The uterus hurts when pressing on the abdomen. Causes of pain. Premature placental abruption

One of the most common complaints when visiting a doctor is pain in the stomach and intestines. The nature of the pain can be mild or severe, but in any case this symptom is quite serious. If such characteristic pain occurs, you should not delay going to the hospital. The doctor will be able to determine by touch what disease this symptom refers to.

Causes

There may be several reasons for the appearance of severe pain when pressing on the stomach:

• appendicitis;
• gastritis;
• ulcer;
• pancreatitis;
• mechanical narrowing of the stomach, intestines, bile ducts;
• injury abdominal wall;
• autoimmune diseases;
• food intolerance;
• gynecological diseases;
• diseases of the liver, spleen;
• intestinal inflammation;
• poisoning;
• hernia.

What does pain when pressing on the stomach indicate?

Appendicitis is characterized by severe pain, including when pressed. To determine, click on the bottom right. The pain is especially severe when the pressure is released. Acute appendicitis is usually accompanied by high temperature, nausea, vomiting. It is important to consult a doctor immediately at the first suspicion of this disease.

Stomach hurts and acute gastritis. This reason is one of the most common when calling a doctor. In addition, the patient experiences a gray coating on the tongue, frustration, severe nausea and vomiting.

Pressing on the abdomen can cause discomfort during peptic ulcer disease. Initially it is localized in epigastric region, and then spreads to the entire abdomen. It hurts a lot when you press on any area. Pale skin, rapid pulse, vomiting, cold sweat and low blood pressure.

Inflammation of the pancreas or pancreatitis is more often diagnosed in those who abuse alcohol or have gallstones. The nature of the pain is sharp, constant, and can radiate to the back. You need to press gently on your stomach, as the sensation is very painful. The attack may be accompanied by vomiting, elevated body temperature, weak pulse and pale skin.

If the body does not accept certain products, this can trigger an attack of severe abdominal pain. Most often these are dairy products and lactose. If you are allergic to milk protein, it is better to exclude everything that contains it. The pain will be characteristic, as if the stool is upset.

If the pain is localized below the navel in women, this indicates gynecological problems, for example, inflammation of the ovaries. It hurts when pressed, or it constantly hurts in the liver area, which may indicate cholecystitis, poisoning, or an enlarged spleen.

With inflammation of the small intestine, it hurts when pressed near the navel. Poorly digested food, eating sweets or legumes can cause intestinal inflammation. Intestinal obstruction is characterized by acute, cramping, intense pain. It is necessary to press gently into the inflamed area. The abdomen swells, severe vomiting and painful urge to defecate appear.

After lifting heavy objects, strangulation of the hernia may occur, which is accompanied by pain.

Types of pain when pressed

When pressed, pain may occur, which is divided into two types:

• visceral pain - can occur in the form of colic, is dull in nature and manifests itself when pressing on the abdomen; associated with irritation nerve endings occurring when the stomach or intestines are stretched; may be caused by a disorder;
• somatic pain – characteristic of pathological processes occurring in the gastrointestinal tract; the pain is sharp, constant, localized in one area, it is difficult for a person to breathe and move, since any movement can increase pain.

Abdominal pain when pressed has a different character:

• pulling;
• piercing;
• dull;
• cutting;
• bursting;
• aching.

Diagnostics

Any pain in the stomach area is a serious symptom. Therefore, when it appears, it is necessary to call an ambulance and immediately consult a doctor. While examining the patient, the doctor begins to press on different areas of the abdomen to determine the diagnosis. It is clarified when the pain began, whether it first appeared, what symptoms accompany the pain (vomiting, fever, nausea). The doctor should take into account that the stomach may hurt even when heart attack and pneumonia. The following diagnostic measures will help to establish an accurate diagnosis:

• general analysis blood and urine;
• abdominal x-ray;
• endoscopic examinations;
• computed tomography of the abdominal cavity.

In some particularly severe cases, urgent surgical intervention.

During a medical examination, the doctor checks how the abdomen feels to the touch, where discomfort occurs during palpation, that is, when pressing on the abdomen, palpating. This is done to identify the clinical sign - pain. If the patient himself feels the pain, the pain is detected by the doctor: the patient may not know what exactly he will feel when pressing on a certain area.

The article will tell you about the causes of pain identified during self-examination by pressing on the front wall of the abdomen.

Topographic division of the abdominal cavity

They start by determining the zone in which, when pressed, .

Doctors identify nine such areas. To detect them, the abdominal surface is conventionally divided by four lines located on the stomach, as in the game “Tic Tac Toe”. The first horizontal line runs directly under the ribs from right to left. The second is from one ilium (the most top part pelvis) to the other, this feature is located approximately where the elastic of panties usually ends up. Vertical lines are located to the right and left of the navel so as to divide the anterior surface of the abdominal cavity into three equal vertical parts. This way we get nine parts equal in width.

We move from left to right along the upper “cells” of the abdominal zone:

• Left hypochondrium (bounded above by the ribs, below by the upper horizontal line).
• The epigastric region or epigastrium (has a triangular appearance: from above it is limited by the ribs and the xiphoid process of the sternum, from below - by the upper horizontal line).
• Right hypochondrium (bounded above by the ribs, below by the upper horizontal line).

We move from left to right along the second level of “cells” of the abdominal cavity, bounded from above by the upper horizontal line, from below by the lower horizontal line:

• Left side;
• Periumbilical;
• Right side area.

We move from left to right along the third, lower level, bounded from above by the lower horizontal line, from below and on the sides by the pelvic bones:

• Left iliac (looks like a triangle);
• Suprapubic (bounded below by the pubic bone);
• Right iliac (also triangular) region.

If you superimpose the zone of pain in abdominal pathologies onto the resulting “map,” each pathology reveals its own localization area.

The main causes of pain when pressing

Here are some of possible pathologies, causing pain when you press your fingers on the stomach. For all pathological processes, pain on palpation does not become the only sign; it is important to pay attention to associated symptoms.

Acute gastritis

A common cause of pain when pressing on the umbilical and suprapubic areas is acute gastritis, in this case the stomach hurts. The disease is accompanied by symptoms:

• Nausea;
• Vomit;
• Diarrhea;
• Feeling weak;
• Grayish;
• Increased salivation or, conversely, dry mouth;
• In some cases, a rise in body temperature.

It is important to confirm the diagnosis with a doctor, since pain when pressing fingers on the lower abdomen can indicate appendicitis.

Appendicitis

With appendicitis, pain becomes maximum when pressing on the right iliac part. During pressing, the discomfort does not reach its peak. It comes when the fingers are removed. This type of pain indicates a serious pathology and the need to urgently consult a doctor.

Stomach ulcer

When palpating the epigastric zone, a patient with a gastric ulcer will feel pain accompanied by spontaneous tension abdominal muscles in the specified area. Muscle tension is felt especially well when you apply jerky pressure with your fingers on the stomach.

Duodenal ulcer

Pain when pressing on the right iliac zone, which is accompanied by spontaneous muscle tension, becomes a consequence of an advanced ulcer duodenum. In the early stages of the disease, there are no obvious pain sensations on palpation.

