfort in the stomach in the morning can cause more harmless reasons, such as overeating in the evening, abuse of fatty or sweet food. Usually it is accompanied by disruption of the intestine.
If the sensations persist and do not pass, we can assume more serious reasons: helminthic invasion, appendicitis (painful cider is localized more often in the right side), partial obstruction.
Discomfort in the "hungry" stomach can be caused by inflammation of the duodenal mucosa or duodenal ulcer. Usually it is combined with the following symptoms: eructation, heartburn, nausea and pain, usually at night, which pass after taking liquid and puree food. Peptic ulcer of the bulb of the duodenum can also manifest itself in the abdominal region, the discomfort is expressed in strong pain sensations in the navel zone that appear when one wants to eat and subside immediately after eating.
Malignant neoplasms in the stomach for a long time develop painlessly, however, can be felt by the severity in the stomach, nausea, alternating diarrhea and constipation.
The severity and discomfort in the abdomen is accompanied by other chronic and infectious diseases of the digestive system in combination with other symptoms of dyspepsia, so if a change in lifestyle and diet does not lead to a positive result, then you should seek medical help.
Discomfort in the lower abdomen is a possible consequence of urolithiasis, inflammation of the bladder, pyelonephritis. The signs of these three diseases are similar - soreness in the lower abdomen above the pubis and an unpleasant pressing feeling in combination with frequent urge to urinate, accompanied by burning and pain. There are edemas, elevated body temperature, urine has a dark color, not transparent, maybe with pus.
To unpleasant sensations in the abdomen can cause spasms of smooth muscles of the large intestine, its overflow, the descent of the genitals.
In women, the appearance of pulling pains in the lower abdomen may be associated with menstruation. Inflammatory processes in the female genital organs (salpingoophoritis, endometritis, colpitis, vaginitis), bacterial infections also manifest discomfort in this zone. In addition to unpleasant sensations, there can be discharge from the genitals, discomfort in the abdomen and weakness, and also - fever.
Pregnancy, developing outside the uterus, is accompanied first by a slight, but persistent discomfort on one side of the abdomen. As the fetus develops and grows, the pain intensifies. They have a cramping character, can be accompanied by fainting, hypotension. In this case, timely medical assistance is needed, it is about life and death.
Neoplasms of the pelvic organs may be asymptomatic, but in some cases they show aching pains. Tears and torsions of cysts are usually accompanied by severe pain and require immediate surgical intervention.
Pain and discomfort in the lower abdomen in the stronger sex can be caused by inflammation of the prostate, testicles, inguinal hernia (which can occur in women, but men are more prone to this pathology). These diseases can last a long time latently and manifest themselves at the time of exacerbation of prostatitis (orchitis) or when the hernia is infringed (in this case, severe pain is needed and urgent surgery is needed).
Discomfort in the abdomen to the left may indicate a diverticular disease of the large intestine. Sacral protrusions in the wall of the intestine (diverticula) can theoretically appear from either side, but in the overwhelming majority of cases they are localized on the left. This pathology can be asymptomatic, but can also be manifested by blunt or paroxysmal pains in combination, usually with constipation, a feeling of overflow and heaviness in the intestine, flatulence. Complication in the form of an inflammatory process (diverticulitis) is expressed in severe pain, fever and requires immediate surgical intervention.
Chronic sigmoiditis also makes itself felt by discomfort in the lower left part of the abdomen, pain can be given in the leg or lower back. It is combined with defecation disorders.
Discomfort in the abdomen to the left may be a symptom of any left-sided pathology (renal, inguinal hernia, ectopic pregnancy developing in the left tube or ovary, etc.), as well as right-sided discomfort. In paired organs, such as the ovaries, kidneys, ureters, pathological changes occur mainly on the one hand. The intestines can be struck from one side and then the uncomfortable sensations are localized there.
Discomfort in the abdomen on the right, first of all makes us remember the appendix, which is located on this side. Acute inflammation is usually characterized by severe pain, high (≈39º) temperature, nausea. Can be vomiting. There are many cases when the pain is quite tolerable, but the pain is stubborn and does not recede, appetite disappears and gases do not escape.
The temperature and discomfort in the abdomen, basically, speaks about the need for emergency medical care. Especially in cases of temperature increase to 39 ° and above, which may indicate the development of sepsis. Such a condition may indicate necrosis of the spleen sites due to vascular embolism or thrombosis; rupture of the ovarian cyst or fallopian tube in the case of an ectopic pregnancy, acute renal infection.
