Why the stomach twists and diarrhea?

The condition when the stomach twists and diarrhea is one of the symptoms of digestive disorders. The patient has liquid stools, in the feces may appear an admixture of mucus, undigested food particles, blood streaks. Diarrhea can be single or frequent, watery. Discomfort in the abdomen is felt, from a slight rumbling and bloating to pronounced painful spasms. Often in relation to pains that appear and disappear, apply such an expression as "twists stomach". This condition can be explained by various reasons, and in many cases, medical advice is required.

Causes of the abdominal discomfort and diarrhea.

If the stomach twists and diarrhea in an adult or a child over one year of age, it is most often a pain in the intestinal region and the appearance of unformed liquid stools 2-3 or more times a day. Due to improper digestion or lesions of the mucous tissue of the digestive tract in the stool may be found mucus, food particles, blood. At the same time, nausea and gagging may be bothersome.

Why stomach twists and diarrhea? In most cases, the problem is caused by pathogenic flora infecting the intestines - for example, rotavirus, adenovirus, coronavirus infection, salmonella, Escherichia coli, the causative agent of disinfection. Pathogens enter the digestive system with contaminated water or food, or through unwashed hands.

Apart from this, the disorder can also be due to other causes such as:

• prolonged chaotic intake of antibiotics and other medications;
• Consumption of poor quality, spoiled, poisoned food;
• lactose intolerance (inability of the digestive system to digest dairy products);
• inflammation of the pancreas (pancreatitis);
• gluten intolerance (inability to digest gluten, a protein substance found predominantly in cereals);
• Consumption of large amounts of artificial sugar substitutes - in particular, mannitol and sorbitol.

Some people often have stomach twists and diarrhea after vaccines, when chronic enteritis and enterocolitis worsens, when ulcerative colitis, irritable bowel syndrome, and in women this often happens during pregnancy.

With improper enzyme formation, diarrhea also appears. Among the most probable causes of this violation stand out:

• viral infection, which is accompanied by watery feces, intense fluid loss, electrolyte metabolism failure;
• intestinal tissue damage, celiac disease, liver or pancreatic pathology;
• inflammatory phenomena in the intestine, increased intestinal motility.

No less common is the so-called functional diarrhea - a disorder of intestinal function, in which there is an increase in the frequency of defecation with the release of watery or pasty feces. In this situation, there is also a strong twisting stomach and diarrhea, which is explained by increased sensitivity of intestinal receptors due to improper diet, frequent or severe stress, etc.

Pathogenesis

In a normal healthy intestine, 99% of the water that enters the intestine with liquids and food is absorbed. Even with a slight decrease in intestinal absorption or increased secretory activity, the presence of moisture in the lumen increases, resulting in a condition of stomach twitching and diarrhea.

Many causes of this condition are known. Specialists emphasize the following main mechanisms of development:

• increased osmotic load;
• increased secretory activity;
• decreased absorption;
• reducing the period and/or area of contact with the suction surface.

In many patients, two or even more pathologic mechanisms are detected at once. For example, in enterocolitis, diarrhea develops as a result of the inflammatory process in the mucosal tissue, exudative reaction and production of all sorts of pro-secretory substances and microbial toxins that can disrupt the intestinal cells.

Common causes: digestive surgery, microscopic colitis, celiac disease. In hyperthyroidism abdominal twisting and diarrhea due to accelerated transit of food mass in the gastrointestinal system.

Activation of intestinal smooth muscle occurs with exposure to certain drugs - in particular magnesium antacids, laxatives, prostaglandins and serotonin, cholinesterase inhibitors and selective serotonin reuptake inhibitors.

Forms

Diarrhea can be secretory (infectious), osmotic (occurs in pathologies of the digestive tract), invasive (inflammatory), functional (stress), as well as acute and chronic.

If suddenly twists the stomach and diarrhea in an adult, and it begins abruptly against a background of relative well-being, lasting 24-48 hours, then we can talk about an acute pathological state. Chronic pathology is characterized by a longer duration (several weeks or months), it is typical for it to alternate between acute and quiet periods. When every day twists the stomach and diarrhea for at least one month, then we talk about chronic diarrhea.

Additional symptoms may include:

• general weakness, drowsiness;
• rumbling in the abdomen, bloating, increased gas formation;
• the appearance of foreign impurities in the feces;
• pain during defecation, tenesmus.