Pathologies of the spleen

Painful sensations on palpation are sometimes caused by an enlarged spleen. It is strictly forbidden to press hard on the area where it is located: the spleen is a fragile organ, its rupture can occur due to inaccurate palpation. If there is a problem with the spleen, a characteristic symptom appears - blueness of the skin surrounding the navel. The intensity of unpleasant sensations with an enlarged spleen can spread to the intestines due to its compression and displacement.

Gynecological diseases

In women, pain when pressing on the abdomen can occur with inflammation of the appendages (adnexitis), polycystic ovary syndrome. The focus of disturbing sensations is localized in the iliac and suprapubic regions.

Diverticulitis

Diverticulitis is an inflammatory disease that affects the intestines. With it, palpation of the left lateral, left iliac regions causes acute pain if you press on the source of inflammation. Painful sensations can intensify with physical activity, coughing, and laughter.

Cholecystitis

This is an inflammation of the gallbladder. In addition to pain in the area of ​​the right hypochondrium, tapping the edge of the right costal arch with the edge of the palm helps to detect discomfort: with cholecystitis, such an action will cause severe pain that appears during tapping and disappears after the cessation of this action.

Pancreatitis

Inflammation of the pancreas is considered a complex procedure that is difficult to perform without special education. Pain is noticeable upon palpation six centimeters above the navel.

What to do after self-examination

If abdominal pain occurs during palpation, you should consult a specialist; only he can determine what caused the ailment. The doctor will conduct a professional examination, review the patient’s medical history, and ask questions about accompanying symptoms. A sick person may miss an important symptom; the doctor will definitely pay attention to it.

Based on the results of the examination and questioning, the patient will receive referrals for tests and additional examinations: ultrasound of the abdominal cavity, computed tomography, endoscopic examinations. If necessary, emergency surgery is prescribed.

How to deal with pressure pain

Self-medication is not recommended. Taking painkillers is especially dangerous. Pain, its nature and location are the main sources of information about what a person is sick with. Before a medical examination, taking analgesics is strictly prohibited!

The only thing you can do is follow therapeutic diet: exclude spicy, salty, fried foods, coffee and strong tea from the diet. Errors in nutrition themselves will cause pain in the abdominal cavity.

Drinking alkaline mineral water will ease the condition. Drinking should be plentiful, frequent, sips should be small. The use of warm mineral water is indicated for patients with peptic ulcers stomach and duodenum.

If pain is caused not by a serious pathology, but by a functional disorder of the digestive tract due to overeating or stress, it is allowed to take Activated carbon or Smecta. To relieve spasms, an adult can take a couple of tablets of No-shpa and Drotaverine.

Pain when pressing on the abdomen can most often be a sign of acute gastritis. This disease affects half of the world's population; among schoolchildren it ranks 4th in prevalence. Acute gastritis is caused by inflammatory changes in the gastric mucosa. The process can affect not only the superficial layer of the mucous membrane, but its entire thickness and the muscular layer of the gastric wall.

For acute gastritis there is a feeling of heaviness in the epigastric region, which is accompanied by nausea, vomiting, and indigestion. The tongue is covered with a grayish-white coating, and profuse drooling or, on the contrary, increased dry mouth. When you press on your stomach, you feel pain in the stomach area ( epigastric region).

If an acute sharp pain appears when pressing in the lower right side of the abdomen, in the vast majority of cases this is - sign of appendicitis. When you release your hand, the pain intensifies. There may be a slight increase in temperature, dry tongue, rapid pulse, nausea, vomiting or diarrhea. This situation requires urgent medical attention.

Pain when pressing on the abdomen on the right under the ribs most often indicates about liver problems. But this could be a sign of duodenum. Only a doctor can understand the intricacies of the problem.

When pain occurs when pressing on the abdomen near the navel or to the right of it, most often plays naughty small intestine . This may be due to fermentation of poorly digested food, causing irritation of the mucous membrane. Pain in this area can be caused by flatulence after eating a lot of beans or sweets. This is often how helminthic infestations manifest themselves.

Pain that occurs when pressing the lower abdomen under the navel in women most likely has gynecological nature. If such pain occurs frequent urge to urination, burning, stinging, cloudy urine, we can talk about problems with the kidneys and urinary tract. If a bowel disorder appears (from constipation to a constant urge, often false), we are talking about colitis - inflammation of the mucous membrane of the colon, which can be caused by poor nutrition or dysbiosis.

Pain in the left upper abdomen occurs less frequently than in the right. They occur if the spleen increases in size. During the examination, the doctor does not press hard on the corresponding part of the abdomen, since the enlarged spleen may rupture. In addition to pain, a sign of its rupture is a bluish tint of the skin around the navel.

If there is a disorder, as well as nausea, weakness and elevated temperature most often indicate indigestion or poisoning.

Pressing on the abdomen increases intra-abdominal pressure, which, in turn, can provoke increased pain in some pathologies. Also, when pressed, the sheet of peritoneum is pressed against the area of ​​inflammation, which causes pain. In general, it is believed that increased pain during palpation of the abdomen in a certain place indicates that the pathological process is localized there. That is, with referred pain ( for example, abdominal pain due to pneumonia or myocardial infarction) the pain will not increase in response to pressure.

If pain appears when pressing on the lower abdomen on the right, we can talk about appendicitis, as well as adnexitis or an ovarian cyst in women. If pain is localized in the upper abdomen on the right, the cause may be cholecystitis, duodenal ulcer, or hepatitis. It should be noted that if the patient notices local pain when pressing on the abdomen, there is no need to specifically press again, “exploring” the nature of the pain. It is better to consult a doctor who will conduct qualified palpation of this area, determine the size of the organs and suggest possible diagnosis.

Abdominal pain on the right in the middle of the menstrual cycle

Abdominal pain in the middle of the menstrual cycle is quite common and does not always indicate a pathological process. They are often caused by the rupture of a follicle in the ovary and the release of an egg into the fallopian tube. If the right ovary is involved in this process, then the pain, accordingly, will be localized on the lower right.

Of the pathological processes that can worsen during menstruation, a number of venereal diseases (gonorrhea, chlamydia, trichomoniasis, etc.). However, these infections rarely rise high enough to cause pain in the right lower abdomen. Also, pain can be associated with benign or malignant neoplasms of the uterus, ovarian cyst.

Right stomach hurts after sex

After sexual intercourse, pain in the lower abdomen occurs most often in women. This is usually due to the presence of a chronic inflammatory process in the pelvis, which is activated through physical activity and increased intra-abdominal pressure. For example, if you have an ovarian cyst during sexual intercourse, it may rupture ( apoplexy). Then in the very first hours ( and sometimes even minutes) After this, pain begins to increase. With apoplexy of the right ovary, accordingly, pain occurs in the right iliac fossa, radiating to the groin, buttock or leg.

