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Abdominal pain and vomiting is a symptom of a disease
Last reviewed: 23.04.2024
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With painful sensations in the abdominal area, accompanied by productive vomiting, apparently, everyone knows everything. These manifestations are observed in the clinical picture of diseases of many organs, mainly located in the abdominal cavity and taking a direct part in the digestion process. Pain in the abdomen and vomiting manifests pathological changes also in organs located close to the abdominal region, or these manifestations may not be related to organic disorders at all.
Often, with such symptoms, immediate medical attention is required - abdominal pain and vomiting are part of the "acute abdomen" symptom complex. Let's try to figure out how to act when such a malaise has befallen you or someone close.
[Causes of the abdominal pain and vomiting
When people talk about abdominal pain, they usually mean sensations 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 desire of the body to clear, get rid of the contents, irritating the walls of the stomach. The appearance of an anti-peristaltic (reverse to the normal course of food) movement begins when the intensity of the stimulation exceeds the permissible threshold.
Pain in the abdomen and vomiting can cause inflammatory processes of infectious and non-infectious genesis, significant deformation (stretching) or ischemia of almost any organ of the abdominal region or retroperitoneal space.
Risk factors for such symptoms include viral diseases, bacterial infections (food poisoning), allergic reactions, appendicitis, diverticulitis, hepatitis, pancreatitis, nephritis, acute gastritis, peptic ulcer, toxicity of toxic substances, parasites and others.
Pain when stretching the digestive organs, ischemic processes in their shell appears under the influence of factors such as blockage or compression of the lumen with calculous formations, neoplasms, curvature of the intestines. The closer the obstruction develops to the stomach, the more vomiting and vomiting is more intense.
Abdominal pain and vomiting can also occur with a mysterious disease - irritable bowel syndrome, when the patient has these symptoms, and organic disorders are absent.
Gynecological diseases in acute stage can be accompanied not only by pain, but also by vomiting, provoked by pain syndrome.
Sometimes the appearance of such symptoms accompanies neuroses and other disorders of the nervous system, for example, acute reaction to severe shocks, unpleasant stimuli, stressful situations. First of all, nausea, vomiting and accompanying vomiting painful feelings cause 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 diaphragmatic nerve is also a stimulus for the appearance of a vomiting reflex.
Pain in the abdomen and vomiting can be observed in a diabetic due to a violation of glucose metabolism or gastroparesis.
Irradiating in the abdominal region, pain in combination with vomiting is sometimes present in the clinical picture of myocardial infarction, pneumonia or bronchitis.
These symptoms are often observed in the treatment of certain drugs (corticosteroids, cytostatics, non-steroidal anti-inflammatory drugs), the course of therapy with X-rays, septic states.
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 refer to the syndrome of "acute abdomen" and, not being rare states, nevertheless, require taking emergency measures to save the patient's life.
When the abdomen and vomiting of the adult hurts, it is necessary to establish, on what additional signs the person complains. Quite often this condition occurs with food poisoning. The presence of vomiting indicates the attempts of the body to get rid of the contents of the stomach, which causes irritation of its walls. When poisoning with poor-quality food or toxic substances, vomiting appears quite often, except these symptoms are characterized by fever, rumbling in the intestine and frequent diarrhea.
Suddenly, abdominal pain, vomiting and fever may indicate the development of acute appendicitis. Vomiting in adults with inflammation of the caecum, as a rule, does not recur more than twice at the beginning of the attack, then other symptoms prevail - displacement of pain in the lower quadrant of the abdomen on the right, temperature, lack of appetite. One of the important signs is the difficulty of the gas escape, the pain is constantly felt, it can be of moderate strength, its intensity can increase, with the development of suppuration can acquire a paroxysmal character.
The most frequent complication of acute appendicitis is perforation of the inflammatory process of the cecum and the 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, an accumulation of gases that do not escape, tension of peritoneal muscles, may be vomiting bile. Intoxication accrues and inflammation spreads, taking more and more space. The patient loses his strength more and more, his features are sharpened, the sweat on his forehead, the confused consciousness, the moments of excitement alternate with periodic retardation and even disconnection of consciousness. Abdominal pain and vomiting are constantly observed. Peritonitis complicates any neglected inflammation of the peritoneum and retroperitoneum. It arises in most cases not suddenly. The patient should already have had uncomfortable sensations in the abdominal area. Such patients need emergency surgical care.
Acute pancreatitis is accompanied by a triad of basic signs - girdling and radiating to the neck and shoulder pain, vomiting and bloating. The temperature fluctuates from the indices above the subfebrile state to the decline of forces, fluctuations are frequent, debilitating.
