Abdominal cramps

Do you often experience abdominal cramps?

Are your cramps very often and are associated with diarrhea sometimes?

Are your cramps isolated?

Do you often experience cramps after eating?

Are your cramps before your menstruation or during it?

Do you experience cramps after a stressful or during stressful episode?

If you want to identify your type of cramps and want to know more about it, continue to read the article you will surely get some tips, remedies of basic dealings with your issue.

 

 

What are the causes of cramps?

Cramp is a nonmedical term which refers to pain in the upper or mid abdominal area usually and is sudden stretch, distension, tightening, aching in the abdominal area. This is usually perceived as stomach cramps but can be associated with any other organ located in your abdomen or some abdominal muscle or even can be a referred pain i.e., from other site.

People may visit to you with cramps/pain. What you need to know is what a person means when he/she mentions the term and what the pattern is. Which part of abdomen is associated? When did it start? What is the nature of cramp/pain? Does it radiate to some other place(s)? What are the associated symptoms?  What makes it worse and what alleviates it? What time of the day does it start?  What is its severity?

 

What are the most common causes of abdominal pain/cramps?

• Gastroenteritis/ stomach flu.
• Gas.
• IBS.
• Stress.
• Food intolerances.
• Celiac disease.
• Constipation.
• GERD.
• Pulled/strained /over-activity of muscles.
• Biliary colic.
• Stomach ulcers.
• Crohn’s disease
• Vomiting.
• Premenstrual syndrome (PMS).

 

There are also some less common causes of cramps/pain and some fatal ones, if not treated immediately with medical care like mesenteric ischemia, IBD, gallstones etc.

Abdominal cramping may accompany diarrhea at times and most common causes of which include: food hypersensitivities, viral infections, and even bacterial infections and medication and may also result from stress such as irritable bowel syndrome (IBS) or chronicity like IBD

Crampy Abdominal Pain can be summarized on the basis of causes as:

• Usually due to organ distension.
• Infection: bacterial, viral, parasitic.
• Inflammatory Bowel Disease.
• Malabsorption Syndrome.
• Small Bowel Bacterial Overgrowth.
• Constipation.
• Porphyria.
• Angioneurotic Edema.
• Familial Mediterranean Fever.
• Adhesions.

 

1)Gastroenteritis:

when your abdominal pain is associated with nausea, vomiting and loose, watery stools and you feel the need to poo sooner than usual this might indicate that your GI lining (stomach and intestines) is inflamed and there is a possible cause of infection by virus and bacteria, and even parasites, but mostly viral. Fever, headache can also be present with diarrhea.

 

2)Gas: 

passing is a natural phenomenon but when it exceeds normal and causes pain it is usually associated with bacteria in your small intestines which breakdown the food and irritates the body causing pressure and tightness in the abdomen with a sharp pain.

 

3)IBS:

IBS is a functional disease and has no cure. It has been seen that IBS patients are less able to digest certain types of food and primarily causes pain and gas, nausea and bloating. IBS have a conservative treatment and needs lifestyle modifications since stress is seen as a precipitating factor.

 

4)Food intolerances:

Certain selective foods are unable to get digested by a body and thus getting accumulated and broken down by stomach and intestinal bacteria, producing a lot of gas. This gas causes a pressure and pain in the abdomen.

 

5)Celiac disease:  such people with celiac disease have allergy to gluten, a protein found in many food items and thus consuming such food causes pain in the abdomen and overtime malnutrition and weight loss.

 

6)Constipation: body when unable to defecate the waste material accumulates it inside the colon that increases the inside pressure and causes pain. Low fiber intake, dehydration less physical activity, certain medications can be some of the potential causes.

 

7)GERD: it is a chronic condition of acid reflux and can cause heartburn, nausea and abdominal pain.  It is very common and treatment is available.

 

8)Over-activity of muscles: injury or strain due to daily activities is common but heavy exercise can lead to muscle damage and severe pain in the abdominal area.

 

9)Biliary colic: Biliary colic can happen when a gallstone blocks a bile duct, causing intense pain usually in the right upper quadrant. This pain comes and goes and in attacks.

 

10)Stomach ulcers: usually caused by consumption of NSAIDS and H. Pylori infection. These ulcers can cause abdominal pain and cramps alongside indigestion and weight loss.

 

11)Crohn’s disease: Crohn’s disease causes inflammation of the GI tract lining, which results in diarrhea, pain, nausea, vomiting, etc. And in the chronicity can cause malnutrition and weight loss.

 

12)PMS (premenstrual syndrome): associated cramps are usually lower abdominal and start two to three days of your period and can continue throughout your period.