Aching pain in the abdomen on the right

Aching pain, as a rule, occurs during inflammatory processes of moderate intensity. For example, during an exacerbation of duodenal ulcer, it is localized in the right hypochondrium or in the epigastrium. This pain begins after eating and lasts for several hours. Its origin is associated with irritation of the mucous membrane of the organ. Also aching pain possible in some cases of cholecystitis, appendicitis and other inflammatory diseases.

Cutting pain in the lower abdomen on the right

Cutting pain in the abdomen on the right is more characteristic of intestinal pathologies. Most often it is localized in the lower abdomen. Such pain is caused by spasm of smooth muscles in the walls of the organ and disturbances in pushing food through. The cause is usually intestinal infections or food poisoning. In both cases, the pain can be quite severe, but there is no such serious threat of death as with an “acute abdomen”.

Throbbing pain in the lower abdomen on the right

Throbbing pain in the lower abdomen on the right can be caused by certain vascular diseases or acute inflammatory process. In the first case we are talking about aneurysms of the lower part abdominal aorta. The expansion of the vessel forms a sac, which pulsates in time with the heart. However, the pain will be moderate ( uncomplicated aneurysm does not cause acute pain). If the pain is severe, then most likely there is purulent inflammation. In the right lower abdomen, this may be due to advanced appendicitis. The vermiform appendix ruptures, causing local inflammation of the peritoneum ( peritonitis).

Constant pain in the abdomen on the right

Constant pain is usually not too severe. Some patients do not attach importance to it for several weeks and only after this time ( usually when it intensifies) consult a doctor. Moderate in intensity, but prolonged pain is characteristic of chronic appendicitis or cholecystitis, gastritis. In some cases, the inflammatory process gradually subsides, but it can also enter an acute phase. In any case, you should not ignore long-term pain. It is better to contact a specialist and immediately determine their cause. Then there is a high chance that the disease will be overcome conservative methods, without surgery.

Periodic pain in the abdomen on the right

Recurrent abdominal pain that occurs over several months or years can be associated with a number of chronic diseases. In this case, pain will appear only in certain conditions during exacerbations. For example, stomach and duodenal ulcers can cause more severe pain in the spring and fall, as well as in response to poor diet.

In addition, inflammatory bowel diseases such as Crohn's disease or ulcerative colitis do not cause constant pain. As a rule, their exacerbation lasts several weeks, and then a period of remission occurs. However full recovery difficult to achieve. Diet and preventive treatment I only reduce the intensity of pain and the frequency of attacks.

Cramping pain in the lower abdomen on the right

Cramping pain in the right side of the abdomen is almost always caused by muscle tension, although it is rarely associated with an inflammatory process in the muscles. Painful spasms can occur, for example, with intestinal obstruction caused by a tumor or blockage of the lumen. Peristaltic contractions of the intestine reach the obstruction, but do not spread further. Instead, an attack of severe pain occurs in the form of contractions.

Sharp sharp pain in the abdomen on the right

Acute pain in the abdomen on the right often appears with ruptures internal organs or blockage of blood vessels. It is in these cases ( in contrast to a gradually developing inflammatory process) there is immediate irritation of a large area of ​​the peritoneum or death of a large volume of tissue. Sudden acute pain, which can even take your breath away, is characteristic, for example, of perforation of a stomach ulcer, rupture of the gallbladder or appendix, or thrombosis of the mesenteric arteries.

As noted above, not a single qualified doctor considers the nature of abdominal pain as a leading sign. He will be guided mainly by accompanying symptoms and complaints. Only by considering them as a whole can one establish the cause of certain pain sensations.

Diagnosis of the causes of pain in the right side of the abdomen

Diagnosing pain in the right side of the abdomen is a very complex process, since this symptom can be caused by many various reasons. At the same time, it is necessary to establish the cause in order to prescribe the correct treatment. A preliminary diagnosis is usually made by emergency physicians or a family doctor upon first contact with the patient. After this, depending on the results of this examination, the patient may be hospitalized in the department of surgery, gastroenterology, gynecology, therapy for further examination and clarification of the diagnosis.

The most informative diagnostic methods for pain in the right side of the abdomen are:

• physical examination;
• radiography;
• ultrasonography ( Ultrasound);
• diagnostic laparoscopy;
• diagnostic laparotomy;
• serological tests;
• microbiological research methods;
• electrocardiography ( ECG);
• diagnostic probing.

Physical examination

Physical examination involves a series of simple manipulations and general examination patient in order to collect primary information about the disease. For abdominal pain, the greatest attention is usually paid to palpation of the abdomen. This is palpation of the organs and formations of the abdominal cavity through the anterior abdominal wall. The patient takes a lying position, slightly bends his knees, breathes deeply and relaxes his abdominal muscles. Palpation should begin from the area that is least painful and end with the most painful area. Some diseases can be suspected with a high degree of probability already at this stage ( provided that the study was performed correctly).

When palpating the abdomen, the following changes are possible:

• increased pain ( often talks about the inflammatory process);
• hypersensitivity of the skin - pain with a simple touch in certain places;
• board-shaped tension of the abdominal muscles - often indicates perforation of the ulcer, peritonitis and other serious surgical pathologies;
• pain when pressing slowly and abruptly tearing off the hand ( positive Shchetkin-Blumberg sign) indicates local involvement of the peritoneum in the inflammatory process;
• liver enlargement - may indicate hepatitis of various origins;
• pain in the right iliac fossa - often occurs with appendicitis, adnexitis in women;
• local bloating - may indicate intestinal obstruction in this place;
• abnormally located seals - as a rule, turn out to be tumors of various organs;
• uniform enlargement of the abdomen with accumulation of fluid - most often indicates pathological processes in the liver.

There are others pathological changes, by which the doctor may suspect a diagnosis. In addition to palpation, it is important to listen to breathing and feel the pulse. Both breathing and pulse increase during an acute inflammatory process. In addition, in case of severe pain, the patient’s breathing is modified; he tries to increase the amplitude of inhalation through the chest, but the abdomen is not involved in this process.

Other important indicators of general condition are temperature, blood pressure, auscultation ( auscultation) heart sounds. All this provides information about how various body systems work and often allows us to suspect the cause of pain.

Radiography

Radiography is the acquisition and subsequent examination of an x-ray image. This image is formed due to x-rays, passing through the area of ​​the body being studied and then captured on film. The source of radiation of these rays is an X-ray tube located in front of the object under study. X-ray ( x-ray image) is formed due to different tissue densities, since the structures human body have varying degrees of absorption of rays. Those fabrics that have more high density, will absorb radiation more strongly ( There are dark areas in the photo), and those with a lower density are weaker ( light areas).

It is advisable to carry out this study in two mutually perpendicular projections ( positions) - straight and lateral. This is done to prevent shadows from overlapping each other and, thus, for more effective diagnosis various pathologies.