The child's stomach twists and diarrhea or as a result of an infectious disease, or against the background of improper nutrition, which leads to increased stress on the digestive system, to disorders of digestion, enzyme failure, the development of inflammatory processes - in particular, gastroenteritis, pancreatitis. With inflammation of the pancreas, the stool is frequent, frothy, stinky. On closer examination, you can find particles of undigested food. Characteristic also shingles, rubbery pain.

If there is abdominal cramping and diarrhea after eating, we can suspect a disorder of enzyme activity, especially if the pain is spasmodic and there is the so-called "rotten" belching. If it is an infectious process or inflammation, the temperature may rise to 37-38°C, there is nausea, vomiting.

In recent years, cases of stomach twists and diarrhea and nausea after a coronavirus infection have become more frequent. Indeed, coronavirus can affect not only the lungs, but also the digestive system. Therefore, many patients, along with catarrhal manifestations, have problems with stool, nausea, abdominal pain. Such symptoms may be present for some time after COVID-19 disease.

It is not uncommon for girls and women to have stomach twists and diarrhea before their periods. This is due to an increase in the synthesis of prostaglandins - physiologically active substances that can cause smooth muscle contractions both in the uterus and in the intestine. Due to changes in the concentration and distribution of hormones in the blood with the beginning of a new menstrual cycle digestive muscles are activated, food absorption slows down, electrolytic metabolism increases. These processes stimulate the intestines, which can be manifested by diarrhea.

About the same reasons for stomach twists and diarrhea in a teenager: hormonal changes may be to blame. However, other causes of the disorder cannot be ruled out, including infection, poor nutrition, poisoning, etc.

If often, strongly, constantly, rumbles, stomach twists and diarrhea, then, first of all, you should suspect a violation of the intestinal microflora with the predominance of pathogenic microorganisms. Among other possible causes:

• Lactose intolerance (inability of the digestive system to digest and assimilate the milk sugar lactose);
• Crohn's disease (granulomatous enteritis, a systemic inflammatory disease);
• enterocolitis;
• prolonged or erratic use of antibiotics;
• improper diet.

Stomach twists and diarrhea after eating vegetables and fruits with a high content of nitrates and pesticides , after overeating or eating low-quality alcohol, carbonated drinks, fast food. For example, it is quite common when after watermelon stomach twists and diarrhea: in this case, the "culprits" are not so much nitrates, as nitrites transformed from them. When entering the bloodstream nitrites provoke oxygen deficiency, complicate the digestive system, negatively affect the entire body as a whole. Liquid feces of yellow or white color is characteristic of hepatitis, tsirrosis of the liver, pancreatic diseases, viral or microbial intestinal infection.

Tummy twists and diarrhea in the morning after heavy evening meals, especially with large amounts of fatty foods and alcoholic beverages. Additional symptoms may include nausea, vomiting, headache.

Rolling stomach and watery diarrhea are quite dangerous symptoms that can indicate celiac disease, a symptom of irritable bowel disease, to various intestinal infectious diseases such as cholera, yersiniosis, rotavirus infection. Watery stools sometimes accompany food poisoning, and are also one of the signs of "travelers' diarrhea".

Frequent or prolonged abdominal cramping, diarrhea and vomiting can trigger dehydration, a disorder characterized by a decrease in the concentration of moisture in tissues. Dehydration is manifested by drowsiness, dizziness, apathy, dry skin and mucous membranes, a feeling of thirst, and decreased frequency and volume of urination.

If there is a high fever, twisting stomach and diarrhea - it is most likely an infectious disease:

• staph infection;
• typhoid, salmonellosis infection;
• escherichiosis;
• rotavirus;
• enterovirus;
• adenovirus.

The causative agents in this case are pathogenic and opportunistic microorganisms, viruses.

Stomach twists and diarrhea after alcohol - poor quality, or taken in large quantities. Alcohol irritates the mucous tissues of the digestive system, which leads to a violation of gastric juice production, activation of intestinal and pancreatic functions. In such a situation, diarrhea is the body's natural response to alcohol intoxication. If a person consumes alcohol for a long time ("enters a binge"), then digestive disorders become regular. This is often due to the development of pancreatitis and cirrhosis of the liver.

Diagnostics of the abdominal discomfort and diarrhea.

During the initial appointment, the specialist collects an anamnesis from the patient. In addition to complaints that the stomach twists and diarrhea, the doctor needs to understand the full picture of the patient's condition, to determine the probable cause of the violation. Mandatory physical examination is carried out. Based on the cumulative information, it is already possible to suspect one or another problem. However, the final diagnosis is made only after appropriate additional diagnostics, which includes laboratory and instrumental studies.

