Causes of pain in the solar plexus: gastritis, pancreatitis or gallstones

We asked Larisa Tretyakova, gastroenterologist, doctor of the highest category, head of the department of the PharmMed Clinic , to tell us what most often hurts in the epigastric area, how to understand your own sensations and what diagnostic procedures are necessary in this case.

Almost every resident of a big city has experienced pain in the upper abdomen - right in the triangle under the ribs. Most often, epigastric pain indicates diseases of the digestive system.

Let's first figure out exactly what organs are located here. This is the stomach that passes into the duodenum. To the left of the stomach is the pancreas, which is responsible not only for digestion, but also for hormonal control - in particular, it produces insulin, which cells need to absorb nutrients. The spleen is also located here, which is responsible for purifying the blood and functioning of the immune system. To the right of the stomach the gallbladder and liver are densely packed. All of these organs (with rare exceptions) can be a source of pain localized in the epigastric region.

The Deepest Essence of Digestion

Every high school student knows that digestion occurs in the stomach. Aggressive hydrochloric acid attacks the food entering the stomach, and it begins to break down into easily digestible components.

But not every school graduate knows that a person without a stomach can live relatively normally. Because only the first stage of digestion takes place here. Much more important processes occur in the next “compartment” - the duodenum. The pancreatic ducts and the common bile duct exit here.

The gall bladder accumulates bile produced by the liver, and as soon as food enters the duodenum, the bile is sent there to help with digestion. An equally important role in digestion is played by the so-called “pancreatic juice” - the secretion of the pancreas, which also enters the duodenum through the ducts.

After food is “processed” in the duodenum, it is sent for further digestion and absorption in the small intestine.

What to do if symptoms are present

If a woman has pain in her lower abdomen for a long time, she should consult a doctor. He will examine the patient, study all the features of the body, and palpate the stomach with his fingers.

If a man comes to the appointment, then usually his testicles and penis are examined, if a woman, then the doctor examines the pelvic area. This allows you to understand whether the lower abdomen hurts due to the uterus, ovaries, and fallopian tubes.

When to see a doctor

You should visit a specialist if the following symptoms appear:

• the duration of pain is more than 6 hours without a break, high intensity;
• in case of sharp pain in the lower abdomen on the right;
• if your stomach hurts after eating;
• if the pain is very strong, appetite disappears;
• when experiencing pain, a person vomits several times in a row;
• if pain in the lower abdomen occurs in pregnant women;
• in case of increased pain when changing body position;
• when the stomach hurts at the navel, then movement occurs. If pain is felt in the lower right quadrant, this may indicate appendicitis;
• if sleep is interrupted due to pain;
• pain ends in bleeding (in pregnant women);
• if in addition to pain there is a high temperature;
• if it is painful for a person to release gases, as well as during bowel movements and urination;
• if there is any kind of pain in the abdomen on the right, which differs from the usual discomfort in the stomach area.

It is best to visit a doctor if your stomach hurts for a week. Then you can avoid serious consequences.

When urgent medical attention is needed

You should call an ambulance as soon as possible in the following situations:

• if your stomach hurts badly and this leads to loss of consciousness and inability to breathe. This is typical for diseases such as liver failure, acute pancreatitis, abdominal bleeding;
• if the stomach hurts badly, a fever appears and the person is unable to move;
• painful sensations in the abdominal area lead to vomiting for several hours or vomiting blood;
• if the intestines do not work for several days due to acute pain. This may indicate obstruction of the digestive tract;
• if bleeding has started from the rectum. If the pain in the lower abdomen is acute, then a person may develop hemorrhagic gastropathy and intestinal ischemia. In the case of a chronic disease, abdominal pain with simultaneous bleeding indicates cancer;
• a person may have pain in the abdomen, chest, but he is not entirely sure of its placement. In such cases, heart disease often occurs;
• Men have stomach pain (groin area). This may indicate testicular torsion. If left untreated, tissue necrosis is possible.

Treatment of abdominal pain

If your stomach hurts, doctors can use two treatment methods - surgery or a conservative method. Sometimes it is necessary to undergo surgery (appendicitis, intestinal obstruction) to save a life. At JSC "Medicine" (clinic of Academician Roitberg), you can undergo effective treatment in a hospital; for this, visit the page.

The most important thing is to visit a specialist on time. He will study the whole picture and prescribe the necessary treatment. If it hurts in the front of the abdomen, tests are taken and all the research is done. Based on this, a diagnosis is already made.