Radiography is of the following types:

• Conventional radiography. The first type is conventional radiography, which is based on the natural contrast of tissues and structures of the human body, due to their different densities.
• Contrast radiography. The second type is artificial contrast radiography. The essence this method consists of introducing contrast agents into the cavities, organs or vessels of the body, which absorb radiation weaker ( oxygen, nitrous oxide, carbon dioxide) or, conversely, stronger ( compounds of iodine, barium) than the organ being studied. After the contrast agent has been introduced into the body, X-ray and analyze the result. This allows you to better assess the contours of cavities, formations, boundaries of organs, etc.
• Survey radiography. Survey radiography is a study of an entire organ or group of organs ( For example, plain radiography abdominal organs). The relative position of the organs and their relative sizes are assessed.
• Sight radiography. Sight radiography is a study of a specific area or formation in any organ ( for example, targeted radiography of a liver cyst).

This method is completely safe for the patient, inexpensive and does not take much time. As a rule, with modern computer devices, an image can be obtained within 10 - 15 minutes after the procedure. Contrast radiography is somewhat more difficult to perform ( it is necessary to administer contrast, check whether the patient is allergic to it). After this procedure, the patient is observed for some time, as adverse reactions may occur.

Magnetic resonance imaging ( MRI) represents diagnostic method study of tissues and organs based on the phenomenon of nuclear magnetic resonance. The bottom line is that each tissue of the body contains a different concentration of hydrogen ions. Their movement in the electromagnetic field is captured by the device.

During the examination, a magnetic field is created in the MRI cabin, and electromagnetic radiation of a certain frequency acts on the body tissues, which causes the excitation of hydrogen atoms. Simultaneously with this MRI scanner in the cabin, the electromagnetic response of these excited atoms is recorded. The information received from the scanners to the computer is processed and then appears in the form of images on the monitor screen. You can print them out and get an MRI image.
MRI is one of the most accurate and safe methods modern diagnostics for pain in the abdomen on the right. However, its limited use in medicine is primarily due to its high cost, as well as the fact that such research cannot be performed by those who have ferromagnetic implants ( pacemakers, spokes, etc.).

There are several types of magnetic resonance imaging:

• Conventional MRI. Conventional MRI is used in the diagnosis of numerous diseases. It is used both to identify space-occupying formations ( cysts, tumors, abscesses, obstructions, hernias, stones), and for the detection of inflammatory, infectious, autoimmune and other pathologies.
• MR perfusion. MR perfusion is a type of MRI that allows you to assess the level of blood supply to organs. For abdominal pain on the right, it is most often used in the diagnosis of vascular, liver and kidney diseases.
• MR spectroscopy. MR spectroscopy helps determine the biochemical concentrations of individual metabolites ( metabolic products) in the organ or tissue being studied. A significant advantage of this type of research is the ability to detect pathology in its early stages.
• MR angiography. MR angiography is a method for diagnosing vascular pathology. There are MR angiography without contrast and with contrast. For abdominal pain in the right region, this type of examination is mainly used in the diagnosis of abdominal aortic aneurysms, thrombosis and embolism of mesenteric vessels.

CT scan

CT scan ( CT) is a method of transverse, layer-by-layer x-ray examination. Just like in radiography, the radiation source is a ray tube ( x-ray). The radiation receiver in this study is special ionization chambers. After X-rays enter the receiver, they are transformed into electrical impulses, which are then transmitted to a computer for processing. During CT scanning, the radiation source and receiver move synchronously in one direction, around the longitudinal axis of the patient’s body, which allows the required number of images to be taken in any area of ​​interest to the doctor.

Although computed tomography compared with x-ray examination relatively expensive, it is a valuable diagnostic method for treating abdominal pain on the right. Being highly informative, CT helps to detect and assess the severity of the disease, the presence of complications, concomitant pathology, the presence or absence of any changes in tissues and organs.

Colonoscopy

Colonoscopy is a diagnostic method that allows you to assess the condition of the mucous membrane of the large intestine. This procedure is performed by an endoscopist using a medical endoscopic probe. It is a tube with a built-in video camera, which transmits information about the condition of the mucous membrane to the monitor screen. Colonoscopy is a quick and indispensable diagnostic procedure for diseases such as cancer, polyps, ulcers, inflammation of the large intestine, ulcerative colitis etc. During colonoscopy, it is possible not only to visualize the condition of the intestinal mucosa, but also to select material for research ( perform a biopsy).

This procedure is harmless, but the patient may experience discomfort during it. To reduce it, before a colonoscopy, the patient is prescribed antispasmodics, which relax the intestinal wall. Then an anesthetic injection is given to make the procedure less painful. And only after this they begin the colonoscopy. On average, the procedure itself lasts from 10 to 15 minutes, depending on the purpose of the study. The results of the study are provided to the patient immediately upon completion of the colonoscopy ( if tissues were not taken for microscopic analysis).

On the eve of the procedure, the patient is prohibited from eating ( 12 hours before the procedure). If the procedure is performed in the morning, then a perfusion enema is done in the evening to completely cleanse the intestines. This is necessary for better visualization of the intestinal walls on the screen during the procedure.

Ultrasonography

Ultrasound is a diagnostic method based on receiving and analyzing ultrasonic waves reflected from body tissues. Principle this study thing is different fabrics and environments in the human body have different acoustic resistance ( interfere with the passage of ultrasound). Tissues with greater resistance reflect ultrasound more strongly ( light and bright images) than those for which this figure is lower. The stronger the reflection, the more waves hit the recorder ( sensor) and the lighter and brighter the fabrics and structures look ( on the monitor screen), reflecting the irradiated area.

There are the following types of ultrasound examination:

• Extracorporeal scanning. Extracorporeal scanning is the most common type of ultrasound, which involves scanning internal organs and tissues from the surface of the human body. The advantages of the method are its high availability, low cost, absence of contraindications, ease of use and information content.
• Intracorporeal scanning. The essence of the intracorporeal ultrasound method is the introduction of special ultrasound sensors into the body cavities. They are introduced through natural openings ( through the urethra, vagina, anus or oral opening), and through artificial ( through traumatic and surgical openings). A significant advantage of this method is the possibility of bringing the sensor itself as close as possible to the organ ( which improves image clarity), which needs to be investigated. The downside is that it is invasive ( traumatic) And special indications, according to which it can be carried out.
• Dopplerography. One of the types of extracorporeal ultrasound is Dopplerography. It is based on the Doppler effect. The principle of this effect is based on a change in the reflection of ultrasonic waves depending on the speed of movement of objects in the medium under study. In medicine, Doppler sonography has found its application in the diagnosis of lesions of the cardiovascular system.
• Echo contrast. This method is based on the introduction of gas microbubbles into the vascular bed ( contrast agent) and assessment of vascular patency and tissue perfusion.

The ultrasound examination method makes it possible to assess the size, shape, position of internal organs, their contours, as well as the structure of parenchymal and hollow organs ( characteristics of walls and shells). In addition to determining physiological characteristics, this study can determine the presence and location of various diseases, which cause abdominal pain on the right.

