Abdominal pain is a common health concern in children and adults. In fact, what people often term ‘stomachaches’ can arise from countless different problems, and not all originate from the stomach organ. Pain that arises from the stomach is typically felt as a pain in the centre of the upper abdomen, and more accurately termed ‘gastric pain’.
What causes gastric pain?
Ranging from a dull ache to a throbbing pain, gastric pain can arise from minor issues like flatulence (gas) and indigestion, or signal a more severe problem like gallstones or bowel obstruction. Here are some underlying issues that can result in gastric pain:
- Flatulence (Gas)
Gas occurs naturally in the digestive tract due to the digestive processes. Sometimes, gas buildup causes a feeling of bloatedness, pressure, fullness, and mild pain. Usually, the pain comes in waves, and the abdomen may swell. Accompanied by burping or passing of gas, increased flatulence after eating certain foods is normal. Common flatulence-inducing foods include beans, garlic, and cauliflower.
Pain from gas is often fleeting and non-serious. If it is uncomfortable, some over-the-counter medications usually ease the pain and bloatedness quite quickly. However, if it occurs with fever, persistent vomiting or diarrhoea, or unbearable pain, a visit to the doctor is recommended.
The full, uncomfortable, burning sensation in the upper abdomen shortly after eating is often labelled as indigestion. Sometimes, the pain or burning feeling can also be felt in the mouth, throat, or chest. Also known as ‘dyspepsia’, indigestion is commonly the result of an acid buildup in the stomach. It can be caused by certain foods, or by eating too quickly.
In some cases, recurring indigestion may be a sign of underlying issues like acid reflux (e.g. GERD) or a stomach ulcer. If symptoms of indigestion occur frequently and are accompanied by severe pain or weight loss, a doctor’s advice may be required to help diagnose and manage the condition.
- Stomach virus (stomach flu)
Although referred to as ‘stomach flu’, the stomach virus is not strictly a type of flu. Also called ‘gastroenteritis’, it typically manifests as nausea, vomiting, diarrhoea, and gastric pain. Some people may experience lethargy, headaches, or muscle aches as well. Most cases of gastroenteritis recover within a few days without medical intervention.
The key concern is to prevent dehydration. Thus, patients are usually advised to suck on ice chips, sip on water frequently, or consume an electrolyte drink. People with gastroenteritis should also avoid heavy meals and ease back into eating using foods that are easy to digest, like plain crackers, bananas, and toast.
When cholesterol or bilirubin forms solid particles in the gallbladder, these are called gallstones. Having gallstones that are small in size and number may not cause problems. However, large or numerous gallstones can result in symptoms like pain, vomiting, and fatigue.
The problems arising from gallstones happen when they form a blockage in the gallbladder. This can lead to impaired functions in the liver and pancreas, as well as jaundice. In some cases of gallstones, they are passed out naturally by the body. But in other cases, medication is needed to dissolve the stones, or a doctor may recommend surgical removal of the gallbladder.
- Liver or pancreas issues
Sometimes, gastric pain arises from problems in the liver or pancreas. Inflammation of the liver (hepatitis) or pancreas (pancreatitis) often results in abdominal pain, hampered organ functions, and other symptoms. Although less often the case, upper abdominal pain may also be due to liver cancer or pancreatic cancer.
Other accompanying symptoms of liver or pancreas problems include yellowish eyes or skin (jaundice), nausea, vomiting, unusually dark urine, and pale or oily stools. Depending on the diagnosis, liver or pancreatic issues can be managed with lifestyle adjustments, medication, or surgical treatment.
- Bowel obstruction
Bowel obstruction occurs when tissue blocks the intestinal pathway, hindering or completely blocking off the passage of digestive waste. It may be caused by an inflamed intestinal wall, fibrous scar tissues, or tumour growth (e.g. colon cancer). On top of intense pain and constipation, bowel obstruction can lead to vomiting of bile, abdominal swelling, and rapid weight loss. The pain is usually worse after eating.
Due to the risk of intestinal wall tearing or becoming infected, bowel obstruction is considered a medical emergency. An immediate visit to the hospital is required to provide medical intervention, pain relief, and if required, emergency surgery to remove the obstruction.
When should you visit a doctor for gastric pain?
While mild and occasional cases of gastric pain usually resolve itself, the more severe and recurrent cases require a visit to the doctor to diagnose the problem and recommend treatments. Here are some examples of gastric pain that should not be ignored:
- Gastric pain accompanied by:
- Persistent changes to bowel movement, e.g. pale, black, or bloody stools
- Persistent diarrhoea or vomiting of more than 12 hours with no improvement
- Rapid weight loss
- Gastric pain in persons with weakened immune systems, e.g. young children, elderly persons, persons with auto-immune diseases like HIV, and persons with cancer
- Gastric pain arising after injury or consumption of medication
- Gastric pain that is extremely intense and debilitating
At the doctor’s, diagnosis methods may include an examination of your diet and lifestyle, imaging methods such as gastroscopy, colonoscopy or CT scans. Only then can the doctor ascertain the cause of your gastric pain and prescribe treatments to address the root problem.