Pain on palpation of the abdomen. Abdominal pain, characteristic of emergency conditions, or an acute abdomen. The main symptoms and signs of gastric diseases

The process of palpation of the stomach and intestines is important in terms of diagnostic study human body. Monitoring of the digestive organs is carried out as follows: at the first stage, a qualified specialist carefully probes the sigmoid colon - this is the most common landmark and the most accessible organ for palpation. Next, the doctor proceeds to study the state of the caecum and transverse colon. The ascending and descending sections of the suction organ are quite problematic to probe.

In practice, in the process of palpation, the fingers must be carefully immersed on the surface of the body area and gently pressed onto the organ under study (in the direction of the posterior abdominal wall). With the help of sliding movements, you can clearly determine the contours, density, presence various neoplasms and deviations. When touching (feeling) the sigmoid colon, one gets the impression that there is a smooth, dense and movable cylinder in the human body. The size of such a "geometric figure" does not exceed the thickness of the human thumb. The formation parameters are directly related to the state of the walls, which are densely filled with gases and decay products (fecal / fecal masses).

During the course of the inflammatory process of the infiltrating walls, a significant thickening of the membrane occurs. Ulcerative manifestations form a bumpy and uneven surface of the suction organ. Acute inflammation of the sigmoid colon is accompanied by the formation of a dense consistency of painful manifestations. Due to dense overflow with gases and liquid contents, motility retardation occurs. The spasm is palpable in the form of a cord and a cord. The patient experiences a systematic rumbling + false urges to defecation (false diarrhea).

AT normal condition the caecum is easily palpable. A specialist can detect a moderately active cylinder up to 3 cm in movement. Its mobility in pathological disorders is significantly increased. The internal consistency is significantly compacted with coprostasis and chronic inflammation. The volume and shape of the cecum directly correlates with the contents. In a normal functional state, the intestines do not rumble.

The patient should remember that the presence of pain during palpation in the region of the caecum indicates the development of the pathological process. The digestive organ requires systematic and complex treatment.

In practice, after examining the caecum (+ appendix) it is possible to examine the less accessible parts of the large intestine. Palpation is carried out from the ascending to the transverse colon and descending intestines. The transverse-colic part of the suction organ is qualitatively palpated only in the case of chronic inflammation. Tone, consistency, volume, shape depend on the tone and degree of muscle tension. For example, an inflammatory process of the ulcerative type forms serious prerequisites for the transformation of the transverse colon. At the same time, the musculature of the organ thickens significantly, its configuration changes.

To date chronic colitis and percolitis are quite common. With these ailments, the wall of the suction organ begins to contract painfully. Due to the bumpy surface, palpation is accompanied by sharp pain sensations. For example, with pericolitis, respiratory and active mobility are lost.

Palpation of the abdomen allows you to feel the tumor of the intestine, which is often confused with the pathology of various organs. Oncology of the caecum and transverse colon is distinguished by already known mobility. Pain is activated during the act of breathing (tumors below the navel are immobile). Feeling the abdomen with enterocolitis is accompanied by rumbling in the navel. The disease has specific signs and symptoms: painful diarrhea (mushy slimy stool, abdominal pain, hardened colon). Palpation of the abdomen is carried out in combination with a digital examination of the rectum (sigmoidoscopy + radiography). These actions make it possible to predict the formation of rectal cancer and the formation of various syphilitic structures. It will also be possible to clearly determine the presence of inflammatory processes, cracks, fistulas, hemorrhoids and all kinds of tumors. The specialist can get a clear vision of the tone of the sphincter, the level of filling of the ampulla of the colon. In some cases, it is rational to palpate neighboring organs (the bottom of the bladder, the prostate gland, the uterus with appendages). This will reveal an ovarian cyst, a tumor of the genital organs, the degree of constipation, etc.

The mechanism of the procedure

Palpation favors last step full and objective research abdominal areas. The patient will need to cough vigorously before the procedure. In practice, a person with developed peritonitis manages to do this only superficially (holding the abdomen with his hands). It is allowed to make a small impact on the couch on which the patient is located in lying position. The vibration impulse will provoke the manifestation of pain in the digestive tract. Thus, it is quite easy to establish the diagnosis of peritonitis without touching the hand. To identify symptoms of peritoneal irritation, it is allowed to gently shake the patient, after grasping the combs ileum(or jumping on one leg).

