What is Chronic Stomach Pain?

Common causes of stomach pain are: cold seasons, improper diet (such as cold food, hunger, overeating, overeating, etc.), excessive drinking, overwork, emotional excitement, irritating food or drugs, etc. The above reasons stimulate the stomach, leading to smooth muscle spasm of the stomach wall, increased intragastric pressure, increased muscle fiber tension, and stimulation of neuroreceptors to cause stomach pain.

Chronic stomach pain

Stomach pain is a common clinical symptom. Acute and chronic gastritis, gastric and duodenal ulcer disease, and gastro-neuropathy are common. Also seen in gastric mucosa prolapse, gastric prolapse, pancreatitis, cholecystitis and cholelithiasis. Acute stomach pain is rapid onset, rapid change, and severe illness. The patient felt severe pain in the stomach, accompanied by snoring, flatulence, nausea, vomiting, diarrhea, and chest tightness. Common causes of stomach pain are: cold seasons, improper diet (such as cold food, hunger, overeating, overeating, etc.), excessive drinking, overwork, emotional excitement, irritating food or drugs, etc. The above reasons stimulate the stomach, leading to smooth muscle spasm of the stomach wall, increased intragastric pressure, increased muscle fiber tension, and stimulation of neuroreceptors to cause stomach pain.

Affected area

abdomen

Related diseases

Bile reflux gastritis Acute corrosive gastritis Acute simple gastritis Acute gastritis Chronic gastritis Bile reflux gastritis Peptic ulcer anemia Atrophy gastritis Acute suppurative gastritis Huge hypertrophic gastritis Congestive heart failure Acute erosive gastritis Elderly Chronic gastritis Duodenogastric reflux gastroenteritis Bile reflux gastritis Postoperative gastritis Diabetes Mellitus Pediatric acute gastritis Pediatric chronic gastritis

Related symptoms

Hold gas, nausea, anemia, abdominal pain, diarrhea, bloating, black stools, intermittent stomach pain, anxiety, nodules, tension ulcers, chronic ulcers, chronic gastric pain, emotional stomach pain, upper abdominal pain, upper gastrointestinal bleeding, fever, heart glossitis, nervous stomach pain, loss of appetite, weight loss, dysmenorrhoea, gastrointestinal symptoms, stomach cramps Hyperacidity gastric acid deficiency indigestive peptic ulcer pain behind anorexia

Affiliated Department

Gastroenterology

Related inspections

Basal gastric juice secretion serum carcinoembryonic antigen gas-barium double contrast angiography

Common causes of stomach pain are: cold seasons, improper diet (such as cold food, hunger, overeating, overeating, etc.), excessive drinking, overwork, emotional excitement, irritating food or drugs, etc. The above reasons stimulate the stomach, leading to smooth muscle spasm of the stomach wall, increased intragastric pressure, increased muscle fiber tension, and stimulation of neuroreceptors to cause stomach pain.

Common causes of stomach pain include cold evil stomach, dietary injury, liver qi and stomach, and weak spleen and stomach. Stomach pain (12 photos) The stomach owner accepts rotten water, and if the cold evil guest stays in the stomach, the cold coagulation does not disperse, and the gas machine is blocked, which can cause stomach discomfort and pain or due to dietary insufficiency, hunger and fullness, or excessive Fattening, stagnant food, obstructed air-conditioning, stomach loss and lowering cause stomach pain; liver has spleen and stomach-relieving effects, such as anger and depression, qi stagnation, liver loss, liver failure, and transversal stomach violations, can also occur Stomach pain; if tired, internal injuries, chronic illness, weak spleen and stomach, or inadequate endowment, Zhongyang deficiency, stomach dehydration, internal cold breeding, middle coke deficiency and pain; also Qi stagnation, chronic stasis, internal stasis, Qi stagnation Blood stasis obstructs the mid-coke gas engine, and causes the onset of stomach pain. In short, the pathogenesis of stomach pain is divided into two ends, which are empirical. Nourishment.

One is caused by anxiety and anxiety, liver dysfunction, and inversion of the stomach, so the main treatment method is to relieve liver and regulate qi.

One is caused by spleen unhealthy movement, stomach loss and lowering. It is advisable to use Wentong and Buzhong methods to restore the function of the spleen and stomach.

There are many causes of stomach pain, including excessive work stress, eating irregularly, working or exercising immediately after eating, drinking too much alcohol, eating too much spicy food, and eating indigestible foods. There may be several factors for stomach pain, but most are caused by acid reflux. That is, the liquid originally in the stomach flows back into the esophagus. These digestive fluids contain hydrochloric acid (hydrochloric acid), which is a corrosive substance used industrially to clean metals. Although the stomach has a protective film against acid attack, the esophagus lacks this protective layer.