Discomfort in the abdomen in the evening can be observed in women during ovulation, with pathologies of the small intestine, in particular chronic enteritis in the form of not too intense painful sensations, which are noisy. Usually they appear in the evening after eating, accompanied by bloating and rumbling, weakness, bleeding gums. Umbilical hernia also worries in the evenings. If there is a bulging out of the rounded shape in the navel, tachycardia, dyspepsia, then you need to call an ambulance and go to the surgical department.
Discomfort in the abdomen and constipation can be accidental. In this case - it is a symptom of using a small amount of fluid, inadequate motor activity, overload of the nervous system, abuse of unsuitable food. Thus, the body can react to taking certain medicines.
However, constipation can also indicate serious diseases of the digestive system. Frequent constipation should be encouraged to be examined in a medical facility to establish their cause. And if constipation is accompanied by fever, nausea, spasmodic pain in the abdominal region, flatulence - it is necessary to call an ambulance.
With bacterial and rotavirus infections, poisoning, allergies, there is often discomfort in the abdomen and diarrhea. Often this state passes independently, as it began. Sometimes the simplest measures - the reception of activated carbon, fixing the infusions of herbs, sparing diet helps to stop the trouble. However, diarrhea is a symptom of serious infections and other diseases requiring treatment. For example, dysentery. All forms of this disease are accompanied by high fever, the frequency of defecation is approximately 13-16 times a day. The patient has fever, weakness, dehydration and anemia. If you do not seek medical help, a toxic shock may develop. Other infectious intestinal diseases are also no less dangerous.
Diarrhea, alternating with obstructed defecation, may be a symptom of irritable bowel syndrome. Diarrhea is accompanied by many acute and chronic diseases of the digestive system. If diarrhea does not last for two days, it is advisable to consult a doctor. As a first aid it is necessary to provide the patient with peace, increase his fluid intake, and offer an enterosorbent.
The constant discomfort in the abdomen, whatever it is, is the reason for the visit to the medical institution. Self-diagnosis and self-treatment should not be engaged, in the abdomen are located vital organs and their pathologies can significantly complicate life, and sometimes break it, and timely diagnosis and treatment can completely eliminate the health problem.
Discomfort in the abdomen during pregnancy
Bearing a child is a crucial period in the life of any woman. This is a natural condition for the fair sex, and most women feel normal during this period. However, like any person, a pregnant woman can feel discomfort in the abdomen.
For example, flatulence and rumbling in the abdomen of pregnant women can cause progesterone, which relaxes the intestinal muscles and reduces the motor activity of the intestine. Excessive gas formation can be triggered by an unbalanced diet (not enough vitamins and minerals), eating a lot of unsuitable food (fatty, sweet, spicy, smoked and pickled). Pain acute, stitching, passes along with the escape of gases. The condition can be combined with a headache, an eructation with an unpleasant odor, nausea and heartburn. Pregnant women can become aggravated by dormant chronic diseases of the digestive system, so with constant discomfort, it is worth paying attention to this doctor.
Flatulence, like gravity in epigastrium, can be caused by an enlarged uterus on long terms. Usually after the birth, everything passes, however, frequent swelling at the end of pregnancy can activate the muscle tone of the uterus and its contractions, which provokes premature birth.
Discomfort in the lower abdomen of a pregnant woman can be a consequence of the physiological processes in her body: in the first weeks the embryo is implanted into the uterine membrane, which can cause some soreness and even small discharge. The growth of the uterus increases the load on the muscles and ligaments in the abdomen, the growing uterus causes displacement of the internal organs, which in sensitive women initiates a feeling of discomfort. These pains are completely tolerable, it is worthwhile to lie down to rest, as the condition improves.
Pathological pain is usually characterized by intensity and persistence. When the threat of termination of pregnancy appears exhausting aching pain in the lower abdomen. If it does not pass for three hours, you need to call an ambulance and go to a gynecological hospital. Later, seizure-like seizures begin with the appearance of bloody discharge. Risk factors for spontaneous abortion are trauma, neuropsychic overload, infection, prenatal pathology.
Premature detachment of the placenta poses a serious danger to the child's future. The pain is intense, intensified with time. In this case, emergency assistance is needed.
Pregnant women are not immune from hernias, acute appendicitis and other troubles, however, if you listen to your body, you can identify a dangerous condition. In the end, it is better to address a trivial problem to a doctor than to neglect something serious.