The palpation procedure begins with the patient being asked to clearly indicate the area where the first pains formed (the primary localization of the disease). The specialist needs to carefully monitor the actions of the patient himself. This is how you can identify the causes of irritation of the peritoneum. Diffuse pain of the visceral type in the abdomen is easily determined with the help of circular movements of the palm. Hands should be warm.

The procedure starts as far as possible from the main focus pain. This helps to avoid unplanned pain at the very beginning of the study. Children, and sometimes adult patients, sometimes do not allow a quality examination due to pain.

First of all, the doctor must perform a gentle and accurate palpation (superficial). An experienced specialist moves gently, methodically and consistently. Fingers make the minimum number of movements. It is strictly forbidden to palpate the abdomen randomly! The pressure on the surface of the body should not be high. Otherwise, there will be protective muscle tension. abdominal cavity. Touching the sore spot should be carried out until the patient says that he really hurts.

A qualified specialist can always determine the degree of tension in the muscles of the anterior wall of the abdomen. The physician must distinguish between voluntary and involuntary muscle tension. To clearly determine this factor during palpation, a person takes a deep breath and exhale. If muscle activity persists, then this indicates the development of peritonitis.

It is rational to make a deeper palpation if peritonitis was not detected during a superficial examination. This allows you to detect various tumor formations, hepatosplenomegaly, aortic aneurysm. It is very important for the physician to remember the optimal dimensions for normal structures so as not to confuse them with malignant ones. Pain during palpation of the abdomen and intestines has two types:

1. immediate local pain - the patient experiences a sharp pain at the site of the study;
2. indirect (reflected soreness) - pain sensations are formed in a different place when palpated. For example, in the course of acute appendicitis, pain accumulates at the McBurney point in the left side of the iliac fossa. This symptom is called "Rovsing" and is a reliable sign of peritoneal irritation.

It is easy to carry out comparative palpation of the patient with tense abdominal muscles. For this, the patient, who is in a supine position, is asked to gently lift their head off a pillow.

The classic symptom of irritation of the parietal peritoneum is not difficult to identify. To do this, at the time of the study, the doctor must sharply remove his hand from the surface of the body and observe the patient's reaction. In most cases, patients experience a significant increase in pain. This classic survey technique is rather crude, some scholars refer to it as a barbaric method of study.

With the development various pathologies in the digestive organs (for example, acute appendicitis), there is hyperesthesia of the skin in the abdomen. It is for this reason that if a patient is pinched or lightly pricked, then a painful reaction of the body will instantly occur. It's pretty common clinical symptom, but its fact of establishment is not enough for a firm diagnosis of acute appendicitis and other diseases of the abdominal organs.

An integral part of the palpation study is gentle tapping along lumbar region(+ sides of the abdomen) to determine the degree of pain in these areas. Quite often, pyelonephritis and urolithiasis correlate with sharp pains in the abdomen (rib-vertebral region).

In doubtful clinical situations, examination alone is not enough. An accurate assessment of the dynamics of the disease is established by repeated palpation of the abdomen by the same doctor.

Varieties of pain syndromes

Causes of pain in women

To date, medicine identifies two types of fundamental causes that affect pain during palpation. Organic factors include:

• inflammatory processes in genitourinary system(cyst, endometritis, fibroids);
• use of the spiral as a contraceptive;
• formation of various pathological formations;
• the presence of inflammation in the gallbladder (including appendicitis, pyelonephritis);
• severe pain during pregnancy (placental abruption, miscarriage).

The functional reasons are as follows:

• systematic failures in cycles during menstruation;
• selection uterine bleeding;
• ovulation + uterus bending.

Inflammatory processes are the main reason for the occurrence of pain during palpation of the stomach and intestines. The disease begins with classic acute manifestations and is supplemented by various signs of intoxication of the body, namely:

1. Endometritis is accompanied by aching pain in the abdomen. You can establish their manifestation with a slight palpation. The patient experiences heaviness in the area of ​​​​the appendages + compaction of the uterus;
2. Endometriosis is a pathological disorder that affects the uterus and appendages. Severe pain is observed on palpation of the middle of the abdomen;
3. Ovarian apoplexy correlates with ovulation. In this case, part of the blood enters the abdominal cavity due to strong physical exertion;
4. Uterine myoma. The pain syndrome is localized in the lower abdomen (squeezing of adjacent organs);
5. Appendicitis requires prompt medical intervention. Pain on palpation in the region of the appendix;
6. Cholecystitis is an inflammatory process of the gallbladder. Pain radiates clearly lumbar and back;
7. Cystitis is a lesion of the bladder. Pain is observed both during palpation and during urination.