Abdominal pain during pregnancy

If the symptoms listed above are absent, then heaviness in the abdomen and pain may indicate other causes. Pain in the lower abdomen may occur during pregnancy in women who are in the first trimester. This happens as the uterus grows and blood circulation increases. If a woman is pregnant, but the term is later, then abdominal pain may be associated with the fact that the baby’s weight has increased. Such sensations inside the abdomen can also occur as a result of stretching of the pelvic floor muscles, pressure on the rectum and bladder from the side of the uterus.

However, if your stomach hurts with nagging pain, you feel heaviness, but you also have vaginal discharge, spasms, pain, then you should definitely go to a specialist. Such symptoms can prevent premature birth, ectopic pregnancy, and miscarriage.

During pregnancy, your stomach may hurt due to diastasis. The growing uterus puts pressure and causes the abdominal muscles to separate. In most cases there is no pain, but sometimes there is pain in the back and navel. You don't need a doctor's help here. Almost always everything returns to normal after childbirth is over.

Treatment at home

Everything is quite simple here; you can use some methods when there is pain in the lower abdomen:

• eat prunes if you have pain in your lower abdomen. You can also take any product that contains a lot of dietary fiber (broccoli, bran). Prunes are especially useful in such situations because they contain sorbitol (a laxative of natural origin);
• Drink tea made from ginger, chamomile or peppermint. Such herbs reduce nausea and help with abdominal pain. With the help of ginger you can normalize digestion, chamomile and mint will help relieve muscle spasms;
• Use baking soda and prepare an aqueous solution. Baking soda is found in most antacid medications. It is worth taking 1 tbsp. baking soda and dilute with warm water (1 cup);
• Get a massage if your stomach hurts during your period. Spasms may occur inside due to the muscles being too tense. You will need a light massage, you need to focus on the place where it hurts the most;
• take a bath with hot water. Water will relax muscles, improve blood circulation, and relieve pain. You need to lie down for about 20 minutes. If a woman has a stomach ache, you can throw Epsom salts into the bath.

Gastritis, ordinary and not very

The most common disease that causes pain in the epigastric region is gastritis, that is, inflammation of the gastric mucosa. Depending on the nature of the disease, gastritis can be acute or chronic.

The danger of chronic gastritis is that most cases of stomach cancer develop against the background of a long course of this seemingly harmless disease.

The type of gastritis is divided into superficial gastritis, in which only the mucous membrane becomes inflamed, and atrophic - in this case, against the background of inflammation, the stomach glands that produce hydrochloric acid gradually die.

Unfortunately, it is possible to identify the type of gastritis and, accordingly, decide on treatment only after an examination, colloquially called “gastroscopy” - during this procedure, an endoscope is inserted into the upper parts of the gastrointestinal tract.

In fact, the study is called “esophagogastroduodenoscopy”, because during the procedure the doctor examines the patient’s esophagus, stomach, and duodenum. It is very important to carry out this study in as much detail and quality as possible, since gastritis very often “adjacent” to duodenitis (inflammation of the duodenum) and pathology of the esophagus.

Causes of abdominal pain

Pain can have a different shape, character, and duration. Taking into account all these parameters, the causes of abdominal pain are distinguished:

• acute appendicitis (the pain does not go away, it can migrate and be aching). If it suddenly calms down, then this may indicate that the intestines have ruptured. In this case, urgent medical attention is needed;
• acute pancreatitis (abdominal pain is quite severe, located on top of the abdomen, but can radiate to the back). This condition is also accompanied by an unpleasant aftertaste, dry mouth, and vomiting;
• acute gastritis. The stomach hurts after eating, there is a feeling of heaviness, pain in the area under the stomach. At the same time, the person wants to burp or vomit violently. In such situations, you need to consult a gastroenterologist;
• intestinal colic. The stomach hurts and pulls sharply, in flashes, reminiscent of contractions. This pain is located near the navel and usually the person feels chills and general weakness. To improve the patient's condition, you need to provide bed rest and take special medications. In addition, it is important to reconsider your own diet;
• kidney inflammation. The stomach begins to hurt and the temperature rises;
• passing of kidney stones. Such pains are acute in nature and occur in the perineum and lower back. A person often wants to go to the toilet. A warm bath and antispasmodic drugs will help here. If there is blood during urination, you should urgently call a doctor;
• diseases of the duodenum and stomach. These pains occur from time to time in the pit of the stomach, near the navel. However, they may appear after eating. The result is heaviness, belching, bloating;
• ulcer. The pain disappears after eating, but heartburn, a white coating on the tongue, and a sour taste appear. In addition, a person suffering from an ulcer may experience toxicosis, constipation, and increased flatulence in the morning;
• cholecystitis. Periodic pain occurs in the right hypochondrium, in the abdomen, and in its upper part. They radiate to the shoulder and lead to decreased appetite, upset stomach, constipation, periodic vomiting, dry mouth, nausea, belching;
• stressful situation. The lower abdomen hurts, the sensations are aching. At the same time, a person becomes too active or passive. In this situation, you should avoid products that contain coffee and take sedatives.