Discomfort in the abdomen of a child
Children's complaints about abdominal discomfort and dyspeptic disorders are mainly due to haste in the process of eating, poor chewing food, abuse of sweet, carbonated drinks, improper food for the children's stomach, sudden changes in the regime of the day or the nature of food. Discomfort in the abdomen can be caused by events that shook the child's psyche, violent unrest, a surge of emotions. In children of different ages, the causes of discomfort and its manifestation are somewhat different.
Discomfort in the abdomen in infants is manifested by crying, crying, they are bent by an arch or are compressed by legs. In children who are breast-fed, gas education causes mother's milk, if the mother does not worry too much about the organization of her diet and the selection of a suitable diet, since he basically determines the composition of the mother's milk. In this case, the symptoms appear after feeding. When a mother uses canned foods, convenience foods and other foods containing preservatives and nutritional supplements, the child may develop an allergy. Her symptoms are rashes, dry skin, too ruddy cheeks, frequent and loose stools. Mom needs to revise and regulate their diet, usually this leads to normalization of the child's condition. If the cause is not the disordered diet of the mother, then the cause of the disco may be the congenital pathology of the digestive tract in the child. Infants can also have a dysbacteriosis caused by bacterial vaginosis or mastitis in the mother, intolerance to the mother's milk, artificial mixtures, frequent ARI and allergies.
In children older than one year, due to the immaturity of the digestive system due to improper food, and also on the nerves, disruption of the gastrointestinal tract and dyspepsia may occur. Soreness of the abdomen, heartburn, belching, a feeling of heaviness and overflow, nausea, vomiting diarrhea. Violation of the balance of intestinal microflora can be a consequence of pathologies of digestive organs, the consequences of poisoning, infection, antibiotic therapy, irrational nutrition, often recurring stressful situations. Children with dysbiosis slowly gain weight, anorexic, suffer from a stool disorder, flatulence. They can have bad breath, irritated bright red mucous membranes, dry skin, stratification of nails, hair loss. The child is capricious, gets tired quickly, does not sleep well.
Discomfort in the abdomen and diarrhea in a child can be a consequence of dysbiosis, as well as - intestinal infection, food poisoning, drug therapy. A child's organism with frequent defecations quickly loses fluid, the child is constantly thirsty, dizziness and disorientation in space may occur. If diarrhea with fever, abdominal pain and bloody veins in the stools should immediately consult a doctor.
Constipation in childhood is considered to be dispatch with an interval of more than two days. The child has difficulty with defecation, stool dense, lean, periodic paroxysmal pain, flatulence. Constipation may be caused by inappropriate eating, the preference of protein or carbohydrate foods, the lack of food of plant origin. Children with frequent constipation eat poorly, complain of weakness, an unpleasant aftertaste in the mouth. The cause of constipation may become shyness. At the beginning of a visit to a kindergarten or school, it is difficult for a child to restructure and adapt to a new environment, the regime of natural departures is violated.
The cause of discomfort in the abdomen may be a food allergy to any product, not necessarily exotic. A common opinion is that an allergic reaction is a rash, but it can manifest as a dyspepsia. The child has a stomach ache after eating an allergen product, until this product is digested. Swelling, nausea or vomiting, dysbiosis, diarrhea, or constipation may occur. Food allergy is almost never manifested as a respiratory phenomenon.
Discomfort in the abdomen can be caused by intestinal parasites that enter the body with poorly heat-treated foods (fish, meat), not washed with raw vegetables and fruits, with dirty hands. Glistovye infestations can be manifested by malaise, dizziness, dyspepsia. Attacks are followed by periods of relief. Children complain of abdominal pain, there may be a rash on the skin. The child is losing weight. Intoxication by the products of the vital activity of parasites aggravates dyspeptic symptoms, the child may have vomiting during meals. When enterobiosis (infection with pinworms), children often experience severe itching in the perineum, they experience bedwetting. Ascariasis is manifested by frequent vomiting with an admixture of bile, the temperature periodically rises, abdominal pains similar to intestinal colic. The child complains of a headache, does not sleep well, becomes irritable.
Acute appendicitis manifests itself first with epigastric pain, which then descends down the abdomen. There may be nausea, constipation, gas retention, high fever, vomiting. In children, the symptoms are usually acute and the process develops quickly. This situation requires immediate medical attention.
Rotavirus infection is manifested by moderate pain in the stomach, rumbling, swelling, lack of appetite and frequent vomiting. Diarrhea lasts from three to six days.
Discomfort in the lower abdomen can be caused by acute cystitis.
In case of acute painful sensations in the abdomen of a child, especially accompanied by a rise in temperature, it is necessary to call a doctor. You do not need to feed, palpate and warm your stomach, give analgesics.