Causes of pain in men

Pain on palpation in men is preceded by a number of factors. It can be both inflammation of the appendages, and prostatitis, cystitis, various formations. Doctors identify some signs of pain in which it is necessary to hospitalize a person. If the pain is concentrated in the area of ​​​​the appendix formation, then this indicates the course of appendicitis. Also dangerous inguinal hernia and her crush. In this case, the organ simply protrudes outward and has a hard cover. The patient experiences severe pain. Abdominal pain is also the result of poor-quality food. Thus, a peptic ulcer is formed. The main causes of pain in men are: diverticulitis, urinary disease, cystitis, pyelonephritis and excessive hypothermia.

In some cases, sharp pains are localized not only on the right side, but also on the left. Quite often, the main reason lies in the spread of intestinal infection. In this case, the main symptoms of appendicitis are observed, which have a paroxysmal manifestation. The pain syndrome often intensifies during the meal.

It begins with obtaining accurate information about those complaints that very often come out in relief in various diseases of the stomach.

When collecting information about pain in the stomach, you need to make sure exactly where the pain is felt. Next, you need to find out the time of onset of pain, whether it is constant or appears only at certain hours - in the morning on an empty stomach or at night; Is there any periodicity in the onset of pain. It is necessary to consider whether the pain depends on meals; how the quantity and quality of food, its consistency affect the appearance of pain; how long after eating the pain appears, whether food relieves existing pain; Is the pain associated with physical stress(jolts, lifting weights, shaking while driving), with working conditions, with mental unrest, mental trauma. It is also necessary to find out the spread of pain, their irradiation (in the back, shoulder blade, in the left hypochondrium).

The intensity and the very nature of the pain (colicky, dull, cutting) are also of known importance.

After clarifying the nature of the disease, they proceed to clarify the disorders of the appetite and dyspeptic complaints of the patient: heartburn, nausea, belching and vomiting.

When questioning a patient about vomiting, it is important to find out when vomiting occurs, how it depends on food intake, how often it is observed, what color the vomit is, whether they contained food substances eaten the day before or even earlier, etc.

Due to the close functional relationship between the stomach and intestines, it is necessary to obtain information regarding bowel movements. Many diseases of the stomach are accompanied by a disorder of the stool - for example, achilia is often accompanied by diarrhea, and hypersecretion and ulcers - constipation. Insufficiency of gastric secretion contributes to the development of gases in the intestines (flatulence).

Regarding the general condition of the patient, it should be clarified whether he had a sharp weight loss, which is of great importance for the diagnosis of gastric cancer.

From before past illnesses are essential inflammatory diseases gastrointestinal tract - gastritis and colitis, often leaving behind a significant vulnerability; repeated acute and mild diseases of the stomach, lasting only 1-2 days and disappearing as if without a trace, are often the starting point of a chronic pathological process in the stomach. Of no less importance are the chronic infections transferred to the patient (tuberculosis, malaria, syphilis); causing chronic toxemia, they are often the most important etiological moment of diseases of the gastrointestinal tract. In the same way, one must be aware of a possible violation of the function of the stomach due to prolonged use of irritating gastric mucosa. medicinal substances(arsenic, quinine, salicylic acid sodium, potassium iodide, etc.).

As for comorbidities, here we need to keep in mind subcompensated heart diseases, chronic diseases kidneys in the stage of their insufficiency, disturbances in endocrine system(thyroid gland, ovaries) - with them are very frequent different kind dyspepsia.

Finally, it is necessary to find out whether the given gastrointestinal disease association with psychogenic factors. In this regard, it is important to study the influence of the doctor's authority on the patient, strict dietary prohibitions and the mental impact on the patient of laboratory data, since this is often the cause of the so-called iatrogenic, i.e., suggested by the doctor or medical measures, diseases of the gastrointestinal tract.

