Chronic Abdominal Pain: Symptoms and Seeking Relief

Q: Chronic Abdominal Pain: Symptoms and Seeking Relief

Hello： Borborygmi may be caused by rapid intestinal motility combined with the accumulation of gas in the intestines. <br>If there is a history of abdominal surgery, there may be mild intestinal adhesions. <br>If there is no surgical history, it is important to first check if the

Chronic abdominal pain with bowel sounds?

I have been experiencing sudden and persistent abdominal pain for about three months, with pain occurring nearly every day.
The intensity varies between severe pain and a more tolerable discomfort.
Sometimes, the pain feels like sharp, stabbing sensations, while at other times, it feels like tightness.
Initially, the pain was localized to the left side of my abdomen (left of the navel), but recently, I have also started to feel pain above the navel and on the right side.
Additionally, I have been experiencing a lot of bowel sounds and gas.
My bowel habits have not changed significantly, but the stool shape varies; sometimes it is cylindrical, sometimes it is granular, and at other times, it feels like it is breaking apart.
I have undergone a fecal occult blood test and an abdominal ultrasound, both of which showed no issues, yet the abdominal pain persists and significantly affects my daily life.

Shòu kùn, 30~39 year old female. Ask Date: 2021/02/28

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: Borborygmi may be caused by rapid intestinal motility combined with the accumulation of gas in the intestines.
If there is a history of abdominal surgery, there may be mild intestinal adhesions.
If there is no surgical history, it is important to first check if the diet contains adequate fiber and hydration, if there is any fecal impaction or constipation, or if there has been excessive consumption of irritant foods (such as spicy foods) or caffeinated beverages (like tea or coffee).
A portion of this may be due to irritable bowel syndrome.
It is recommended to consult a gastroenterologist for appropriate treatment.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2021/02/28

More Info

Chronic abdominal pain can be a complex and frustrating issue, especially when it persists for an extended period, as you have described. Given that your symptoms have lasted for about three months and have evolved from localized pain on the left side of your abdomen to more generalized discomfort, it is essential to consider a variety of potential causes and seek appropriate medical evaluation.

Possible Causes of Chronic Abdominal Pain
1. Functional Gastrointestinal Disorders: One common cause of chronic abdominal pain is functional gastrointestinal disorders, such as Irritable Bowel Syndrome (IBS). IBS can manifest with symptoms like abdominal pain, bloating, and changes in bowel habits. The pain often fluctuates in intensity and can be associated with stress or dietary factors.

2. Gastrointestinal Conditions: Although your ultrasound and stool tests have returned normal, conditions like gastritis, peptic ulcers, or even gallbladder disease can cause chronic pain. These conditions may not always be evident on initial imaging or tests, especially if they are mild or in the early stages.

3. Musculoskeletal Issues: Sometimes, abdominal pain can be referred from musculoskeletal problems, such as muscle strain or issues with the spine. Given that you mentioned a sensation of tightness, this could be related to muscle tension or spasms in the abdominal wall.

4. Psychological Factors: Anxiety and stress can significantly impact gastrointestinal function and may exacerbate pain perception. Chronic stress can lead to muscle tension and changes in gut motility, contributing to abdominal discomfort.

5. Visceral Pain Syndromes: Conditions like pelvic inflammatory disease or endometriosis in women can cause chronic abdominal pain that may not always be detected through standard imaging.

Next Steps for Diagnosis and Treatment
1. Comprehensive Evaluation: Since you have already undergone several tests, it may be beneficial to consult a gastroenterologist who specializes in functional gastrointestinal disorders. They may recommend additional tests, such as a colonoscopy or specialized motility studies, to evaluate your gastrointestinal function more thoroughly.

2. Dietary Assessment: Keeping a food diary can help identify any dietary triggers that may be contributing to your symptoms. Certain foods can exacerbate IBS or other gastrointestinal conditions.

3. Psychological Support: If stress or anxiety is a contributing factor, consider seeking support from a mental health professional. Cognitive-behavioral therapy (CBT) has been shown to be effective for managing chronic pain and gastrointestinal disorders.

4. Pain Management Strategies: Discuss with your healthcare provider about pain management options that do not solely rely on medication. This could include physical therapy, relaxation techniques, or dietary modifications.

5. Follow-Up: Since your symptoms are significantly affecting your quality of life, ensure that you have regular follow-ups with your healthcare provider to monitor your condition and adjust your treatment plan as necessary.

Conclusion
Chronic abdominal pain is a multifaceted issue that often requires a comprehensive approach to diagnosis and management. By working closely with your healthcare team and exploring various potential causes, you can develop a tailored treatment plan that addresses both the physical and psychological aspects of your pain. Remember, it is essential to advocate for yourself and seek further evaluation if your symptoms persist or worsen.

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