Ultrasound can detect the following types of pathological changes:

• Increase in organ size. Enlargement of the organ can be observed with cholecystitis, pancreatitis, hepatitis, appendicitis, chronic prostatitis, intestinal obstruction, hydronephrosis, etc.
• Decrease in organ size. Organ reduction is noted in diseases such as liver cirrhosis, renal amyloidosis, chronic poisoning various heavy metals, etc.
• Volumetric formations. The main space-occupying formations include cysts filled with serous fluid and tumors. On ultrasound, cysts look like a circle or oval. Their edges are smooth, with clear contours. Inside the edges there is a black ( anechoic) zone, which is a mapping serous fluid located inside the cyst. The ultrasound structure of neoplasms is varied. There are anechoic ( bleeding) black, low echogenic ( necrosis) dark gray, echo-positive ( tumor tissue) light gray and hyperechoic ( calcification) light zones.
• Cavity formations. Cavity formations, such as abscesses or tuberculous cavities, unlike cysts, have uneven edges and heterogeneous ( heterogeneous) internal structure.
• Inflammatory formations. Inflammatory formations are characterized by irregular edges, varied shapes and moderate hypoechogenicity of the affected area. This, for example, can be observed in various inflammatory and infectious diseases of the abdominal cavity.
• Obstruction blood vessels . Doppler ultrasonography or echo contrast is often used to diagnose blocked blood vessels. These methods allow you to quickly determine the presence and location of blood flow disturbances.
• Stones. Ultrasound can easily diagnose diseases such as cholelithiasis and nephrolithiasis. On photographs, stones appear as round, hyperechoic formations with clear edges.
• Pathological accumulation of fluid. Ultrasound can detect pathological fluid accumulation ( exudate) in the abdominal cavity. Exudate ( anechoic zone) is one of the signs of inflammation and is observed in peritonitis, trauma, infectious lesions intestines, etc.

Diagnostic laparoscopy and laparotomy

Laparoscopy and laparotomy are very rarely used as diagnostic methods. They are used only in cases where other methods are not informative enough, and the doctor wants to obtain more reliable information about the disease.

Laparotomy is the surgical cutting of tissue in the abdominal wall to gain access to various abdominal organs. During laparoscopy, an endoscopic device called a laparoscope is inserted into the abdominal cavity through a small hole. It allows visual ( via monitor screen) examine the external structure of the abdominal organs.

The advantages of laparoscopy, in contrast to laparotomy, are speed, low tissue trauma, and the absence of postoperative rough and painful scars. After laparoscopy, patients generally recover very quickly, resulting in a shorter hospital stay. Significant disadvantages of both methods are their invasiveness ( traumatic) and the inability to assess the internal structure of organ tissues.

The main possible complications during laparoscopy and laparotomy may be internal bleeding or peritonitis ( when an infection occurs). The causes of complications are often accidental mechanical damage blood vessels and intestines that arose during diagnostic procedures.

General blood analysis

A general blood test is the most common laboratory method research. He gives important information about the state, first of all, of the cellular composition of the blood, as well as the level of other specific indicators. The appearance of changes in the blood is often associated with pain in the right region, so the appointment of this study is an important diagnostic step.

Blood for this analysis can be taken either from a finger or from a vein ( often taken from the finger). It is not necessary to take blood on an empty stomach, but fatty foods or a generally heavy lunch may skew the results somewhat.

Blood chemistry

A biochemical blood test is a type of laboratory test that helps analyze the concentration of certain metabolic products and enzymes found in the blood serum. Based on the results of this study, the doctor can make a conclusion about the condition and functioning of many organs. A biochemical blood test is a very fast, economical and informative method for studying the function of internal organs, which is widely used in the diagnosis of various diseases.

When studying the results biochemical analysis blood, various changes in biochemical parameters can be detected. These changes are mainly associated with their increase.

Changes in basic biochemical parameters and possible causes

Analysis of urine

Urinalysis is a standard diagnostic element in the complex diagnosis of diseases of the genitourinary, cardiovascular, digestive and other systems. For diseases that cause pain in the abdomen on the right, changes in urine can often be detected in a urine test. normal indicators, some of which are presented in the table below.

Typical changes in urine analysis and examples of pathologies

Usually, the first portion of morning urine is needed for analysis, since the person does not drink water during the night. During this time, a significant volume of blood is filtered in the kidneys, and the concentration of various substances will most objectively reflect the processes in the body.

Stool analysis

The color of stool also plays a significant role. Lighter colors ( and sometimes even almost a chair white ) talk about problems with the release of bile into the intestinal lumen. If there is pain in the right hypochondrium, this speaks in favor of cholecystitis, cholelithiasis, cholangitis or other problems with the gallbladder. Almost black loose stool (melena) is a consequence of bleeding in the upper sections gastrointestinal tract (stomach, duodenum). As the blood passes through the intestines, it is partially digested and becomes almost black.

Serological tests

Serological tests are special reactions that detect various antigens or antibodies in a patient's blood. This research method is widely used in suspected cases of various intestinal infections or autoimmune diseases. In the first case, they look for antigens ( foreign fragments) bacteria or antibodies produced by the immune system. At autoimmune pathologies You can detect specific autoantibodies to the body's own cells.

This test is only used if appropriate symptoms are present. It requires a routine blood donation and results can be ready in a few hours or days ( depending on the method used). Serological tests can confirm the presence of an infectious disease and make a definitive diagnosis.

This method can detect the following causes of abdominal pain:

• dysentery ( shigellosis);
• Escherichiosis;
• other infections.

Microbiological research methods

Microbiological methods are used to detect pathogens of infectious diseases that could cause pain in the right side of the abdomen. Any biological material in which, in the opinion of the attending physician, contains microbes that cause the disease, can be examined. In the case of abdominal pain, these are most often stool samples, but in some diseases samples of urine, blood, vomit, etc. are also taken.

One of possible reasons pain in the right side of the abdomen may also be a myocardial infarction. Electrocardiography allows you to evaluate the bioelectrical activity of the heart muscle. This is the simplest, fastest and safe way to exclude a heart attack as a possible cause of pain. As a rule, this study is recommended for most patients whose abdominal pain is not combined with other symptoms ( no bloating, palpation of the abdomen does not increase pain, no digestive problems).

Taking an ECG takes no more than 15 - 20 minutes. At the same time, an experienced doctor can use its results to make a conclusion about the functioning of the heart with high accuracy. Thus, this method allows us to exclude cardiology as the cause of abdominal pain and gives Additional information, which may be needed for future treatment.

Fibroesophagogastroduodenoscopy

This diagnostic method is instrumental. The essence of the method is the introduction of a special device - an endoscope - through the mouth. At the end of the flexible wire there is a small camera that transmits the image to the monitor. The patient should not eat before the procedure ( at least 12 hours in advance). To weaken the gag reflex, antiemetics and sedatives are also prescribed.

FEGDS allows the doctor to examine the upper gastrointestinal tract ( gastrointestinal tract). It can be used to confirm the presence of stomach ulcers, gastritis, and cancerous tumors. If necessary, a biopsy of suspicious formations is performed directly during the procedure ( a piece of tissue is taken for analysis). It is also possible to stop minor bleeding. Using this procedure, you can exclude or confirm a number of pathologies of the stomach and duodenum, which can cause pain in the right upper abdomen.