Regarding heredity it is necessary to establish whether there are any diseases of the gastrointestinal tract in this family. In the development of anomalies of secretion, ulcers and cancer of the stomach, hereditary predisposition seems to be of some importance.

The profession often predisposes to certain diseases. Some occupational hazards, such as lead, mercury, phosphorus, acid fumes, etc., with their massive or prolonged exposure, they can lead to diseases of the digestive tract (stomatitis, gastroenterocolitis, etc.). Diseases of the stomach and intestines are caused not only by occupational hazards, but also by the very working conditions or lifestyle. Thus, persons leading a sedentary lifestyle, being very disposed to habitual constipation, at the same time suffer from gastric dyspepsia; persons who are constantly on the move and unable to eat regularly are prone to gastric catarrhs.

The survey is very important patient's habits, especially about the order of eating and about nutrition in general. Incorrect, irregular introduction of food, often after long intervals, sometimes in excessive amounts, is one of the important predisposing factors for various gastric diseases.

The nature and quality of the food introduced is also of great importance. Equally important is the habit of drugs(smoking, alcohol).

Inspection. During a general examination of the patient, it is important to establish the constitutional features of the body, since they are often a factor that to a certain extent determines the anatomical and physiological properties stomach and predisposing to a number of functional disorders.

Already the appearance of the patient, his constitutional-morphological type allows, by virtue of the law of general constitutional correlation, to assume certain relationships in terms of the shape, position and functional slopes of the stomach. According to the two main constitutional types - hypersthenic and asthenic - two "gastric diathesis" are also noticed: hypersthenic the shape of the stomach in the form of a horn, with its high location, with increased motor and secretory ability and hyposthenic - with opposite features (the shape of a siphon, low position, decrease in motor and secretory functions). The connection of these gastric diatheses with pathology is revealed in the fact that persons with asthenic constitution often have prolapse of the abdominal viscera, and they often develop atony of the stomach and its neuroses; hypersthenics are predisposed to acid gastritis and the formation of ulcers in the pyloric part of the stomach and duodenum. In the case of the development of a stomach ulcer in asthenics, it is more often localized in the body of the stomach, on the lesser curvature.

Further, when examining, you need to pay attention to general state patient and his nutritional status. Sudden exhaustion (cachexia) is characteristic of late stages stomach cancer. Great pallor of the patient may indicate a bleeding stomach ulcer.
Inspection digestive organs you need to start with an examination of the oral cavity: teeth, gums, tongue, soft palate and pharynx. The condition of the teeth is especially important, since their lack entails poor chewing of food, and it is one of the reasons pathological changes in the stomach; on the other hand, carious teeth are a source of infection of the digestive organs. Coated tongue with a foul-smelling coating is characteristic of acute diseases gastrointestinal tract; a clean, red, plaque-free tongue is seen with hyperacidity gastric juice and for stomach ulcers.

Examination of the stomach area must be done in good light. It is necessary to inspect the entire abdominal wall in order not to miss an increase in part of the abdomen due to a tumor, a hernia of the white line, etc. It is necessary to offer the patient to breathe strongly with the diaphragm to make sure that one or another part does not lag behind. abdominal wall when breathing, which is an expression of local inflammatory changes in the peritoneum.
Inspection of the stomach should be done in standing and lying positions. Inspection in a standing position gives an idea of ​​the condition of the abdominal wall. With severe flatulence of the stomach, especially an enlarged one, the stomach area is often clearly protruding; in asthenics and with enteroptosis, a sharp retraction of the abdominal wall above the navel and its protrusion and sagging in the area below the navel are observed. A noticeable retraction of the stomach area is also observed with an empty, collapsed stomach, for example, with obstruction of the esophagus or after prolonged vomiting.

In persons with an asthenic physique and poor nutrition (thin abdominal integuments), as well as in persons who are emaciated or have a lethargic abdominal Press when examining them in a supine position, it is sometimes possible to see normal peristaltic movements of the stomach. Pathological is the presence of gross peristaltic movements in the form of shafts, periodically raising the stomach area and observed in cases where there is difficulty in moving gastric contents due to narrowing of the exit from the stomach (scar, swelling, constant spasm). With a slight obstruction, one can see only the contours of the stomach, its respiratory displacements and unclear independent movements. But if the obstacle is significant and there is a consistent hypertrophy of the muscles of the stomach, then peristaltic movements are indicated on the abdominal wall in the form of deep waves going from the left hypochondrium to the right. Thus, the visible peristalsis of the stomach indicates the presence of an obstruction at its exit or in the duodenum. Peristalsis is better expressed when the stomach is full and can be caused artificially by massaging the stomach area or tapping it (especially with a wet towel).