Pancreatitis is a threat to life

Acute pain in the epigastrium can be a symptom of pancreatitis - inflammation of the pancreas. This organ can sluggishly signal a problem with regular, mild pain. And this means it’s time for an examination.

But if the pain in the epigastrium has become almost unbearable, plus stool disturbances and vomiting develop, in some cases an increase in temperature, then this means acute pancreatitis. And this is an indication for urgent hospitalization.

Pancreatitis usually occurs when pancreatic secretions (pancreatic juice) stagnate. The duct that should carry secretions into the duodenum is blocked by a stone, cyst, swelling or pus. But the juice continues to be produced and enthusiastically digests the gland itself. Therefore, in acute pancreatitis, delay is literally death.

Oddly enough, pancreatitis often attacks young people who lead an active lifestyle, love to eat, sometimes drink, and, most importantly, are subject to constant stress.

Problems with the pancreas can be diagnosed in advance - before the development of acute pancreatitis - using a simple ultrasound and blood test. If an ultrasound shows any problems with the pancreas, the doctor may prescribe a computed tomography scan - a study that gives a layer-by-layer image of the gland and allows you to examine in detail the essence of the problem.

The nature of pain in the upper abdomen after eating

• Acute intense pain

This feeling in the upper abdomen can be caused by food poisoning, overeating, constipation, indigestion, physical fatigue, muscle tension, injury, viral or bacterial infection, various psychogenic factors and many other reasons, sometimes not amenable to diagnosis.

• Burning pain

Burning pain in the upper abdomen is often a consequence of eating hot, salty, sour or spicy foods, which irritate the gastric mucosa and lead to increased secretion of gastric juice.

• Constant nagging pain

Most often it occurs due to overeating, eating dry food or due to quickly eating food on the go without first thoroughly chewing. Sometimes such a condition can develop as a reaction to certain foods.

to come back to the beginning

Types of pain and symptoms

Abdominal pain is possible in the following manifestations:

• spicy. Severe pain that occurs suddenly;
• chronic. The pain intensifies gradually, in many cases over a month or more;
• chronically recurrent. The pain occurs periodically - it appears suddenly and just as suddenly goes away, appears again after a certain period of time;
• tonic. The main characteristic of such pain is strong muscle tone and the appearance of compactions. Pain may also be accompanied by spontaneous contraction of muscle fibers;
• clonic pain – supplemented by rhythmic muscle spasms;
• burning (“cuts”, “aches”) pain – reminiscent of a feeling of hunger.

The pain can be localized in the umbilical region, the upper part of the peritoneum (hypochondrium), below the navel on the right or left, and the entire abdomen can also hurt.

A patient complaining of a stomach ache will exhibit different symptoms. Pain may be characterized by:

• colic – paroxysmal stabbing sensations;
• spasms - spontaneous contractions of muscle fibers with simultaneous blanching of the skin. In some cases (depending on the type and specificity of the disease), a painful abdomen may be accompanied by fever and bleeding;
• strong burning sensation;
• feeling of fullness. For example, a feeling of bulging in the lower back may indicate problems with the colon;
• cyclicality (either increasing or decreasing pain intensity);
• increased gas formation;
• itching in the anal area;
• discomfort in the abdomen during a period of rest, disappearing during movement. This symptom may indicate a circulatory disorder in the abdominal cavity.

Lower left quadrant

The organs in this quarter are the left kidney, part of the large and small intestine, and in women, the left ovary and fallopian tube.

Abdominal pain in this quarter can be a symptom of colitis, colonic diverticulosis or kidney stones, and in women can also be a sign of ovarian or pelvic inflammation.