Therefore, when gastric acid is refluxed into the esophagus, it can cause burning, sometimes severe enough that you think it is a heart attack. The most common cause of stomach pain is eating and drinking, but this is not the only reason. Some people do not overeating but also suffer from stomach pain. In fact, stomach cramps have nothing to do with food. Most of them are caused by mental reasons, and anger, nervousness, and stress can cause stomach cramps.

The stomach is one of the most important digestive organs in our body. Under normal conditions, it should be constantly peristaltic and grind the food sent down the esophagus. If its peristalsis is abnormal, it will hinder digestion and absorption, causing excess gas to accumulate and form stomach gas. Traditional Chinese medicine calls this condition "stagnation."

When the stomach is stagnant, the food you eat cannot be ground in real time and sent to the intestine, so you are forced to stay in the stomach. The semi-processed food will arbitrarily ferment and odor, forming a sour rot smell, that is, breath. Symptoms of bloating.

When an ulcer appears in the stomach, Helicobacter pylori will parasitize the wound, causing inflammation of the ulcer. Even if the drug is used to kill the bacteria, if the eating habits are not changed, the ulcer will still feel pain from time to time.

Laboratory and other inspections

I. Gastric fluid analysis: Determine the amount of basal gastric fluid secretion (BAO) and increase the amount of secreted acid (MAO) and peak secreted acid (PAO) after increasing histamine or pentagastrin to determine the function of gastric acid. Helps diagnose and guide clinical treatment of atrophic gastritis. Superficial gastritis is more normal in gastric acid, and extensive and severe atrophic gastritis reduces gastric acid, especially in gastric body gastritis. Gastric sinusitis is usually normal or has mild disturbance. Superficial, such as verrucous gastritis may also have increased gastric acid.

Second, serological test: Chronic atrophic gastritis serum gastrin usually increases moderately, which is because the lack of gastric acid can not inhibit the secretion of G cells. If the disease is severe, not only the secretion of gastric acid and pepsinogen, but also the secretion of endogenous factors, will also affect the decline of vitamin B12; serum PCA is often positive (more than 75%), and the level of serum gastrin decreases in chronic gastroenteritis. It depends on the degree of G cell destruction; serum PCA also has a certain positive rate (about 30-40%).

III. Gastrointestinal X-ray barium meal examination: When gas-barium double contrast is used to show the fine structure of gastric mucosa, atrophic gastritis may have relatively flat and reduced gastric mucosal folds. Gastric sinus gastroenteritis X-ray manifestations are blunt serrations of the gastric antrum mucosa and spasm of the gastric antrum, or persistent concentric stenosis of the anterior pylorus and rough mucosa. The characteristics of the X-ray meal of verrucous gastritis were changed to large nodular folds in the gastric antrum, and some plaques had barium spots in the center.

Fourth, gastroscopy and biopsy: is the main method for the diagnosis of chronic gastritis. Superficial gastritis is most often seen in the antrum of the stomach, mostly with diffuse mucus on the surface of the gastric mucosa, gray-white or yellow-white exudates, red and white or variegated mucosa at the lesion, like measles-like changes, and sometimes erosion. The mucosa of atrophic gastritis is mostly pale or grayish white, and it can also be red and white, and the white areas are sunken; the folds become thin or flat, and the mucosa becomes thinner and can be seen as purple submucosal blood vessels; the lesions can be diffuse or mainly in the stomach Sinus, if accompanied by proliferative changes, the surface of the mucosa is granular or nodular.

Biopsy specimens should be used for pathology and Helicobacter pylori detection. One specimen can be placed in a urea solution containing phenol red for a urease test. The test solution turns pink within 30-60 minutes, and the other specimen is placed in a special position. The medium was cultured in a micro-oxygen environment, and then a specimen was prepared into sections and stained with HE or Warthin-Starry or Gieemsa. There were piles of micro-curved bacilli in the mucosal layer on the slices, which were arranged in a fish-like manner.

Differential diagnosis of chronic stomach pain:

1. Chronic stomach pain: Chronic stomach pain is common in chronic gastritis. Chronic gastritis refers to a variety of chronic gastric mucosal inflammatory lesions caused by different causes. It is a common disease and one of the most frequent illnesses in the army. Its incidence is among various stomach diseases. first place. Since the widespread application of fiber endoscopy, the understanding of this disease has improved significantly. Chronic gastritis often has a certain degree of atrophy (loss of mucosa) and metaplasia, often involving the cardia, accompanied by loss of G cells and reduced gastrin secretion. It can also affect the body of the stomach, accompanied by the loss of acid secreting glands, leading to gastric acid. Reduction of pepsin and endogenous factors.