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Complications and consequences
One-time discomfort in the abdomen caused by inaccuracies in the diet and diet and eliminated with sorbents, phytopreparations and a sparing diet usually does not entail any consequences.
Nevertheless, if the discomfort, even moderately expressed, periodically reminds of itself or is present constantly, it testifies to organic infringements. To determine the causes of discomfort in the abdomen and effectively eliminate them, you need to seek medical help.
Long to ignore the symptoms of the "acute abdomen" is unlikely to succeed, but for a small, but persistently repeated digestive disorders, many people do not pay attention for a long time. This can lead to serious chronic diseases of the digestive system, such as inflammatory, calculous, erosive-ulcerative lesions. And if with timely begun and full treatment, the consequences may be absent or minimal, then with neglected forms of chronic diseases, conservative treatment is often not enough. Operative treatment is carried out, consisting in the removal of part or all of the diseased organ, after which the quality of life of the patient is significantly reduced.
Diagnostics of the discomfort in the abdomen
Diagnostic measures include examining and interviewing the patient for the time of onset and frequency of symptoms of discomfort, their relationship to eating, the expected causes.
Assign laboratory tests: blood (clinical, biochemistry), urine, feces (for eggs helminths, hidden blood, coprogram). The modern diagnostic method is the blood analysis "gastropanel", which allows to detect Helicobacteriosis (by the presence of antibodies to Helicobacter pylori), the level of Pineinogen I (proenzyme isolated by the fundal glands of the stomach, the precursor of pepsin), the level of gastrin (digestive hormone, which allows to recognize the disturbances in the formation of hydrochloric acid ).
Widely used instrumental diagnostics, primarily, esophagogastroduodenoscopy, allowing to visually assess the structure of the internal surface of the esophagus, stomach and duodenum. During this procedure, a biopsy specimen is taken and acidic products are tested with the stomach. A respiratory diagnosis of Helicobacteriosis may be prescribed.
The organs of the abdominal cavity are examined by ultrasound (US) to exclude or establish the presence of pancreatic tumors, the membrane of the stomach or duodenum.
Colonoscopy and sigmoidoscopy (according to indications with biopsy) allows to evaluate the structure of the internal surface of the large intestine. If suspected of a neoplasm or stricture of the esophagus, contrast radiography is prescribed.
With the help of computer tomography, difficult-diagnosed formations or lesions of the esophageal canal are revealed. The motor and the contractility of the esophageal organs are determined with the help of electrogastroenterography, esophageal and anthroduodenal manometry.
Differential diagnosis
Differential diagnosis of functional dyspepsia involves a thorough examination of the patient in order to eliminate it ulcers of the stomach and duodenum lesions, tumors of the gastrointestinal tract, chronic pancreatitis, cholelithiasis, eneterita granulomatous, ulcerative colitis, gastroesophageal reflux disease, the effects of medications and herbal remedies.
Irritable bowel syndrome is also set by exclusion of colorectal neoplasms, inflammatory pathologies, tuberculosis and intestinal polyps, chronic inflammation of the pancreas, gynecological diseases and physiological conditions in women, endocrine and psychiatric pathologies, intestinal infection, effects of medications and herbal remedies.
These two diseases are diagnoses of exclusion and differentiate among themselves, and cross-symptomatology complicates the task of differentiating functional dyspepsia and irritable bowel syndrome.
Treatment of the discomfort in the abdomen
If the uncomfortable state is accidental and provoked by inaccuracies in the diet, then it does not represent a serious danger. It is enough to adjust your daily menu and organize the correct diet - unpleasant signs of frustrated digestion will quickly disappear. Eliminate the existing symptoms with enterosorbents or alternative agents.
To eliminate constipation, you need to use more liquid (at least two liters per day), plant foods containing fiber, replace whole milk with fresh yogurt or kefir, exclude food that causes intestinal spasms.
To eliminate diarrhea, exclude for a while food that leads to frustration and flatulence (cabbage, beans). In all digestive disorders it is important to organize a fractional re-usable diet.
However, if the condition does not go away for several days, the symptoms return stubbornly, it is necessary to show it to a specialist, since nutritional errors could provoke a relapse of a chronic digestive disease, which you did not even suspect. If the discomfort in the abdomen is a pain syndrome accompanied by a high temperature, then this condition requires emergency measures.