Acute cholecystitis and acute nephritis, renal colic also occur with symptoms such as abdominal pain and vomiting. The same symptoms may be accompanied by a disturbed ectopic pregnancy, apoplexy of the ovarian cyst. Often vomiting occurs as a reaction to severe pain. In such cases the pain does not let go, the vomiting is repeated and the patient's condition deteriorates rapidly. In such cases, urgent medical attention is needed.
The presence of high temperature is a sign of an acute process, however, do not relax if the patient's body temperature is normal or even a decline in strength.
The abdomen, vomiting hurts, there is no temperature in most cases in the presence of gynecological problems related to the syndrome of an acute abdomen - an abnormal ectopic pregnancy, apoplexy of the ovary or a torsion of the legs of his cyst. Inflammatory diseases of the peritoneal organs do not in all patients are accompanied by an increase in temperature, at least their initial stages, but if with viral hepatitis the speed of seeking help does not greatly affect the outcome of the disease, then in the case of acute pancreatitis, appendicitis, curvature of the bowels or ectopic pregnancy, the timeliness of the medical interference significantly affects the volume of surgery, postoperative therapy and the prognosis of the disease.
The condition described by the patient as "it hurts the stomach, feels sick, weak", can simply go by itself and, at the same time, be present at a variety of pathologies of various organs. If such symptoms are felt for a long time, worry from time to time, it is worth turning to the gastroenterologist, because they can indicate the presence of gastritis, peptic ulcer, irritable bowel syndrome; to the gynecologist, if the pains are localized above the pubis, from the side in the lower part of the abdomen and give to the waist region; to the nephrologist or urologist. If the stomach is sick strongly and suddenly, and then nausea and malaise appeared, then it is not worth waiting for the further development of events. It is better to see a doctor, especially if there is no improvement.
Abdominal pain, diarrhea and vomiting in most episodes of diseases with such symptoms accompany with intestinal infections, food poisoning. The occurrence of such symptoms is usually associated with the ingestion of pathogenic microorganisms - bacteria, viruses, parasites, causing inflammation of its mucous membrane in some area - the stomach, duodenum, small or large intestine, into the digestive canal. Additional signs indicating intestinal infection are weakness, headache, rumbling in the area below the navel, bloating. The temperature can be different - 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 the patient temporary relief, its appearance usually precedes diarrhea, or these symptoms appear simultaneously. It is the presence of diarrhea that suggests intestinal infection, however, a survey is necessary, because, for example, in the irritable bowel syndrome, all these symptoms can be present, and infection and organic pathologies do not reveal.
Pain in the abdomen without diarrhea and vomiting is more typical for ruptures, sprains, torsions or squeezing of the peritoneum and extraperitoneal space. The pain itself speaks of ill-being, its intensity is a signal for urgent diagnosis. Localization may suggest where to look for pathology, however, abdominal pain in itself is not the only diagnostic sign of any disease.
Diarrhea, vomiting, fever and abdominal pain - if the symptoms are described as they are significant, it is most likely that the patient has consumed poor-quality food or contracted an intestinal infection. When combining frequent vomiting with diarrhea, a great danger, up to a lethal outcome, is pronounced water-electrolyte loss. There are about thirty common enteric infections, many of them are so-called food poisoning. Depending on the massiveness of the infestation, the type of pathogen and the immunity of the patient, some of them flow more easily, for example, abdominal pain and diarrhea without temperature can pass through the day on their own. Often accompanied by severe symptoms with signs of general intoxication - a decline in strength, headache, fever. High fever (39-40 ℃), abdominal pain and diarrhea in combination with nausea and vomiting are also present in severe food poisoning.
The presence of the above symptoms can not be ruled out and with acute appendicitis, diverticulitis, pancreatitis, with hepatitis. Although diarrhea in this case - not a typical symptom. For inflammatory diseases, ischemic pathologies and obstructions of the hollow organs, nausea, vomiting and abdominal pain are more common. And the leading sign is pain, and nausea and vomiting, especially at the initial stages of the disease, appear due to severe pain syndrome.
Vomiting, abdominal pain and chills can occur as a result of food poisoning, and with exacerbation of gastritis or cholecystitis. It is impossible to exclude in this case gynecological inflammations, acute appendicitis and hepatitis. Chills can accompany an increase in body temperature, fever, sweating and trembling of the limbs may be manifestations of extreme weakness due to intoxication or severe pain, for example, when the ovary or fallopian tube is ruptured with an ectopic pregnancy. The same manifestations can be hysterical, manifest as the effects of severe stress or overwork.
Pain in the abdomen and vomiting of bile, in the first place, make us remember about the possibility of chronic pathologies of the liver, bile reflux, stones in the gallbladder or its ducts. In such cases, biliary colic is observed after eating non-dietary foods (fatty, spicy, fried, freshly baked dough products), after a feast with abundant libations. And usually such attacks are observed periodically after gastronomic excesses. In this case, you need to visit a gastroenterologist and undergo a survey.