 

How to diagnose it?

This can be done by history taking, physical examination and through a series of lab tests.

History lets you know about the event that has occurred before the pain (travel, outing, etc), its site/location, characteristic and pattern of the pain, may be acute or chronic, and much more and may guide you to a medical emergency.

Likewise physical examination helps in marking the area like if:

• Localized (center) can significantly point towards: gastroenteritis, injury.

Upper abdomen: gallstones.

•  May be diffused: Crohn’s disease, irritable bowel syndrome, urinary tract infection, the flu.
• Guarding, tenderness, swelling etc.

Lab tests helps in checking certain components like Hb, WBCs, CRP, and even stool sample to rule out certain diseases.

Imaging like MRI scans, ultrasounds, and X-rays, show certain abdominal  structures in detail and can be helpful in diagnosing tumors, ruptures etc.

 

Other diagnostic tools which may help include:

Endoscopy: (to detect inflammation and abnormalities in the UGI tract).

Colonscopy: (to check the intestines (colon) for inflammation).

Upper GI (checks for inflammations, growth, etc in the stomach)

 

Clinical Evaluation of Abdominal Pain:

1. Women:

Depends on last menstruation and eventually a pregnancy test (HCG). And pelvic examination can be done if urine analysis is negative. For pregnant patients with abdominal pain imaging can be considered.

2. Men with a pain in lower abdomen should always have a genital examination.
3. TR should be done for all patients alongside stool examination.
4. Orthostatic vital signs should be performed.
5. Upper Abdominal Pain:
6. a)On palpation tenderness indicates, imaging is essential.
7. b)No tenderness indicates a consideration of an ECG.
8. Lower abdominal pain along with flank pain should always include a urinalysis
9. Surgical importance:
10. a. Abnormal vital signs like temperature > 38^oC
11. Rebound tenderness or guarding on examination.
12. White blood cell count >10/ml

 

How to treat it?

Prevention is better than cure:

• Have a healthy diet.
• Avoid eating fatty foods.
• Avoid foods to which you’re intolerant.
• Reduce your alcohol intake.
• Stop binge eating.
• Reduce your stress.
• Maintain your sleep hygiene.
• Proper hydration is always necessary.
• Maintain proper distance with people having stomach flu.
• Proper hygiene of preparing and storing foods.
• Precautions while traveling to areas with high prevalence of food poisoning and infections.
• Take medication side effects into consideration
• Treat chronic conditions, such as IBS and IBD.

Treatment can be done according to the condition of patient, being mild or severe and also on the underlying disease and thus has a spectrum:

 

Home remedies:

Home remedies can be the first step and can prove very useful to prevent further suffering.

• Drink plenty of clear liquids, such as water, juice,etc.
• Hydration is very important.
• Avoid caffeine and alcohol.
• Eat small amounts of low-fiber, mild foods when bowel habits esort to normal again.
•  Avoid spicy, oily food and high fiber food.
• Natural probiotics are found in foods such as yogurt, may help.
• Chamomile (tea)- anti anxiety.
• Ginger.
• Yoga, deep-breathing, and other relaxation techniques may help to reduce anxiety and stress.

 

Medications:

• Antibiotics can be efficiently used to treat bacterial infections, also food poisoning.
• Anti-allergic medications.
• Antidepressants to treat stress and anxiety.
• Non-steroidal anti-inflammatory drugs (NSAIDs) to treat PMS.
• Anti-parasitic drugs like albendazole for parasites.

Sometimes if the diarrhea is severe, a need for hospital admission may be foreseen.

 

When to consult a doctor?

• Abdominal cramps that lasts longer like more than 24 hours.
• Prolonged constipation, can lead to obstipation and serious consequences.
• Vomiting.
• Fever.
• Loss of appetite.
• Unexplained weight loss.
• Diarrhea with no improvement after 2 days.

 

Other symptoms to watch for include:

Bloody stools, severe abdominal pain, or a fever of 102°F or higher and consult the doctor if you experience any of these.

If your child has diarrhea, you should call their pediatrician may be and take them to the emergency if they have following symptoms:

• No improvement even after 24 hours.
• No wet diaper in three hours or more.
• Fever of 102°F or higher.
• Your child has xerostomia (dry mouth) or tongue.
• Your child is crying without tears can indicate severe dehydration.
• Poor turgor skin.
• Sunken appearance of cheeks, abdomen or eyes.
• Bloody stools or black stools.

The sooner you rush to your nearby health care facility or doctor after experiencing any of these symptoms within yourself or your baby, the better it’s.