Treatment of discomfort in the abdomen, caused by organic pathologies, is prescribed by the doctor depending on the specific diagnosis. If such pathologies are excluded from a thorough examination of the patient, and if he is constantly and for at least three months disturbed by the pain in the upper abdomen, burning, heaviness in this area after eating, flatulence, premature saturation, the urge to vomit, we are talking about the syndrome of functional dyspepsia .
Therapeutic measures include the optimization of the patient's lifestyle (rejection of bad habits, fractional dietary food) and drug therapy, which is carried out in three directions: the application of standard treatment regimens aimed at the destruction of helicobacteria; decrease and normalization of gastric acidity; restoration of motor function of the stomach and duodenum. Most patients require complex therapy, combining all three techniques.
Elimination of Helicobacteria is carried out according to the international protocol. Proton pump inhibitors used in eradication schemes simultaneously reduce acid production and can be used for this purpose independently if the patient does not have Helicobacteriosis. As practical experience shows, rabeprazole and esomeprazole are second-generation drugs.
The first of them with the active substance of the same name (rabeprazole) inhibits acid production by reducing the enzymatic activity of hydrogen-potassium adenosine triphosphatase on the surface of the covering cells. The effect of the application depends on the dose and reduces both the main and stimulated release of hydrochloric acid. It has slightly alkaline properties, is quickly absorbed and cumulated in the lining cells. The effect of the drug is somewhat potentiated with the daily intake of one pill, a stable effect occurs on the fourth day of admission. After the end of therapy, acid formation is normalized after two to three days. Metabolized by the cytochrome 450 system, which should be considered when prescribing drugs with a similar metabolism. Has a lot of side effects, with prolonged treatment, patients need to be monitored. Contraindicated in children, pregnant and lactating women, sensitized persons. It is prescribed in dosages of 10 to 20 mg, per day - once. Duration of treatment is from one to two months.
Esomeprazole (S-isomer omeprazole) is a weak basic hydroxide. It acts in a similar manner, inhibiting the enzymatic activity of hydrogen-potassium adenosine triphosphatase on the surface of the lining cells. Reduces both basal and stimulated production of sulfuric acid. Quickly absorbed by the envelope of the food canal, the maximum concentration is reached after an hour or two from the beginning of the intake. Systemic blood flow reaches 64% of the once-only dose of esomeprazole 0.04 g. This indicator increases with repeated intake of this dose daily up to 89%. The consumption of food slightly reduces the rate of absorption of it in the stomach, which, however, does not affect the efficiency of reducing the production of hydrochloric acid. The drug is completely cleaved with the enzymatic participation of the cytochrome P450 system. With a daily, one-time oral intake of the recommended dose, the drug is completely eliminated from blood serum in the interval between doses and does not accumulate. It is not recommended for use by pregnant and lactating women because of insufficient data on its effect during this period.
Ganaton (active ingredient - itopride hydrochloride) is a modern prokinet of selective action, enhancing propulsive peristalsis of all organs of the digestive tract and preventing the development of duodenogastric reflux. The effect of this drug is due to the stimulation of the release of endogenous acetylcholine and an increase in the time of its activity, which is achieved by inhibiting the activity of the enzyme acetylcholinesterase. This tones the muscles, including sphincter, leads to an increase in the duration of contractions of the smooth muscle tissue of the stomach and intestines, accelerates the movement of the contents of these organs in the right direction.
Absorption of the active substance (approximately 90%) occurs in the intestine, the highest plasma concentration is fixed after ¾ hours from the time of taking Ganaton. Absorption is not dependent on food intake. Metabolism of this drug is carried out in the liver with flavone monooxygenase without the involvement of cytochrome P450, which makes it possible to avoid the negative interaction when combined with the intake of other drugs, the metabolism of which is realized by the enzymes of the CYP450 system. Ganaton has practically no toxic effect on the liver, is not cumulated and does not pass through the blood-brain barrier. Inactive metabolites of the active ingredient are excreted in the urine, for a complete elimination of one dose, ½ day is enough.
The recommended single dose is 50 mg, it is taken every eight hours. The maximum permissible dose is 800 mg per day. Duration of treatment - from two to three weeks.
It is not prescribed to pregnant and lactating women, persons aged 0-11 years, with bleeding, perforation, obstruction of the digestive organs, sensitization, increased prolactin level.
With a positive response to treatment with the above medicines, it is recommended that they be gradually phased out or changed to "on demand" treatment regimen. If the therapeutic effect has not been achieved, the treatment continues to take into account the psychosocial status of patients with functional dyspepsia, prescribing selective serotonin reuptake inhibitors (the most modern and not having serious side effects) or tricyclic antidepressants. Medications are taken at the recommended dosage orally, overnight. The effectiveness of psychopharmacotherapy is estimated after a month and a half from the start of treatment. If there is a response, treatment can last up to six months.
