How does IBS (irritable bowel syndrome) cause abdominal pain?
As previously mentioned, the discomfort of irritable bowel syndrome is due either to abnormal intestinal muscle contractions or visceral hypersensitivity. Generally, abnormal muscle contractions and visceral hypersensitivity are much more difficult to diagnose than other diseases or other health conditions, particularly since there are no typical abnormalities on physical examination or the usual diagnostic tests. The diagnosis is based on the history (typical symptoms) and the absence of other cause.
Foods, natural remedies, and OTC treatments for certain causes of abdominal pain
If you aren’t sure if you need to seek medical advice for belly pain, contact your doctor or other health care professional before using any home remedies.
Common home remedies and over-the-counter (OTC) medicines include:
- Eat less food
- Take small amounts of baking soda
- Use lemon and/or lime juice
- Start a BRAT diet (banana, rice, applesauce and toast) for a day or so for symptom relief.
- Don’t smoke or drink alcohol.
Some health care professionals recommend:
- Taking ginger
- Peppermint
- Licorice
- Chamomile tea
- Medications such as bismuth subsalicylate (Pepto-Bismol), loperamide (Imodium), ranitidine (Zantac) and other over-the-counter substances
Some of these may help reduce symptoms, but if symptoms persist, seek medical care. Beware of "cures" advertised as a single treatment that can cure all causes of this problem because no such remedy or cure exists.
Why can diagnosis of the cause of abdominal pain be difficult?
Modern advances in technology have greatly improved the accuracy, speed, and ease of establishing the cause of belly pain, but significant challenges remain. There are many reasons why diagnosing the cause of it can be difficult.
Symptoms may be atypical
- For example, the pain of appendicitis sometimes is located in the right upper abdomen, and of diverticulitis on the right side. Elderly patients and those taking corticosteroids may have little or no pain and tenderness when there is inflammation, for example, with cholecystitis or diverticulitis. This occurs because corticosteroids reduce the inflammation.
Tests are not always abnormal.
- Ultrasound examinations can miss gallstones, particularly small ones.
- CT scans may fail to show pancreatic cancer, particularly small ones.
- The KUB can miss the signs of intestinal obstruction or stomach perforation.
- Ultrasounds and CT scans may fail to demonstrate appendicitis or even abscesses, particularly if the abscesses are small.
- The CBC and other blood tests may be normal despite severe infection or inflammation, particularly in individuals receiving corticosteroids or other drugsthat suppress the immune system.
Diseases can mimic one another.
- IBS symptoms can mimic bowel obstruction, cancer, ulcer, gallbladder attacks, or even appendicitis.
- Crohn's disease can mimic appendicitis.
- Infection of the right kidney can mimic acute cholecystitis.
- A ruptured right ovarian cyst can mimic appendicitis; while a ruptured left ovarian cyst can mimic diverticulitis.
- Kidney stones can mimic appendicitis or diverticulitis.
The characteristics of the pain may change.
- Examples discussed previously include the extension of the inflammation of pancreatitis to involve the entire abdomen and the progression of biliary colic to cholecystitis.
What medications can be used to treat certain causes of abdominal pain?
Medications that are used for the treatment of underlying cause(s) of the pain are the medications of choice. For example, medications are not needed for the treatment of simple viral gastroenteritis (stomach flu or stomach bug), while surgery and/or chemotherapy may be the best approach to treat certain cancersin the abdomen. Other causes may require antispasmodics, antimicrobials, H2 blockers, or even nitrates or morphine. The diagnosed cause usually narrows the choice of medications. A few causes can only be treated by surgery (for example incarcerated hernia, abdominal adhesions from previous surgeries, and certain abdominal injuries), although some medications may be used (for example, morphine) while the person is waiting to have surgery.
What lifestyle choices can I make to prevent abdominal pain?
Lifestyle changes really depend on the cause of the pain.
- Eat a healthy diet, exercise, and avoid smoking and excess alcohol consumption to reduce the chances that you will experience certain causes.
- Good hygiene, especially hand washing and avoiding materials and foods contaminated with viruses and bacteria will reduce your chances of developing illness from many infectious causes.
When should I call my doctor about abdominal pain?
Some doctors suggest that if you have a "less serious" cause of abdominal pain you likely won’t need to see a doctor if the symptoms resolve in about 24 to 48 hours. For example, if you have viral or bacterial food poisoning, have had discomfort, but aren’t dehydrated.
If you have a chronic problem that occasionally causes abdominal discomfort, most doctors suggest you contact the person treating you for the ailment for an appointment or prescription (refill). However, if you have any of the problems or symptoms listed in the "serious abdominal pain "section above, you should seek immediate medical care.

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