House Calls: What's causing that belly pain?

By Doris Fitch April 16, 2013 08:49 am

Fitch
Fitch
House Calls runs every other Saturday. Today’s column is written by Doris Fitch, a registered nurse at Sutter Coast Hospital and trainer at College of the Redwoods.

Have you ever had belly pain? Did you wonder why?

There are multiple conditions that can cause belly pain. It occurs between the chest and lower belly or abdomen. It can be cramp-like, achy or sharp. It can be constant or intermittent.

The organs in the abdomen are intestines, kidneys, appendix, spleen, stomach, gallbladder, liver and pancreas. Inflammation or diseases can cause pain in the abdomen.  Viral or bacterial infections that affect the stomach and intestines can cause significant pain in the belly. This abdominal pain is sometimes referred to as a stomachache. 

The intestines have multiple bulges that balloon out of their walls. These bulges, called diverticula, absorb water and nutrients for our body to use as energy.

Diverticulosis is a condition where the diverticula become swollen and tender, making them easily inflamed by seeds. The complications of diverticulosis include infection (diverticulitis) and bleeding.

When the diverticula are infected they become sore and thin and can slit open and bleed into the bowel. The inflammation is what causes the pain and loose, foul stools.

In the past it was recommended to stay away from all seeds in food because even the small seeds can get lodged in the diverticula and cause a flare. New studies now show that the small seeds that are in tomato, strawberries and cucumbers are not as aggravating to the diverticula. But, if you find any seeds to cause a problem, then continue with what works for you.

Most definitely, you should stay away from popcorn, nuts, caraway, sesame, sunflower and pumpkin seeds.  In addition a high-fiber diet, stool softeners and six to eight cups of water daily will help prevent most flare-ups. Fiber is found in fruit, vegetables whole grain breads, brown rice beans, whole wheat crackers, oatmeal and other grains.

Gradually increase the amount of fiber so you don’t experience gas or bloating. If you are having problems consuming enough fiber, a doctor may recommend fiber supplements such as Citrucel and Metamucil. Staying away from refined foods like pasta, white rice, and flour will help too.

Diverticulosis is more common with advanced age. Over 50 percent of people older than 60 have this condition, although most do not have any discomfort or symptoms. 

Symptoms may include abdominal pain — usually in the lower left abdomen, bloating and constipation.

If you have a leak from the intestine into the perineum or gut, this is called a perforation. This pain is usually more intense and constant. There might be fever, nausea and vomiting.

In addition, you might experience an intestinal blockage from the infection. This can be a medical emergency and you may need to be seen by your doctor or emergency room physician, depending on the severity. 

The physician will ask you a lot of questions about your history and will perform a physical. Keeping a record of your signs and symptoms will help the physician. A current medication list including any over-the-counter medications and list of allergies to medications,  will help the physician diagnose your condition.

Bringing in a stool specimen would be helpful. Your physician might order a complete blood count. If there is an infection, the white count will be elevated. If you have any bleeding from the intestines, the hemoglobin and hematocrit will be lower. Other tests might be a chemistry panel, urine analysis, stool specimen, a cat scan, abdominal MRI, barium enema, and a colonoscopy.

In extreme cases, surgery may be required.

Dehydration and infection can be very serious and can cause you great harm if you do not recognize the signs. As we get older our immune system does not work as well.

If you’re not experience belly pain, lack of appetite, fatigue and confusion might be your only warning signs.