Treatment of patients with functional disruption of the intestine is aimed at relieving the aggravation, returning to active social life and improving the quality of life in general. Patients with irritable bowel syndrome should exclude products containing a lot of fructose (honey, pears, watermelon, apples, cherries, plums, fruit canned food, juices and sauces) and lactose (milk and products based on it), as well as legumes, cabbage (white, Brussels), beets, garlic and onions (onions, leeks, shallots).
Drug treatment depends on the symptoms prevailing in the patient. The leading role is assigned to selective antispasmodics, for example, Spasmomen. Synthetic medicine with anticholinergic effect. The active component, otilonium bromide, selectively blocks the transport of calcium ions through the cell membrane and inactivates the cellular receptors, tachykinin and muscarinic. As a result smooth muscles of the intestine relax, their contractions slow down, gas formation decreases, and a definite analgesic effect is achieved. Otilonium bromide is practically not absorbed (no more than 5%), therefore systemic actions that relax the smooth muscle tissue of other organs are absent. Of the contraindications, only hypersensitivity to the active ingredient and age 0-12 years is indicated. Possible treatment of pregnant women under the supervision of a specialist. Interaction with other drugs is not fixed. Usually, take 40 mg twice or thrice during the day. The duration of therapy is determined by the doctor.
Discomfort in the abdomen and constipation in the diagnosis of irritable bowel syndrome is currently treated with bioactive additives in part water-soluble fiber. For example, Psyllium, the main active ingredient of which is the plantain powder. It replenishes the deficit of fiber, strengthens the motor activity of the intestine, promotes its purification, eliminates the difficulty of defecation. It is not intended to be sensitized to active and additional components to patients, pregnant and lactating women, to persons with severe organic diseases of the digestive system. Take in solution (sachet / glass of water) from one to three times during the day.
Lactulose can be prescribed , which increases the number of lactobacilli in the large intestine. They contribute to the breakdown of carbohydrates, resulting in the formation of lactic acid and increased acidity in the intestines, which activates peristaltic movements. Suppress the development of salmonellosis, it causes addiction, does not prevent the absorption of vitamins, can be used to treat infants from six months, pregnant and lactating women. Contraindicated in galactosemia. After the first reception can cause flatulence and intestinal colic, which then pass. Orally 15-30g twice a day.
With diarrhea , Loperamide, an opioid that relaxes the smooth musculature of the intestine, can be prescribed , toning the sphincter of the anus. Contraindicated in the age of 0-2 years, pregnant and lactating women, diarrhea with an admixture of blood, inflammation of the large intestine (ulcerous, caused by the intake of antibacterial drugs). May cause allergy, weakness and drowsiness, dry mouth, nausea, tenderness in the stomach area. It is prescribed for 2-4 mg symptomatically.
It is possible to eliminate diarrhea with the use of enterosorbents.
With prolonged conditions associated with discomfort in the abdominal area, vitamins are prescribed, as dyspeptic disorders cause a deficiency of vitamins and minerals. Vitaminotherapy is prescribed by a doctor, based on the symptoms and the survey data.
Physiotherapeutic treatment is appointed depending on the nature of the pathology and is included in the therapeutic regimen as remedial measures. It should be borne in mind that the physical procedures are contraindicated in erosive and ulcerative lesions, bleeding and the presence of tumors, with symptoms of an "acute abdomen".
Standard procedures are electrophoresis or phonophoresis with medications. Are carried out with the purpose of removal of painful sensations and an inflammation.
Amplipulse therapy restores muscle motility, beneficial effect on gastric epithelium and secretory function.
Acupuncture activates the functions of the digestive organs, affecting them through active points on the human body.
DMV-therapy (electromagnetic decimeter waves), UHF-therapy (ultra-high-frequency) - improve blood circulation, stimulate healing and eliminate swelling and pain.
In diseases of the female sexual sphere, physiotherapy plays a leading role. Depending on the nature of the disease, DC and AC electroprocedures, di- and inductothermy, Franklin currents, UHF, ultrasound are prescribed. Light therapy, hydrotherapy, mud, ozocerite, paraffin applications, as well as - from peat bogs and warm sand are used.
In chronic prostatitis, magnetotherapy, laser and induction therapy, thermal procedures are used to prevent recurrences of the disease.