Required laboratory tests:

• general and biochemical blood tests, urinalysis and fecal analysis;
• if there's vomiting, analyze the vomit.

Instrumental diagnostics may include:

• ultrasound examination of abdominal organs (helps to detect functional disorders of the digestive organs, inflammatory processes);
• CT scan of the abdomen (provides complete information about the condition of the organs);
• colonoscopy (allows you to examine the inside of the large intestine using endoscopic equipment).

If necessary, the diagnostic list can be supplemented. For example, if the doctor suspects pathology of the upper parts of the gastrointestinal tract, he may prescribe gastroscopy (fibrogastroduodenoscopy). If neoplasms are detected, a tissue biopsy is required.

Differential diagnosis

Pathological signs, in which the stomach twists and diarrhea, occur in a variety of diseases. And some of them are not even related to the gastrointestinal apparatus.

To avoid diagnostic errors, the doctor must exclude the presence of the following diseases in the patient:

• gastritis, pancreatitis;
• gallstone disease, cholecystitis, hepatitis, cirrhosis;
• diabetes;
• Celiac disease (gluten enteropathy);
• enteritis, colitis;
• lactose intolerance;
• secretory deficiency;
• tumor processes;
• intoxication, poisoning.

Depending on the identified problem and its causes, the treatment of diarrhea and abdominal discomfort can be handled by doctors of several specializations. Most often the help of a gastroenterologist, infectious disease specialist, therapist, endocrinologist, surgeon is required.

Treatment of the abdominal discomfort and diarrhea.

The most dangerous condition in diarrhea is considered a disruption of the water-electrolyte balance. To prevent this, it is necessary to take measures to hydrate the body as soon as possible.

In case of mild diarrhea and abdominal discomfort, fluids are taken orally. In particular, it is recommended to use saline solutions, which are a combination of sodium chloride and citrate, potassium chloride and glucose. If such solutions are not available, as replenishing fluids use mineral water without gas, decoctions of rose hips, infusions of chamomile, compotes of dried fruits, etc.

If the patient's condition is severe, fluid loss is pronounced, drip administration of drugs and solutions may be required.

To stabilize liquid stools prescribe antidiarrheal, astringent drugs. Enterosorbents are prescribed for intoxication.

Infectious diarrhea may require broad-spectrum antibiotics. If a culture result is obtained, the prescribed antibiotic may be changed.

For correction of intestinal microflora and leveling of side effects after antibiotic therapy, the use of probiotics is appropriate.

With chronic diarrhea and abdominal discomfort, treatment is prescribed only after a full course of diagnosis.

An important component of treatment is diet. It is recommended to eat easily digestible, light food that does not have an aggressive and irritating effect on the mucosa of the digestive system. The basis of the diet is: dried bread, boiled rice, steamed cutlets, mucous and pureed soups, mashed potatoes.

What to do if you have a twisting stomach and diarrhea?

If the disorder is small, without serious additional symptoms, and it is an adult, it is possible to take Loperamide and bismuth preparation. If the patient has a fever, there is blood in the feces, then self-treatment is not recommended: it is necessary to consult a doctor. In such a situation, the cause of diarrhea may be hidden in the infectious process.

When it comes to a child, you should not offer them over-the-counter remedies that are usually taken by adults. It is better to consult a pediatrician or pediatric gastroenterologist.

Such cases require urgent medical attention:

• stomach twists and diarrhea for more than two days;
• there's a rise in temperature;
• there's vomiting, especially frequent vomiting;
• There are more than six visits to the toilet with liquid stools in a 24-hour period;
• Black, bloody, tarry, or purulent stools;
• signs of dehydration appear (drowsiness, apathy, dry skin and mucous membranes, decreased volume and frequency of urination).

Drug treatment

Diarrhea is only one of the symptoms of a disease. If possible, after all diagnostic measures, it is necessary to direct treatment to eliminate the underlying pathology. Although in many cases it is necessary to use and symptomatic drugs.

Less stomach twisting and less diarrhea after ingestion:

• Loperamide in the amount of 2-4 mg three times a day (optimally - half an hour before meals);
• Diphenoxylate 2.5-5 mg three times daily;
• Codeine phosphate 15-30 mg three times a day.

In some cases, taking anti-diarrheal drugs aggravates the patient's condition and can lead to the development of hemolytic-uremic syndrome. To prevent this, these medications are not prescribed if diarrhea in the feces is found bloody impurities of unknown origin. It is optimal to use anti-diarrheal agents if it is about diarrhea without manifestations of general intoxication of the body.

