Frequent Stomach Cramps: Causes and Solutions - Gastroenterology and Hepatology

High frequency of stomach cramps occurred on 5/15, 5/17, and 5/21?

Hello, Doctor.
I have experienced stomach cramps on May 15, May 17, and May 21.
I went to the emergency room at Far Eastern Memorial Hospital for the first two incidents.
The third time occurred in the morning, so I waited for the clinic to open.
The doctor immediately administered an injection to relieve the cramps.
I had eaten cookies, so I was unable to undergo an ultrasound.
All my health check-up results were normal.
The emergency room performed X-rays, and tests on my pancreas, gallbladder, and an electrocardiogram, all of which were normal.
I also had an endoscopy on May 9, which showed mild inflammation in the stomach, but no abnormalities in the duodenum or the head of the small intestine.
I have been eating very light meals, but I still experience severe stomach cramps at night (very painful) without any fever.
What should I do? What could be causing these frequent episodes? Since the endoscopy, I have been taking Pantoprazole for 14 days and also have medication for anxiety and panic disorder.
Could this be related to mental stress? Thank you, Doctor.

Mr. Lin, 40~49 year old female. Ask Date: 2020/05/21

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello! A 48-year-old male has been experiencing stomach cramps.
A gastroscopy performed on May 9 revealed gastritis.
In addition to taking medication as prescribed, it is important to pay attention to diet by reducing the intake of sweets and coffee.
Furthermore, it is advisable to avoid excessive stress and anxiety, as these can negatively impact gastrointestinal health.
If pain persists, it is recommended to investigate other causes, such as an abdominal ultrasound to check for gallstones and biliary issues.
Wishing you good health and safety! Sincerely, Dr.
Ming-Hui Lin, Attending Physician, Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2020/05/21

More Info

Frequent stomach cramps can be a distressing experience, and understanding their causes and potential solutions is crucial for managing your symptoms effectively. Based on your description, it seems that you have undergone various tests, including X-rays, an electrocardiogram (ECG), and an endoscopy, which have ruled out serious underlying conditions such as pancreatitis, gallbladder issues, and heart problems. The findings of mild gastric inflammation suggest that your stomach lining may be irritated, which could be contributing to your symptoms.

Possible Causes of Stomach Cramps
1. Gastritis: As noted in your endoscopy report, you have mild gastric inflammation. Gastritis can lead to abdominal pain, cramps, and discomfort, especially after eating. It can be caused by factors such as excessive alcohol consumption, certain medications (like NSAIDs), or infections.

2. Functional Gastrointestinal Disorders: Conditions such as functional dyspepsia or irritable bowel syndrome (IBS) can cause recurrent abdominal pain and cramps without any identifiable structural abnormalities. Stress and anxiety can exacerbate these conditions.

3. Dietary Factors: Certain foods can trigger stomach cramps, especially if you have food intolerances or sensitivities. Common culprits include dairy, gluten, spicy foods, and high-fat meals. Keeping a food diary may help identify any patterns related to your symptoms.

4. Stress and Anxiety: Given that you are taking medication for anxiety and panic disorders, it is essential to consider the role of stress in your gastrointestinal symptoms. The gut-brain connection is well-documented, and psychological stress can lead to physical symptoms, including stomach cramps.

5. Medication Side Effects: Some medications, including those used for anxiety, can have gastrointestinal side effects. If you suspect that your medications might be contributing to your symptoms, it’s worth discussing this with your healthcare provider.

Recommendations for Management
1. Dietary Modifications: Since you mentioned that you eat light meals, continue to focus on a balanced diet rich in fiber, fruits, and vegetables. Avoid known irritants such as caffeine, alcohol, and spicy foods. Eating smaller, more frequent meals may also help reduce the burden on your stomach.

2. Stress Management: Incorporating stress-reduction techniques such as mindfulness, meditation, or yoga can be beneficial. Cognitive-behavioral therapy (CBT) is also effective for managing anxiety and can help alleviate gastrointestinal symptoms.

3. Medication Review: Consult with your healthcare provider regarding your current medications. They can assess whether any of your medications might be contributing to your stomach cramps and discuss potential alternatives.

4. Follow-Up Care: Since you have already undergone several tests, it may be helpful to schedule a follow-up appointment with a gastroenterologist. They can provide further insights into your symptoms and may recommend additional testing or treatment options.

5. Hydration: Continue to drink plenty of water, as staying hydrated is essential for overall digestive health. However, if you notice that certain beverages (like carbonated drinks) exacerbate your symptoms, consider reducing their intake.

6. Monitor Symptoms: Keep a detailed diary of your symptoms, including the timing, severity, and any associated factors (like food intake or stress levels). This information can be invaluable for your healthcare provider in determining the best course of action.

Conclusion
Frequent stomach cramps can arise from various factors, including gastritis, dietary choices, functional gastrointestinal disorders, and stress. By addressing these potential causes through dietary modifications, stress management, and regular follow-up care, you can work towards alleviating your symptoms. It’s essential to maintain open communication with your healthcare provider to ensure that your treatment plan is tailored to your specific needs and circumstances.

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