2. Nervous gastric pain: When some people are under great mental stress, a large amount of gastric acid will be secreted, showing a state of excessive gastric acid, causing heartburn, interval, and stomach pain. In addition, the work of the stomach is dominated by vegetative nerves. When a person's mental stress is too great, the autonomic nervous system loses balance and the stomach cannot work properly (secretion of gastric acid, peristalsis, etc.), causing stomach upset and causing stomach pain. Furthermore, because of insufficient sleep, poor diet, life, work, study and other reasons. Both can cause autonomic nervous disorders and cause stomach pain, which is neuropathic stomach pain.

3. Intermittent stomach pain: Stomach pain refers to chronic ulcers that are only found in the contact part of the gastrointestinal tract and gastric juice, also known as ulcer disease. Traditional Chinese medicine refers to the categories of stomach pain, heartache and epigastric pain. Intermittent stomachache means that the stomachache is intermittent and has no regular pattern.

4. Emotional stomachache: Psychological stomachache is a psychiatric disorder, which is mainly due to people's nervousness, anxiety and other uneasy emotions reflected to the stomach, leading to upper abdominal pain. Symptoms include stomach cramps and bloating. Usually, anxiety can relieve symptoms. But it is disturbing that sometimes there is no way for psychological pain to alleviate symptoms immediately, and the degree of pain is unbearable. A more serious consequence is that stress can cause gastric acid secretion. Once excessive gastric acid secretion, it can easily cause gastritis, peptic ulcer, gastric acid reflux and other diseases.

symptom

Chronic gastritis lacks specific symptoms, and the severity of the symptoms is not consistent with the degree of gastric mucosal lesions. Most patients are asymptomatic or have varying degrees of dyspepsia such as epigastric pain, loss of appetite, postprandial fullness, and acid reflux. Patients with atrophic gastritis may have anemia, water loss, glossitis, diarrhea, etc. Individual patients with mucosal erosion have more obvious upper abdominal pain and may have bleeding.

Upper abdominal pain, indigestion, vomiting blood, melena. Frequent symptoms are recurrent, irregular abdominal pain, pain often occurs during eating or after meals, and most of them are located in the upper abdomen, umbilical cord, and some children are not fixed, intermittent intermittent pain or blunt push, severe in severe cases colic. Often accompanied by loss of appetite, nausea, vomiting, and abdominal distension, which continues to affect nutritional status and growth. Gastric mucosal erosion and bleeding are accompanied by vomiting and melena.

Clinical manifestation

The disease progresses slowly and often recurs. It develops well in middle age and has a tendency to increase with age. Some patients may be free of any symptoms of chronic gastritis, and most patients may have symptoms of indigestion to varying degrees without obvious signs. The manifestations of different types of gastritis vary.

1. Superficial gastritis may have chronic irregular epigastric pain, abdominal distension, belching, etc., especially when the diet is not obvious, some patients may have acid reflux, upper gastrointestinal bleeding, and gastroscopy confirmed erosive and verrucous in these patients Most gastritis.

Second, the symptoms of different types of atrophic gastritis are different. Gastric gastritis generally has fewer gastrointestinal symptoms, and can sometimes show significant anorexia, weight loss, glossitis, and tongue atrophy. May be accompanied by anemia, rare cases of malignant anemia in our country. Atrophic gastritis has obvious gastrointestinal symptoms when it affects the gastric antrum, especially when there is bile reflux, which often manifests as persistent upper mid-abdominal pain, which appears immediately after eating, and may be accompanied by bile-containing vomitus and post-sternal pain and Burning sensation, sometimes there may be repeated small upper gastrointestinal bleeding, and even vomiting, which is caused by the destruction of the gastric mucosal barrier and acute gastric mucosal erosion. Chronic gastritis is mostly without obvious signs, sometimes with tenderness in the upper abdomen.

1. The weather is cold before and after the Spring Festival, which is an active season for stomach problems. Keep warm and reduce the cause of seizures.

2. Pay attention to adjusting the rhythm of life, avoid stress, anxiety, fear, and prevent excessive fatigue. Prolonged mental stress can cause cerebral cortex dysfunction, increased secretion of gastric acid and pepsin, smooth muscle spasm, gastric submucosal vasospasm and ischemia, and damage to the gastric mucosal barrier.

3. Ban overeating, spicy and irritating food, excessive drinking, etc.

4. Avoid using drugs that are harmful to the stomach, such as aspirin.

5. Actively prevent and treat other diseases, such as upper respiratory diseases, facial features (sinusitis, sore throat), oral diseases (caries, gingivitis), etc.