The use of Psyllium and methylcellulose is indicated to increase the volume of the intraintestinal mass. In low doses, stool consistency can be normalized in this way.

The use of preparations of pectin, kaolin, activated carbon helps to absorb excess moisture.

Treatment of irritable bowel syndrome, with abdominal twisting and diarrhea, may include taking Eluxadoline. The dosage is 75-100 mg twice a day. This drug is not used if the patient has a history of pancreatitis or gallbladder removal.

Irritable bowel syndrome may also require the prescription of an antibiotic - specifically Rifaximin tablets 550 mg orally three times a day for two weeks.

Herbal treatment

Self-treatment with all sorts of herbs and potions of severe diarrhea, as well as any digestive disorders in young children is inadmissible. It is important to see a doctor in time.

In mild cases, you can do and such common means of phytotherapy:

• Sage. Sage infusion is prepared as follows: 50 g of dry raw materials pour 500 ml of boiling water, cover with a lid and insist for one hour. Then the infusion is filtered, take half a cup during the day every two hours.
• Oak bark: take 1 tsp. Fine oak bark, pour 400 ml of vodka, insist for a week. The tincture is filtered, take twice a day 20 drops.
• Infusion of St. John's wort. One tablespoon of dry St. John's wort mixture is poured 250 ml of boiling water, insist under a lid for an hour, filtered. Take 30 minutes before meals 100 ml, until normalization of the condition.
• Ryabina.Ryabina juice is taken twice a day, half an hour before meals, 50 ml each. To eliminate the unpleasant sour bite is allowed to add a little honey.

An effective remedy is considered a tincture of a collection of herbs such as St. John's wort, chamomile, wormwood. For its preparation, take 3 tbsp. Equal mixture of these plants, pour 500 ml of vodka, insist at least 2 weeks. The medicine is taken 1 tbsp. L. Before each meal.

Read also:

• Pills for diarrhea: what effective, fast-acting and inexpensive pills
• Infusions and decoctions for diarrhea
• Herbs for diarrhea
• Folk remedies for diarrhea
• Drinks for diarrhea
• Foods for diarrhea

Prevention

Preventive measures that help prevent the appearance of abdominal pain and diarrhea consist in the general correction of the digestive process. It is important to observe the following recommendations:

• Carefully observe the generally accepted rules of personal hygiene;
• Keep food storage and food preparation areas clean;
• subject food to heat treatment (especially eggs, meat and fish);
• Properly store perishable products, observe storage periods;
• Do not drink water from dubious sources (preferably bottled or boiled water);
• to eat only quality foods;
• Do not overeat, eat a balanced diet, avoid fast food, carbonated drinks, alcohol, excessively fatty and spicy food;
• Do not take any medications without a doctor's prescription.

Forecast

If the stomach twists and there is severe diarrhea, the risk of dehydration is multiplied. This is due to the fact that with liquid stools a person loses much more fluid than usual. To improve the prognosis and prevent the development of complications is recommended:

• to see a doctor;
• replenish lost fluids to restore water balance in the body;
• drink often and a little (you can use simple water or tea without sugar, as well as solutions of Rehydron, Ionica, Regisol, Re-salt, Rehydraton, etc.);
• adhere to the recommended diet;
• Do not take antibiotics or other medications unless prescribed by your doctor;
• don't drink alcohol, coffee, carbonated drinks.

It is mandatory to consult a doctor if the stomach twists and diarrhea in a child, as well as in cases:

• If there is blood (streaks or clots) in the feces;
• if the feces are black or, conversely, white;
• if you have a fever;
• if the abdominal pain doesn't go away, or even gets worse;
• if there's abdominal bloating, cramping, frequent vomiting;
• If it is not possible to drink fluids (for example, because of vomiting).

Twisting stomach and diarrhea - such symptoms can be a sign of functional failure, or pathology. Only a doctor will be able to accurately answer the question of the origin of this disorder after conducting appropriate diagnostic measures.

Literature

• Ivashkin, V. T. Gastroenterology. National guide / ed. By V. T. Ivashkin, T. L. Lapina - Moscow : GEOTAR-Media, 2018. - 464 с.
• Infectious diseases : national guide / edited by N. D. Yushchuk, Y. Y. Vengerov. - 3rd ed. Moscow : GEOTAR-Media, 2023. - 1104 с.