Diagnostic probing

The purpose of diagnostic intubation is to obtain bile directly from the gallbladder. To do this, a special probe on a flexible tube is inserted through the esophagus and stomach into the duodenum. When it reaches the exit of the common bile duct, the probe is fixed. After this, the patient lies on his right side and places a warm heating pad under the ribs. Under the influence of heat, the muscles of the gallbladder relax, and bile begins to flow through the probe. Sometimes, to speed up the flow of bile, you have to resort to a stimulating massage.

Before the procedure ( in 10 - 12 hours) the patient should not eat anything, as this may increase the gag reflex when swallowing the tube. They also drink a certain amount of sorbitol solution or special mineral waters in advance, which stimulate relaxation of the gallbladder. To obtain a good bile sample, the patient lies on a heating pad for 1 - 2 hours, after which the probe is removed.

Using this method, you can collect information about pathological processes in the liver and gall bladder. If an infection is suspected, the obtained bile can also be examined using microbiological methods.

What to do if you have pain in the right side of your abdomen?

One of the most serious conditions in medicine is considered acute stomach. It is characterized by severe pain in any part of the abdominal cavity and is most often caused by an active inflammatory process. Diseases with symptoms of an acute abdomen are an urgent indication for hospitalization in a specialized hospital ( most often surgical) department of the nearest hospital. The prognosis is most favorable when surgery is performed within the first few hours from the onset of symptoms. When visiting a doctor later, they develop serious complications, which worsen the evolution of the pathological process and prolong recovery period after provision of qualified medical care.

If you have severe abdominal pain, it is unacceptable to engage in self-medication and self-diagnosis, refuse hospitalization, or use various manipulations at home to reduce symptoms. It is also inappropriate to waste time at the prehospital stage trying to determine the exact cause of the symptoms. There are too many of these reasons, and some of them require immediate treatment. The final diagnosis will be made in the hospital. Sometimes it is revealed only during surgery, which is performed if the pain does not go away and the cause is not clear.

For severe abdominal pain, there are the following recommendations:

• call an ambulance;
• take the most comfortable position in bed, which reduces pain;
• apply cold to the stomach - this slows down blood circulation and inhibits inflammatory processes in the abdominal cavity;
• regular blood pressure monitoring;
• upon arrival of doctors, it is advisable to transport the patient to supine position on a stretcher;
• special measures for transportation are usually not required, but with the development of acute arterial hypotension (a sharp decrease in blood pressure) may require transfusion of colloidal solutions ( rheopolyglucin, plasma).
• Before hospitalization, it is advisable to limit drinking and not consume any food until examined by a doctor and an accurate diagnosis made.

There are also several important prohibitions that must be remembered when providing first aid. In case of acute abdomen, drugs from the NSAID group should not be used to reduce pain ( non-steroidal anti-inflammatory drugs) and painkillers ( Nimesulide, Ibuprofen, Ketoprofen, Tramadol, etc.) before examination by a specialist. Data medicines reduce pain, but do not eliminate the cause of the disease. The symptoms of the disease become erased, and in such conditions it is more difficult for the doctor to diagnose in a timely manner. correct diagnosis. This, in turn, can worsen the prognosis during the pathology due to delays in providing qualified medical care. It is also undesirable to use various warming procedures, take hot baths, or apply a heating pad to the sore area of ​​the abdomen. This can lead to a faster deterioration of the general condition and accelerate the progression of inflammatory processes ( the vessels dilate, swelling increases, and the infection becomes more active).

You should also not drink alcohol. Alcoholic drinks inhibit the effect nervous system, have an analgesic effect, which, as with the use of analgesics ( painkillers), reduces symptoms and makes it difficult for the surgeon to quickly make a diagnosis. For the same reasons, it is necessary to refrain from using sleeping pills, antipsychotics and other medications that depress the nervous system.

It is extremely dangerous to stimulate intestinal motility with various laxatives medicines, and also apply cleansing enemas. Stretching the intestine and straining its walls often causes increased pain. For example, if the intestine is perforated, its contents will begin to enter the abdominal cavity in large quantities and generalized peritonitis will develop. The patient's condition will seriously deteriorate in a matter of minutes. For the same reason, you should not force vomiting or lavage your stomach.

If abdominal pain is moderate or appears periodically, then this condition is not regarded as an acute abdomen. However, it is still advisable to consult a doctor and try to follow the rules prescribed above. After diagnosis or if the patient already knows the diagnosis ( there is an exacerbation of a known pathology) take special measures to combat pain. In the case of each pathology, they are different, and therefore there are no uniform standards of treatment for all abdominal pain.

For each separate disease Specific measures are needed to eliminate abdominal pain and complete treatment:

• acute cholecystitis;
• acute appendicitis;
• pyloric stenosis;
• intestinal infections;
• irritable bowel syndrome.

Acute cholecystitis

For acute cholecystitis, treatment is strictly surgical. Once diagnosed, pain is usually relieved by antispasmodics, which relax the smooth muscle of the gallbladder. The patient is then operated on, most often removing the gallbladder. This operation is called cholecystectomy.

Cholecystectomy can be performed in two ways:

• Laparotomy. This method considered traditional but outdated. The abdominal wall is dissected, followed by removal of the gallbladder. In this case, the patient is left with long-healing sutures, and there is a risk of postoperative complications.
• Laparoscopy. During laparoscopy, only a few small holes are made in the anterior abdominal wall. Through them, the gallbladder is removed using special equipment. Bleeding is avoided by cauterizing the tissue. Rehabilitation after such an operation is much faster, and the risk of complications is lower.

Acute appendicitis

In acute appendicitis, urgent removal of the inflamed appendix is ​​also recommended - appendectomy. It is almost always done with a dissection of the anterior abdominal wall. This is necessary, since during the operation it may become clear that the appendix occupies an atypical position. Then the incision will have to be enlarged. Appendectomy is considered a routine procedure and has a very low mortality rate. The pain goes away within 1 - 2 weeks after surgery.

If you refuse surgery, there is a risk of developing peritonitis. Then the prognosis gets much worse. The formation of an appendicular plastron is also possible, in which the appendix “sticks together” with neighboring organs, forming a large inflammatory focus. Then the risk of complications during surgery increases.

Pyloric stenosis

The definitive treatment for gastric pyloric stenosis is surgery. It consists of widening this opening so that food can freely pass into the duodenum. Sometimes this can be achieved with the help of a special probe, which is passed into the stomach through the mouth. Air is pumped into the bulb at the end of the probe, it increases in diameter and expands the narrowed area.

However, surgical treatment in this case is not the only option. This is not the case with stenosis. high risk complications, as with inflammatory diseases of the abdominal cavity. Patients may be prescribed antispasmodic drugs and a special diet. The principle of the diet is liquid and semi-liquid food (soups, cereals, etc.). It passes through the stomach more easily and quickly, without lingering in the area of ​​the narrowed pylorus. In this case, you should regularly see a doctor in order to detect possible changes in the patient’s condition if anything happens. If the patient loses weight, this indicates that conservative treatment is insufficiently effective and surgery is recommended.