Alternative treatment
Discomfort in the abdomen happened at all times. Alternative medicine abounds in recommendations for eliminating this trouble. However, if there is a certainty that dyspeptic symptoms have appeared as a result of nutritional factors, or if you know your diagnosis and your attending physician does not object to the use of alternative drugs, then you can self-medicate. Otherwise, at first it is better to be surveyed and consult with the doctor.
So, the proven remedy for nausea, diarrhea, flatulence is activated charcoal, which is usually found in every home medicine cabinet, and is considered an alternative drug. Dosage it from the calculation: one tablet per ten kilograms of the body weight of the sufferer.
In addition to activated charcoal, with food poisoning, our mothers and grandmothers also used a slightly pink solution of potassium permanganate. With potassium permanganate it is necessary to be careful, it must be filtered in order to avoid getting into the non-dissolved crystalline (which can be completely overlooked in the solution). Drink one glass at night and one more - in the morning. Enemas from this remedy disinfect the intestines and remove intoxication, and most importantly - the patient will not feel the opposite taste of the solution.
Diarrhea has long been treated with rice broth, boiled on a small fire in the proportions: a quarter of a glass of rice per liter of water. Mucous broth filter and take 1/2 cup at intervals of one hour.
The natural antibiotic, allicin, is found in garlic, it is recommended to eat it in food to prevent the development of putrefactive bacteria, and onions and wild garlic possess bactericidal properties. In addition to disinfection, these vegetables contain a lot of nutrients and vitamins.
To treat the inflammatory processes of the mucous membrane of the gastrointestinal tract, as well as its protection on an empty stomach, it is recommended to drink raw eggs. One egg every morning for a week. But there is a danger of picking up salmonella, so you need to buy eggs in safe places.
To relax the intestinal membrane it is recommended to drink tea with the addition of cinnamon powder and ginger (at the tip of the knife).
When swelling, pain syndrome and spasms in the abdomen are recommended treatment with herbs: alteem, chamomile, peppermint, ayr, yarrow, St. John's wort. These herbs have a pronounced bactericidal, anti-inflammatory and soothing effect.
Broth from the leaves of peppermint: pour 200 ml of boiling water a teaspoon of grass, boil for at least five minutes. Strain and drink 1/4 cup before eating.
Infusion of chamomile: pour 200 ml of boiling water a tablespoon of flowers, insist four hours. Strain and take two tablespoons before meals four times a day.
Homeopathy
With discomfort in the abdomen, you can, together with your doctor, choose complex preparations offered in a homeopathic pharmacy or a Heel brand drug. They are usually universal and are intended for curing various dyspeptic disorders and inflammatory processes in the stomach. For example, Gastriculum-Heel. The complex means includes the most popular homeopathic components used in the disturbance of the digestive function and the functioning of the gastrointestinal tract. This drug can be used both independently, especially at the initial stages of the development of the disease, and in combination with medications. Tablet Gastricumel 30 minutes before eating or an hour later put under the tongue and dissolve until it dissolves. To relieve an acute attack, you need to dissolve the tablet at intervals of a quarter of an hour, but watch that a day does not take more than 12 pieces. Treatment is continued for two or three weeks. Repeated reception is possible in the event that it is appointed by the attending physician. The drug can be taken from three years of age, future and nursing mothers - only under medical supervision. It is impossible to exclude the development of allergic reactions.
In the case of severe acute inflammation of the gastric mucosa can be combined with Traumeel C, to accelerate the recovery process. Traumeel is able through the activation of its own immunity to quickly stop the inflammatory process, swelling, tenderness, hyperemia.
If the digestive system is not functioning properly, Gastricumel-Heel can be used in conjunction with Nux vomica-Homaccord drops that eliminate the effects of unwanted effects on the gastric mucosa of toxic substances, tone up its musculature and activate the motor, not only the stomach, but the entire digestive canal from top to bottom, eliminate the symptoms of dyspepsia.
Perhaps the combination with Mucosa compositum, especially with erosive ulcerative lesions of the mucosa of the digestive canal, to enhance motility and normalize coordinated organ movements, eliminate bleeding, accelerate the regenerative process. If necessary, the combination is supplemented by Traumeel.
Dosage of a combination is prescribed by the attending physician. If necessary, all these tools can be combined with anthelicobacter therapy.
In the case of gynecological diseases, complex homeopathic drops of Gynecochel are used. The active ingredients of this drug have the ability to stop the inflammatory process, pain, swelling, soothe and improve blood circulation. There is a normalization of the work of female genital organs. It is indicated for infectious and inflammatory gynecological diseases. May cause allergies, with caution appoint to persons with thyroid dysfunction. Pregnant and lactating women - only as prescribed by the doctor. The recommended dose: for ½ cup of water - ten drops, take three times, holding in your mouth before swallowing, two to three weeks. You can buy an acute condition by taking the recommended dosage every quarter of an hour for two hours. Can be combined with other medicines.
