Stomach

Gastric colic - causes, symptoms and treatment


Stomach colic: its causes and therapies

Colic is always an extremely painful affair for those affected. It is often an intestinal colic. However, the cramp-like pain can also come from the stomach area and then usually have different causes.

Definition

As is well known, that is stomach (Gaster) in the body responsible for the pre-digestion of any food. For this purpose, the parietal cells of the gastric mucosa continuously Stomach acid from. This exposes itself significantly

  • Hydrochloric acid,
  • Mucus,
  • protein
  • and the digestive enzyme pepsin

together. The stomach acid also contains the so-called Intrinsic factor (IF). A glycoprotein for the absorption of the vitamin B12 compound cobalamin, which is needed in the body for cell division, blood formation and the maintenance of nerve functions.

The actual stomach wall is located behind the gastric acid-producing gastric mucosa, which lines the inside of the stomach. It mainly consists of muscle tissue, but is also traversed by numerous blood vessels and nerves. The latter have the function of transmitting contraction impulses to the stomach muscles and thus generating the digestive-inducing stomach peristalsis in the form of muscle contractions. The so-called serves as an essential transport mechanism for forwarding the food pulp into the intestine usher (Pylorus) - a ring-shaped sphincter at the end of the stomach, which prevents the passage of chyme that has been digested in the stomach into the Duodenum (Duodendum) controlled.

A gastric colic now arises when the nerves in the stomach are irritated by the corresponding disturbances. The result is nervous disturbance impulses, which provoke the peristalsis of the stomach muscles into cramps. It should be mentioned that colic generally describes cramp-like pain in the digestive tract. They result from a constant irritation of the nerves in the gastrointestinal tract, rarely also in the area of ​​the uterus, sperm or urinary tract, and usually indicate a serious illness.

A diagnosis is often made more difficult by misinterpretations regarding the exact origin of pain. For example, intestinal cramps can radiate to the stomach and vice versa. The causes of intestinal and gastric colic, as well as any accompanying symptoms, are often identical and therefore cannot be clearly distinguished from one another. However, a few basic differentiations can be made.

In contrast to intestinal colic, a real stomach colic, for example, causes central pain cramps in the upper instead of in the lower abdomen. Due to the location of the stomach in the left half of the upper abdomen, the pain is also clearly pronounced on this side of the body. Accompanying symptoms such as heartburn, which generally indicates an impaired gastric acid drainage, also speak for gastric colic. Furthermore, the colic-like pain in the area of ​​the stomach is noticeable immediately after eating, since the food porridge arrives first after it has passed through the esophagus and can therefore quickly cause acute irritation of the stomach's own nerves.

Stomach disorders as the main cause

It is obvious that gastric colic most often result from gastric disorders. As part of the digestive process, this is also exposed to numerous irritant factors that can lead to illness if the patient is in poor health. Even gastric acid itself, whose digestive enzymes mainly serve to digest proteins in the stomach, can be problematic here. Although their high acid content actually serves to break down the food pulp naturally, the aggressive acid does not stop at body tissue when it comes into contact with it.

If the stomach lacks the protective layer of mucous membrane that lines the inside of the stomach wall, the stomach acid can attack the muscle and nerve tissue of the stomach unhindered. This is the case, for example, if infections or caustic substances lead to inflammation of the gastric mucosa, which decomposes more and more in the further course of the disease and thus clears the way for the stomach acid to the stomach wall.

Gastritis caused by gastritis

A classic inflammation of this type is, for example, with gastritis. The inflammation of the stomach is caused when the protective acid mantle of the stomach is damaged or too much stomach acid is present due to certain influences. As a result, gastric acid comes into direct contact with the cells of the gastric mucosa and attacks them.

A distinction is made between gastric mucosal infections on the one hand according to their course into acute and chronic gastritis. On the other hand, medicine also differentiates between the various causative factors. Here is a brief overview:

Gastritis as an autoimmune disease

An autoimmune gastritis occurs when the own immune system attacks the cells of the gastric mucosa and destroys them.

Gastritis from infections

The bacterial pathogen Helicobacter pylori is the most common cause of gastritis with a share of 85%. The bacteria cause an increased production of stomach acid and additionally cause inflammatory stomach ulcers. Helicobacter pylori is also suspected to be involved in the development of gastric cancer.