Intestinal infections

For intestinal infections, it is recommended to follow a diet. Do not consume meat, fatty or salty foods, alcohol, raw vegetables and fruits. All this will increase intestinal contractions, while its walls are already weakened due to infection. Nutrients will not be absorbed, and the pain will intensify.

Most intestinal infections go away on their own after 2-3 weeks, when the body produces antibodies to the pathogens. To speed up treatment and prevent severe forms For diseases, antibiotic therapy is most often prescribed. The choice of antibiotic depends entirely on the type of infection. A properly selected drug will reduce pain and other symptoms within 5 to 7 days.

Products that can trigger these diseases are:

• alcohol;
• smoked meats;
• pickles;
• excessively fatty or spicy foods;
• mushrooms;
• pickled products.

Allergic reactions are also a possible cause of abdominal pain in children. They, contrary to popular belief, are not limited to skin manifestations. For example, in response to feeding honey, nuts, or citrus fruits, a child may develop diarrhea and abdominal pain.

At the same time, inflammatory diseases of the abdominal cavity such as gastritis, appendicitis, and cholecystitis are less common in children. These pathologies develop as a consequence of poor lifestyle and nutrition, and therefore require longer exposure to provoking factors. Also rare in children is, for example, thrombosis of the mesenteric arteries. At the same time, an abdominal aortic aneurysm ( if it is congenital) may well give periodic pain.

Thus, the range of possible causes of pain in the right side of the abdomen in children is quite wide. Examination of such patients also presents certain difficulties. Young children cannot indicate the nature of the pain, and sometimes they simply cannot say what hurts them. Then you have to navigate by the baby’s behavior and accompanying symptoms. If unusual behavior, constant crying combined with diarrhea, vomiting or flatulence, abdominal pain should be suspected. Only timely contact with a specialist will help establish the real reason diseases.

Why does the right lower abdomen hurt during pregnancy?

Abdominal pain during pregnancy is a fairly common phenomenon experienced by the vast majority of women. Most often they are caused by physiological reasons and do not indicate the development of any serious disease. Moderate periodic pain and discomfort can be caused by overeating, fetal growth, and child movements ( in later stages), compression of some organs or their displacement. However, any regular pain, and especially acute pain, should be taken seriously. Many dangerous diseases debut or worsen during pregnancy. In this case, they can jeopardize the health of both mother and fetus.


Frequent exacerbation of certain pathologies in pregnant women is explained by the following changes in the body:

• Hormonal changes. From the moment a child is conceived, the endocrine glands of the expectant mother begin to work differently. The process of attachment of the fetus in the uterus is accompanied by increased production of a number of hormones that prepare the body for the period of pregnancy. This may trigger some autoimmune and genetic diseases, which had not appeared before.
• Displacement of abdominal organs. The growing fetus displaces some movable organs. For example, the cecum, together with the appendix, in late pregnancy rises from the right iliac fossa to the level of the navel, and sometimes higher. Compression of intestinal loops, blood vessels or nerves can trigger an inflammatory process.
• Presence of a growing fetus. Often pain is associated directly with the growing fetus and is a consequence of pregnancy complications.
• Changing food preferences. Pregnant women often change their diet. Some are trying to move to more healthy food, while others simply begin to like new, sometimes exotic dishes. However, the organs of the digestive system, accustomed to a certain diet, do not always accept such changes. Intestinal dysbiosis and exacerbation of some of its diseases may develop.
• Weakening of the immune system. During pregnancy the immune system Normally it works worse than usual. This increases the risk of infectious diseases. Intestinal infections caused by opportunistic microbes that are normally present in the intestines but do not cause disease are often observed.

Taken together, all these changes create favorable conditions for the development of various diseases. In principle, all the reasons that cause abdominal pain in ordinary people, can also occur in pregnant women. However, some of them, due to the development mechanism, occur more often during pregnancy.

The most common causes of pain in the right side of the abdomen during pregnancy are the following pathologies:

• Inflammatory diseases of the abdominal cavity. Diseases such as appendicitis, cholecystitis, and colitis occur more often during pregnancy due to mechanical compression of organs by the enlarging uterus. In the appendix, for example, its lumen may be compressed, and in the intestine, the permeability of its contents may deteriorate. However, without chronic problems with these organs or infection, inflammation will not develop.
• Circulatory disorders. There are known cases when the growing fetus displaced the abdominal organs in such a way that some vessels were pinched. In these cases, acute oxygen starvation of certain tissues occurs. For example, torsion of intestinal loops leads to compression of the mesenteric arteries. It is also possible to twist the ovary or other organs that have relatively high mobility.
• Autoimmune processes. Some diseases associated with increased activity immunity, can also worsen during pregnancy. Abdominal pain can cause Crohn's disease and ulcerative colitis.
• Complications of pregnancy. Such dangerous complications how fetal hypoxia, placental abruption or intrauterine death can cause acute pain. Also, acute pain in the right lower abdomen may be associated with ectopic pregnancy, when the fertilized egg attaches not in the body of the uterus, but in the > fallopian tube. Then, as the fetus grows, the tube stretches and may rupture.
• Endocrine diseases. Hormonal changes can have a cascade nature, since many glands internal secretion influence each other's work. Therefore, increased secretion of hormones necessary for normal course pregnancy, sometimes cause thyrotoxicosis ( high concentration hormones thyroid gland in blood), exacerbation of diabetes mellitus ( up to diabetic coma). In these cases, periodic abdominal pain may appear various localizations.
• Genetic diseases. Some genetic diseases may not appear for a long time. Their development is often triggered by various types of stress ( one of which can be considered pregnancy). A typical example Such a disease is porphyria, in which increased secretion of the protein porphyrin causes periodic severe abdominal pain. It has been proven that this pathology is largely predetermined by congenital factors, but often manifests itself during pregnancy.

In general, there can be many reasons for abdominal pain during pregnancy. You should definitely notify the doctor managing your pregnancy about the appearance of this symptom.

If your stomach hurts when pressed, you can understand what exactly triggered the appearance of this symptom by undergoing an examination by a specialist and diagnostic measures, or you can try to independently understand the cause of the pain, knowing the nature of the pain in specific diseases.

The anatomical location of the stomach suggests its projection onto the epigastric region (the upper abdomen between the costal arches, under the xiphoid process and above the navel), but there are exceptions: prolapse of the stomach in athletes, adolescents, people of asthenic physique or prolapse caused by pathological changes, then pain can be observed and below the navel or with a shift to the right. In addition, pain in pathologically altered abdominal organs, including the pancreas, liver, gallbladder, small and large intestine, may be observed in the epigastric region. Therefore, we will try to figure out what and how can cause pain when pressing on the abdomen at the presumed location of the stomach. First of all, it is necessary to establish exactly when pressure on the stomach causes pain: before eating or during meals, when bending over, walking, or at rest. What is the nature of the pain: aching, dull, cramping or stabbing? Many people periodically experience discomfort in the epigastric region. It can be caused by both functional (functional dyspepsia, pylorospasm, gastrostasis, biliary dyskinesia, irritable bowel syndrome) and organic changes in the gastrointestinal tract and abdominal organs (gastritis, gastroduodenitis, gastric ulcers, duodenal ulcers, pancreatitis, cholecystitis).