Muliman - complex drops for the treatment of menstrual pain and other uncomfortable sensations during this period and on the eve of it, irritation and spasms of the hypogastric plexus and normalization of neurohormonal processes related to the female sexual sphere. Has no contraindications and side effects. Pregnant and lactating women should take the doctor's prescription.
Immediately before use, drip 15-20 drops in 20-50 ml of water and drink, holding in your mouth as long as possible. Reception is repeated three to five times a day. You can dissolve the daily portion in 200ml and drink during the day at regular intervals in small sips, trying to ensure that the solution is absorbed as much as possible into the mucous membrane of the mouth. For relief of acute manifestations of discomfort in the lower abdomen, 10 drops are allowed with an interval of 30 minutes for two to three hours. Ensure that there is no excess of 200 drops / day.
Momordika Compositum - a homeopathic solution in ampoules, is used in the treatment of pancreatic, acute and chronic disorders. It has the ability to remove inflammation, eliminate vomiting and pain, soothe and relax the muscles, has an astringent and antioxidant effect. Normalizes the pancreas and enzymatic activity.
The drug in its composition has iodine, so it should be prescribed to patients with increased thyroid function after consultation with the endocrinologist and under his supervision. Increased salivation is the only established side effect. Pregnant and lactating women should take the doctor's prescription. It is combined with any medicines.
The solution can be used parenterally (by any means) and orally. Children 0-1year - 0.25 ampoules, 2-5 years, 0.5 ampoules, individuals over six years - one ampoule (2.2ml) from one to three times during the week. The duration of therapy is three to five weeks.
Sabal-Gommakord - drops to normalize the retention of urine with prostatic hyperplasia. Contraindicated in case of sensitization to components, not prescribed to women, caution should be exercised, prescribing the drug to persons with hepatic pathologies, alcoholics, with cerebral pathologies, incl. Traumatic. It is combined with other drugs.
Immediately before taking 10 drops drop in 30 ml of water and drink, holding in the mouth as long as possible, so that the solution is absorbed as much as possible into the mucous membrane of the mouth. Reception is repeated three times a day. For relief of acute manifestations of discomfort in the lower abdomen, 10 drops are allowed with an interval of a quarter of an hour for two hours. Duration of therapy is five weeks.
Soligado Compositum C - ampoules with a solution used for acute and chronic inflammatory and degenerative diseases of the urinary system in men and women. There are no contraindications, side effects are extremely rare - allergies, hyperergic reactions, hypersalivation. Pregnant and lactating women should take the doctor's prescription. It is combined with any medicines.
The solution can be used parenterally (by any means) and orally. People over six years old - one ampoule (2.2ml) from one to three times during the week. For oral administration, dilute the ampoule in two tablespoons of water and drink, keeping it in your mouth as long as possible so that the solution absorbs as much as possible into the mucous membrane of the mouth. The duration of therapy is four to six weeks.
With discomfort in the abdomen may be appointed Galium Heel (immunomodulating homeopathic drops with the effect of detoxification). It is used in the same way as the previous preparation.
Classical homeopathic preparations can also seriously improve the condition and even lead to complete recovery, however, they must be prescribed by a homeopathic doctor.
Prevention
Since discomfort in the abdomen is most often the result of nutritional errors, you should carefully and carefully treat your body, try not to overeat and not to starve, eat in a variety of ways, without leaning on spices, fatty and sweet dishes, fried foods, carbonated drinks and alcohol.
Unpleasant sensations in the abdomen are constant companions of heavy smokers. There are studies that the risk of functional dyspepsia and irritable bowel syndrome, not to mention organic pathologies, among smokers is twice as high as that of non-smokers. It is also noted that the motor function of the gastrointestinal tract is quickly restored after the patient has said goodbye to a bad habit.
In patients with impaired functions of the gastrointestinal tract, nervous upheavals, emotional and physical overloads, chronic stress were often noted. Therefore, one should try to avoid, if possible, neuro-psychic overstrain, increase stress resistance, learn to control their emotions.
Compliance with hygienic norms also prevents infectious and parasitic infections of the digestive organs.
Timely treatment in a medical institution with the appearance of persistent symptoms of digestive disorders will help avoid complications and achieve in most cases a complete recovery.