In addition to Helicobacter pylori, other bacterial pathogens, such as staphylococci, enterococci, Salmonella, Campylobacter, Yersinia or Clostridia, are among those infectious agents that can trigger inflammation of the stomach or stomach. Here it is often the toxic excretion products of the bacteria that trigger the inflammation. The pathogens usually get into the digestive tract through contaminated food.

Gastritis from chemical substances

In addition to bacterial toxins, the fungal, plant, animal and industrial toxins can also cause gastritis. Even medicinal ingredients cannot be excluded as the cause. Common to these chemical substances is that they have a very aggressive effect on the gastric mucosa. In the field of fungal toxins, amatocin, gyromitrin, muskarin and orellanin should be mentioned in particular. In plant poisons, it is often atropine and solanine. The latter is contained in the parts of nightshade plants, which also include conventional crops such as potatoes, tomatoes and peppers. So if you are not careful when cooking and serve the vegetable green of these vegetables, you could be at risk of stomach cramps as a result of poisoning.

In turn, the toxins of mussels and other shellfish (e.g. ciguatoxin, sacitoxins and tetrodotoxin) are known to cause cramps in seafood. Mucosal irritants such as alcohol and certain medications (especially antibiotics and pain relievers) should also not be underestimated. Extreme spasm reactions also trigger industrial pollutants, acids, alkalis and metal compounds such as antimony and zinc.

Gastritis as a result of frequent heartburn

Chronic heartburn is also referred to in medicine as acid reflux or reflux esophagitis. Parts of the stomach contents flow continuously back into the esophagus due to malfunctions of the stomach muscles or the diaphragm. Logically, there are also large amounts of added stomach acid in the digested stomach contents. The corrosive acid causes severe damage to the upper gastric mucosa during chronic heartburn, which can trigger inflammation that promotes colic.

Gastritis as a result of other diseases

This includes inflammation of the gastric mucosa that is caused by another underlying disease. For example, inflammation due to Crohn's disease. Chronic intestinal inflammation sometimes moves to the stomach, which then causes severe intestinal and stomach colic.

Gastric colic in gastrointestinal infection

Similar to gastritis and its infectious forms, most other inflammatory infectious diseases of the gastrointestinal tract usually begin with gastric colic. In addition, there are symptoms such as vomiting and diarrhea, possibly also infection-related fever. Most often, such infections are in the form of a Abdominal influenza triggered by highly infectious rota or noroviruses. However, pathogens such as salmonella, cholera bacteria, chlostridia and certain strains of the E. coli bacterium can also cause gastrointestinal flu.

In this context, the scenario of food poisoning should be mentioned again. Either the affected food contains the poison when consumed (e.g. when eating poisonous mushrooms or plants) or the consumption of spoiled food leads to the secretion of toxic excretion products by infectious agents in the digestive tract.

Unhealthy lifestyle is a risk factor

It's no secret that the digestive tract is the first to react to an unhealthy lifestyle. Among other things, nutrition also plays a crucial role. In this context, nutritional gastric colic usually comes from the choice of dishes that are too spicy, too high in fat, too rich or too acidic. After enjoying these dishes, nerve irritation and colic-like abdominal pain can occur due to the excessive stretching of the stomach wall.

In addition, the foods mentioned also promote an increased production of stomach acid. There is an imbalance between stomach acid and stomach protection, which attacks the gastric mucosa if it occurs repeatedly. Some nutritional examples of bad foods are:

  • Coffee,
  • Cola,
  • Juices,
  • Citrus fruits,
  • Chili,
  • alcoholic drinks.

Eating disorders such as bulimia, anorexia and obesity should also be mentioned with regard to eating habits and gastric colic. The constant suppression of hunger affects the gastric mucosa as well as constant vomiting or prolonged stretching of the stomach wall due to very generous meals. In the area of ​​intoxicants and addictive substances, chemical drugs, alcohol and nicotine occasionally lead to a compensatory overproduction of stomach acid as well as to a decrease in the strength of the sphincters at the stomach entrance. A delay in the digestive processes is also conceivable in this regard.