Pain that occurs in the stomach area is called “gastralgia” in medical terminology. This symptom is characterized by a variety of pain sensations: cramping, burning, pulling or pressing in the epigastric region. Mainly observed when various pathologies stomach, duodenum, gallbladder, pancreas, small and large intestine.

Classification of pain according to diseases that cause pathological changes in the abdominal organs with a projection on the anterior wall of the abdomen.

1. Cramps or colic. They are provoked by a spasm of the smooth muscles of the organ during its inflammation. They are acute, paroxysmal in nature and require emergency care. Types of colic: hepatic, renal, gastric, pancreatic, intestinal.

At functional disease colic manifests itself in the form of “irritable bowel syndrome”, and in case of intoxication – in the form of “lead colic”.

1. Pain when stretching hollow organs (stomach, gall bladder) is dull and aching.
2. In case of circulatory disorders in the peritoneum (the nature varies depending on the degree of ischemia: from moderate to critical): angiospastic and stenotic in nature.
3. Pain due to inflammation of the abdominal membrane (peritonitis phenomena, usually complicated by bleeding, perforation, penetration of peptic ulcer).
4. “Mirror pain” – the pain radiates to another area, distant from the location of the pathologically altered organ.

Read also Prolapse of the stomach: symptoms, treatment and possible complications

Click on various areas abdomen and the occurrence of pain indicate possible pathological changes in the organs located there:

• Epigastric: disease of the stomach, duodenum, liver, gall, pancreas.
• Periumbilical (periumbilical): inflammation of the blind section of the large and small intestine.
• Hypogastric (lower abdomen): disease of the colon and organs located in the pelvis.

According to the mechanism of occurrence, pain is classified into:

• Visceral.
• Parietal.
• Irradiating.
• Psychogenic.

Visceral pain occurs due to the presence of an inflammatory focus in the stomach or intestines. Feels like Blunt pain When you press on the stomach, the force of its action changes and weakens after a while. It is concentrated inside the abdominal cavity and often radiates to other places. With it, autonomic reactions can be observed: sweating, pale skin, increased heart rate.

Somatic pain occurs when there is damage to the abdominal wall or appendicitis, and is more intense than visceral pain. It intensifies with movement of the diaphragm and coughing, and it can hurt in:

• epigastrium: for pancreatitis, cholecystitis, gastric ulcer;
• right upper part: cholestasis, hepatitis, biliary dyskinesia, hepatitis;
• left upper section: pancreatitis;
• lower right: appendicitis, lymphadenitis, diverticulitis;
• left lower part: disease of the sigmoid colon.

Irradiating (mirror or radiating). This is visceral pain, which is reflexively transmitted to nearby tissues or bone from the pathological focus.

Psychogenic is diagnosed when other types of pain are not objectively confirmed and there is a visible psychological basis for their occurrence. The main cause is depression. This is explained by a violation of general biochemical processes in the regulation of the nervous and digestive systems. The pain in such cases is felt as monotonous and prolonged. At the same time, according to patients, everything can hurt: the head, the back, there is aches throughout the whole body, that is, other symptoms appear without the presence of pathological changes in them.

Stages of pain:

• Acute – a sign of acute surgical pathology, injury or infection.
• Chronic – recurring pain of different nature during inflammatory processes.
• Recurrent. It subsides during the treatment of the inflammatory focus and occurs again when the disease recurs.

The forms of pain can be varied:

• Acute, cramping.
• Stitching pain.
• Cutting.
• Dumb.
• Sucking.
• Aching.
• Pulling.
• Pressing
• Bursting.

According to the teachings about the physiological components of pain, it is considered as irritation of receptors in serosa, skin, muscles. It is provoked by an inflammatory process or lack of blood supply, obstruction of patency in the cavities, sudden stretching or, conversely, narrowing of the organ.

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The reasons why the stomach may hurt when pressed may be the following:

• Inflammatory process in the organs of the digestive system: gastritis, pancreatitis, cholecystitis, hepatitis, colitis.
• Appendicitis, urinary tract infections, ulcers complicated by perforation, bleeding, acute intoxication due to pancreatitis.
• Mechanical narrowing of the bile-urinary ducts.
• Thrombosis of organs and blood vessels.
• Mechanical trauma to the peritoneum.
• Violation of intestinal digestion and absorption of food.
• Gynecological inflammatory diseases.
• Intestinal adhesions after surgery.

Clinical manifestations of pain

If it is painful to press on the stomach, you should pay attention to a number of other clinical manifestations of pain in order to timely prevent a threatening condition.

• Increased sweating.
• Tachycardia.
• Nausea and vomiting.
• Significant increase in body temperature.
• Loss of appetite.

Important! Below is a list of clinical manifestations that can threaten human life. If they are present, you must immediately call an ambulance.

• The stomach hurts for more than two hours, and the pain only intensifies or becomes cramping.
• Body temperature reaches 39 degrees or more.
• Vomiting is episodic or repeated.
• Presence of blood in vomit.
• Weakening of the pulse.
• Decreased or increased heart rate.
• An unusual increase in abdominal size or abdominal muscle tension.

Certain symptoms (signs) make it possible to determine the part of the gastrointestinal tract or organ in which the inflammatory, mechanical or intoxication process occurs, and indicate a violation specific function organ. So, if a person, in addition to abdominal pain, also experiences rumbling when pressed, increased stool frequency, increased body temperature, and vomiting, this may indicate an intestinal infection. Dark color urine, yellowing of the whites of the eyes or facial skin - for blockage bile ducts stones. Dark urine and light stool in combination with pain in the right hypochondrium indicate hepatitis. Black stool indicates bleeding from the upper gastrointestinal tract, scarlet stool - from lower sections. Sharp pain, perceived as “a blow from a knife or blade,” signals a perforation of a stomach or duodenal ulcer and requires immediate hospitalization!

Possible complications

If the main symptom (pain) is accompanied by additional ones from the list of life-threatening ones, this is fraught with a number of complications: internal bleeding in case of rupture of an ulcer or large vessel, perforation (rupture) of an organ, blockage of the ducts with a stone, rupture acute appendicitis with the formation of peritonitis, abundant uterine or intestinal bleeding lead to large blood loss and possible death.

An examination is necessary to determine the cause of the pain that may be felt when pressing on the abdomen. Initially, the patient is examined by a gastroenterologist or surgeon. He must gently press on the patient’s stomach and, based on subjective sensations, as well as the degree of muscle tension, determine exactly where it hurts, in the area of ​​which organ, in order to then prescribe, if necessary, a series of diagnostic procedures to establish a diagnosis and the causes of this disease:

• Ultrasound of the abdominal organs.
• Fibrogastroscopy (FGDS).
• Colonoscopy.
• Irrigoscopy.
• X-ray of the stomach if it is impossible to perform FGDS.
• General blood test, general urine test, blood biochemistry.
• Stool analysis for intestinal infections, helminths, occult blood.