The sudden appearance of such symptoms may be a sign of acute pancreatitis, small intestinal obturation, acute appendicitis and hepatitis, and damage to the central nervous system. With peritonitis, vomiting is also observed with bile.
Pay attention to the nature of pain. Strong, sharp pain in the abdomen and vomiting, basically indicates an acute development of the process - inflammatory or destructive. Although the concept of pain intensity is very individual. Everyone perceives pain at an accessible level, there are many cases where people with acute appendicitis came on foot to see a doctor, not including their pain is quite strong.
Sharp abdominal pain and vomiting can be psychogenic. They are usually spilled, not having a specific localization, vomiting is preceded by nausea. These symptoms are accompanied by feverish excitement, or, conversely, a decline in strength.
Cutting pain in the abdomen and vomiting are most often an anxiety symptom, an occasional spasm or colic rarely carries such a character. Often they testify to the conditions of the "acute abdomen", requiring urgent surgical care - appendicitis, peritonitis, pancreatitis, perforation of the ulcer, impaired ectopic pregnancy.
With exacerbations of gastritis, the consequences of taking unsuitable food can also be cutting pains in the abdomen and vomiting, preceded by nausea, heartburn, belching.
The same nature can be pain in cholecystitis, parasitic invasions, severe inflammation of the pelvic organs, intestinal infections.
To suggest which organ is to be examined first of all will help the localization of pain. For diseases of the liver, gallbladder, right-sided divisions of the intestine, a normally located appendix (right bottom), right kidney or paired genitals (pain often gives back), abdominal pain and vomiting are characteristic. A little to the left of the central line at the level of the lower edge of the stomach is the pancreas (often the pain is shrouded in nature). In the left middle and lower abdomen are localized pain associated with problems in the intestine, left kidney, appendages. The abdomen above the pubis hurts during processes in the uterus and bladder, the lower parts of the intestine. When the appendix is abnormal, the localization of pain may be different.
Pain in the abdomen and vomiting with blood indicate the presence of bleeding. More often - gastric or intestinal, sometimes from the vessels of the pharynx or esophagus. Significant blood admixtures are characteristic for ulcerous bleeding. With cirrhosis of the liver, bleeding occurs from the dilated vessels in the esophagus. Erosive gastritis can be manifested by vomiting with bloody veins. With hemorrhagic phenomena in the digestive canal, usually black stools or black areas are observed.
Headache, vomiting and abdominal pain can be the companions of migraine, hypertensive disease (especially with primary damage to the kidneys), tumors and the consequences of brain injuries. With any defeat of the organs, this combination of symptoms with hyperthermia is possible, which often causes a headache.
Vomiting and pain in the back and stomach often indicates acute pancreatitis. Have a back pain in the back. Pain sensations in the inflammatory processes in the genitalia in patients of either sex are often localized in the back and lower abdomen, infringement of the inguinal hernia and atypical location of the appendix, neoplasms can be manifested by the pain of this localization.
Pain in the lower abdomen and vomiting is a characteristic sign of inflammatory bowel disease - while the patient develops diarrhea and rumbling in the abdomen. Severe pain in the lower abdomen and vomiting as a result of the pain syndrome is possible with acute pelvic organs, appendicitis (right), diverticulitis (left).
The time of occurrence of vomiting is a diagnostic criterion. The emergence of vomiting in the morning suggests its alcoholic etiology, without prior nausea, sudden morning vomiting may indicate brain diseases.
Pain in the abdomen and vomiting after eating occurs most often with gastritis and peptic ulcer, late in the evening vomiting occurs with diseases that contribute to the disruption of the passage of the food lump in the digestive tract.
The smell of vomiting can also suggest its origin. The sour smell indicates the excessive production of hydrochloric acid, rotten - about indigestion, fecal - about partial or complete obstruction. When poisoning with chemical substances, vomit will produce a corresponding odor. With the development of renal failure in emetics expressed ammonia odor, vomiting diabetics have the smell of acetone.
Separately, we will talk about pregnant women, for whom the pain in the abdomen and vomiting, as a rule, in the morning hours is quite normal in the first months of pregnancy. Nevertheless, if the abdominal pain is strong enough, and vomiting is frequent, it is necessary, as a minimum, to report this to the gynecologist who leads the pregnancy. In addition, pregnancy can become an impetus to exacerbation of chronic diseases, from organic accidents in the abdominal cavity pregnant women are also not insured.
Diagnostics of the 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 syndrome of "acute abdomen" the pain differs, as a rule, by intensity. With a sudden attack, the patient tries to take a convenient position for him to reduce the pain syndrome. Often, any movement, coughing and deep sigh are accompanied by increased pain. Concomitant symptoms can be different, depending on the pathology, vomiting is one of them. Under the clinical picture of the "acute abdomen," other pathologies that do not require urgent surgical intervention can be masked, however, only a specialist can help distinguish one disease from another by means of analyzes and instrumental methods.