In addition to eating habits and substance abuse, psychosomatic factors must also be mentioned as a recurrent cause of gastric colic. Doctors have long known that long-term stress, grief and worries can have a negative impact on the body and especially on the gastrointestinal tract. There is even the phenomenon of Stress ulcer - an ulcer of the gastric mucosa, which develops specifically in the course of massive stress, for example after traffic accidents, major surgeries or strokes of fate. The exact mechanism has not yet been fully investigated, but the appearance of the ulcers is explained as a result of stress reactions in the autonomic nervous system. As a result, the blood flow to the gastrointestinal organs is reduced and the entire digestive process is slowed down before ulcers may form.

Peptic ulcers as the cause

When it comes to abnormal tissue growths in the digestive tract, many first think of colon cancer. But various forms of growth can also appear in the stomach. The best known is probably that Gastric ulcer (Ulcus ventriculi). The disease usually results in benign ulcers of the gastric mucosa. Similar to inflammation, this gradually decomposes the mucous membrane, causing the stomach acid actually intended for digestion to attack the stomach walls more and more.

The causes of a stomach ulcer largely coincide with those of the stomach inflammation. However, a family cluster can also be identified for the ulcer in particular, which makes genetic factors relevant. In addition, there seems to be a link between gastric ulcers and psychological factors such as stress, depression and psychological trauma.

In addition to gastric colic, stomach ulcers are also noticeable due to a number of other complaints. For example, they can bleed and lead to life-threatening blood poisoning. In addition, stomach ulcers do not heal without scars. Corresponding scars always harbor the risk of adhesions and perforations. In addition, patients with peptic ulcer are also prone to malignant degeneration in the form of gastric cancer. It is the worst cause of stomach cramps and, in addition to the stomach ulcer, can also result from persistent stomach inflammation.

Diseases of other organs as triggers

Some diseases that lead to gastric colic are not due to stomach-based health problems, but have their cause in other organs. Diseases of the further digestive tract such as the intestine, liver, gallbladder and pancreas are very obvious. But a heart attack can also lead to stomach problems and otherwise go asymptomatic. This is a major risk of heart attacks if they go undetected due to stomach symptoms.

Symptoms of gastric colic

The symptoms of gastrointestinal colic depend very much on the underlying cause. In addition to the characteristic left-sided cramp pain in the upper abdomen, general digestive complaints such as constipation, nausea or feeling of fullness are relatively common. If the gastric mucosa has already been severely attacked and the stomach wall has been severely affected, severe accompanying symptoms such as blood in the stool can also occur. In the course of an infection, complaints such as general feeling of illness and fever cannot be excluded. Overall, the following symptoms must be expected for gastric colic:

  • left cramp-like upper abdominal pain,
    burning pain or heartburn,
  • Constipation or diarrhea,
  • Feeling of fullness,
  • Nausea and vomiting,
  • Loss of appetite,
  • bloody bowel movements,
  • Feelings of anxiety,
  • Fever,
  • Exhaustion.

Important: Symptomatic gastric colic is often confused with radiation pain that actually comes from other organs. Apart from the intestinal colic, which due to its proximity to the stomach often leads to misinterpretation, radiating abdominal pain should also be mentioned here. In the course of endometriosis, in particular, cramp-like pain occurs in the course of menstruation, which can radiate into the stomach. Furthermore, the pain symptoms of an impending heart attack are often confused with gastric colic. If the pain in this connection extends to the left arm in addition to the stomach, this is a clear alarm signal. Therefore, please call an emergency doctor immediately!

Diagnosis

Gastric colic can be identified quite reliably by patients with appropriate, interval-like cramp pain. On the other hand, a little more effort often requires finding the cause of the colic. You shouldn't waste time going to the doctor here, because the list of serious underlying diseases is long. A doctor will first carry out a careful medical history (patient survey), within which existing health problems and everyday habits are inquired.

Afterwards, laboratory tests of blood and stool samples are important to determine possible pathogens and signs of inflammation. Damage and degeneration of the gastric mucosa and the stomach walls are also detected using imaging techniques, which include, in addition to ultrasound examinations, gastric examination in particular.