Diagnostics includes an express examination that confirms the need for urgent surgery or allows you to observe and doobesledovat patient for pathologies that do not require emergency surgical measures.
The main diagnostic measures are the examination of the patient, the superficial palpation of the abdomen with checking the symptoms of irritation of the peritoneum, tapping and listening to the sounds of organ functioning, general blood and urine tests, and ultrasound examination of the peritoneal, retroperitoneal and pelvic organs. There may be a need for endoscopic examination of the gastrointestinal tract. Another instrumental diagnosis is also prescribed: tomography, radiography, laparotomy.
If there is a suspicion of having an infection, tests are done on the rapid detection of the pathogen antigens by any method available in this medical institution - immuno-enzyme, radioimmunoassay, using the latex agglutination reaction. Finally, the form of the infectious agent is established using a polymerase chain reaction or serological methods. A longer time interval takes the isolation of pathogens from the vomit mass or stool culture using the bacteriological method.
The purpose of the tests depends on the symptoms detected and the expected pathology. It can be hepatic tests, biochemical analysis of blood and urine, assessment of the degree of dehydration and electrolyte losses.
For the differentiation of pseudo-abdominal syndrome, ECHO and electrocardiography, bronchopulmonary system studies, radiography of the pelvic region and thorax can be prescribed.
Differential diagnosis
Differentiation is performed between surgical and therapeutic pathologies, as well as acute appendicitis, cholecystitis, pancreatitis, perforated ulcer, acute and obturation (due to the presence of a tumor), intestinal obstruction, phlegmon of the intestine and stomach, diverticulitis, impaired ectopic pregnancy, hemorrhage into the ovary, strangulated hernia, the presence of peritonitis and other diseases requiring urgent surgery.
Peritoneal pathologies that are not subject to immediate surgical intervention, for the first time uncomplicated cholecystitis and pancreatitis, exacerbation of peptic ulcer, Crohn's disease, celiac mobility syndrome, endometriosis and lipoomatosis of the ileocecal valve, renal colic, have also been identified.
Surgical pathologies distinguish from non-surgical pathologies - dyskinesia of the intestine, acute gastritis, cyclic vomiting syndrome, parasitic infestations, intestinal infections (cholera, salmonellosis, dysentery, actinomycosis, food poisoning, etc.), irritable bowel syndrome, lead colic, acute gynecological inflammations without organ perforation and peritonitis, pseudoabdominal syndrome (acute pleuropneumonia, cardiovascular pathology, spine diseases).
Complications and consequences
The greatest danger is the delay in the case when abdominal pain and vomiting are symptoms of conditions, united by the term "acute stomach". Uncomplicated inflammatory processes of the peritoneum are easily eliminated, which can not be said of complicated, for example, perforation, when the purulent contents of the inflamed organ and the necrotic tissue fragments enter the abdominal cavity. There is a diffuse peritonitis, it can be cured only at the initial stages of its development. The operation to clean the abdominal cavity can last several hours, then the patient undergoes a long course of inpatient treatment with the use of detoxification and antibacterial therapy. In case of diffuse peritonitis, every fourth patient dies, so the cause of abdominal pain and vomiting should be established as soon as possible, at least diseases that require immediate surgery - acute appendicitis, severe forms of acute cholecystitis and pancreatitis, perforated ulcers, intraperitoneal hemorrhages, are excluded.
Abdominal pain and vomiting with diarrhea in intestinal infections are complicated by the development of dehydration, which can also lead to death. Especially fast dehydration occurs in young children. In severe forms of intestinal infections, for example, salmonellosis may develop an infectious-toxic shock with further edema of the brain, kidney or cardiovascular insufficiency. Dysentery can be complicated by the prolapse of the mucous membrane of the rectum.
Avoiding undesirable consequences is quite possible, having applied for medical help in a timely manner and having conducted adequate treatment.
Prevention
A huge role is played by high-grade food, refusal from bad habits and an active way of life - walks on fresh air, feasible physical activities, hardening measures increase our stress resistance and immune status.
Also, a measure that prevents the development of diseases manifested by abdominal pain and vomiting is adherence to the basic sanitary and hygienic norms, as well as the normalization of rhythm and lifestyle, the provision of conditions that allow to relax and relieve emotional tension, to cope with negative emotions in case of their occurrence.
You can use everything - autogenic training, yoga, other practices that bring up a positive attitude in us.
In the presence of chronic diseases in time to undergo preventive examinations, perform prescribed by the doctor's recommendations to avoid exacerbations.
Forecast
Severe consequences can be avoided by calling for medical help in a timely manner, since virtually all uncomplicated diseases that cause abdominal pain and vomiting are now curable, if not conservative, then by surgical methods.