Therapy for gastric colic

Timely treatment is very important for gastric colic, because the cramps often indicate an advanced stage of the disease. Complications such as blood poisoning in the course of an infection, metastases in stomach cancer or functional disorders of adjacent organs (e.g. disturbed bowel function or cardiac arrhythmia) do not take long in the worst case. Depending on the triggering factors, the following treatment measures are available:

Medical therapy

Since many gastric colic are caused by an imbalance between gastric acid and the protective function of the gastric mucosa or said imbalance at least worsens the symptoms, the use of medicinal acid inhibitors such as maaloxan, pantozol or omeprazole is usually part of the standard procedure in therapy. This is intended to relieve the gastric mucosa and thus to heal the mucosal damage faster, which ultimately also relieves the nervous spasms.

A gastrointestinal flu and most food poisoning can only be treated symptomatically by the administration of special medications (e.g. antibiotic agents) and infusion solutions against the loss of fluid in the presence of diarrhea. Infections by Helicobacter bacteria are also treated with a triple therapy consisting of 2 antibiotics and a proton pump inhibitor. The therapy of fungal poisoning and other plant poisoning is based on the corresponding poison. It is imperative to seek medical advice and to consult the poison control center.

Home remedies and medicinal measures

A change in diet and life in gastric colic often brings noticeable improvements in symptoms. A review of lifestyle regarding external stress factors is definitely important here, since experience has shown that stress affects the gastrointestinal tract quite quickly and exacerbates existing symptoms. In particular, a consistent avoidance of addictive substances and a reduction in acid-enticing dishes relieve the stomach. It also depends on the amount of harmful food. A glass of cola for lunch does not have to be avoided here at all. However, the permanent enjoyment of acidic soft drinks and citrus fruits is definitely not recommended.

A glass of milk, a tablespoon of dry oatmeal or a piece of dry bread have proven to be beneficial as an acute measure against an increase in gastric acid production. In addition, in the case of overacidification, potato juice can be used to neutralize stomach acid due to the mucilages and pectins it contains. In the case of pronounced gastric colic, teas or envelopes with extracts of wormwood herb also help.

If an infection or food poisoning is the cause of the gastric colic, often only a temporary lack of food with subsequent diet increases helps to calm the stomach. It is important to make sure you have enough fluids because there is a risk of dehydration in the event of diarrhea due to infection. Still water, unsweetened teas or light broths can be used here. Herbal teas with chamomile and / or fennel also have a calming effect on the gastrointestinal tract. If the stomach feels better in the course, the teas can be sweetened with a spoonful of honey. Honey is said to have a positive effect on the gastric mucosa.

Operative measures

Surgery on the stomach can be considered if severe gastric perforations have occurred or to prevent this life-threatening complication. This is necessary, for example, in the case of gastric ulcers, which always harbor the risk of developing tumors. If there is already a malignant tumor, it must of course also be removed to prevent metastasis. Depending on how the individual diagnosis is structured, chemotherapy drugs or radiation therapy may be used beforehand in order to initially reduce the size of the tumor.

Diseases of gastric colic

Gastritis, Crohn's disease, gastrointestinal infection, food poisoning, peptic ulcer, stomach cancer, intestinal, liver, gastric inflammation, general stomach problems, biliary and pancreatic diseases. (ma)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Swell:

  • Möhler, M. et al .: Gastric carcinoma "Diagnosis and therapy of gastric adenocarcinomas and esophagogastral transition", oncology guideline program of the AWMF, German Cancer Society and German Cancer Aid: German Society for Digestive and Metabolic Diseases (DGVS), (accessed 28.08.2019) , AWMF
  • German Red Cross: Acute diseases of the abdominal organs, (accessed August 28, 2019), DRK
  • Johannes-Martin Hahn: Checklist Internal Medicine, Thieme Verlag, 8th edition, 2018
  • Jürgen Stein, Till Wehrmann: Functional diagnostics in gastroenterology, Springer Verlag, 2nd edition 2006
  • Hubert Hauser (ed.), Heinz J. Buhr (ed.), Hans-Jörg Mischinger (ed.): Acute Abdomen, Springer Verlag, 1st edition, 2016

ICD codes for this disease: R10ICD codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.


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