Tumors of the stomach become visible when they reach a "considerable size, and only with a flabby thinned abdominal wall.

Palpation. Method of palpation. In order for palpation of the stomach to give proper results, a number of conditions must be met. It is best to palpate when the patient lies comfortably on a couch or bed with outstretched legs and outstretched arms along the body. During palpation, the patient should breathe deeply and not talk. The abdomen must be completely exposed. The examiner sits to the right of the patient, facing him, on a stool. Palpation in the supine position must be supplemented by palpation in the standing position. Due to the fact that the diaphragm in a standing position descends, the organs lying directly below it, including the stomach, are located lower. This circumstance makes available for palpation those sections of the stomach (lesser curvature, pylorus), which are hidden under the left lobe of the liver when lying down.

For successful palpation, the abdominal wall must be in a state of maximum relaxation, for which it is necessary to palpate with a warm hand. The hand should lie completely flat during palpation. Palpation should be done carefully so as not to cause, especially in sensitive persons, a reflex contraction of the abdominal wall, which prevents penetration into the depths of the abdominal cavity. To relax the abdominal wall, it is also important to distract the patient's attention with a conversation. In order not to draw the patient's attention immediately to the diseased organ, one should not start the study from the stomach, but first systematically feel the rest of the abdomen and thus get an idea of ​​the state of other organs (intestines, liver, spleen).

Palpation of the stomach is performed according to the rules of methodical deep and sliding palpation Obraztsov. The essence of this method is that the examiner with the right hand with the tips of four fingers folded together slightly bent, carefully overcoming the resistance of the abdominal wall, penetrates deep into the abdominal cavity and, if possible, reaches its back wall, which is done gradually with each exhalation of the patient. Then the doctor slides bent fingers along the back wall of the abdominal cavity. Pressed against the back wall of the abdomen, the desired part of the stomach or tumor first slides along the back wall along with the fingers, and then, with further downward movement, due to the maximum tension of the ligaments that strengthen the stomach and its walls, slips out from under the fingers. At the moment of slipping, you need to get an idea of ​​​​the size, shape and consistency of the probed part. It is often possible to obtain clearer data if, having reached the posterior wall of the abdominal cavity with the fingers, the doctor leaves the hand motionless and invites the patient to breathe deeply. The stomach follows the diaphragm, and if the doctor's fingers are at the right level, the greater curvature of the stomach or the pylorus passes up and down under the fingers. Thanks to this technique, it is often possible to feel the greater curvature of the stomach, and sometimes the pylorus.

Under normal conditions pyloric part of the stomach covered by the left lobe of the liver and therefore often not amenable to palpation. Nevertheless, the pylorus is often somewhat lower than the liver, and then it is palpated behind the right abdominal muscle to the right of the spine, below the edge of the liver. In healthy people, the pylorus is not always palpable in the form of a cylinder as thick as a thick pencil, sometimes clearly felt (contraction), sometimes suddenly disappearing and rumbling during palpation (relaxation). Such periodic contraction and relaxation of the pylorus, as well as its detection above the lower border of the stomach and palpation only for a short distance, make sure that the palpable formation is a pylorus, and not a transverse one. colon. In the event of any pathological process in the pylorus (ulcer, neoplasm, scar), it physical properties are changing. With spasm of the pylorus, its consistency is denser. Palpation of the pylorus is easier when the stomach is lowered. In these cases, it is sometimes possible to palpate a small curvature.

Feeling the greater curvature is performed as follows: the palpating hand methodically, step by step, feels epigastric region to the navel, and if necessary, then lower, until he feels the roller lying on the spine and at a certain distance (10-12 cm) on the sides of it - this is a large curvature; when probing it, it is sometimes possible to hear a special sound resembling a rumbling. Large curvature in healthy people is palpable quite often.

In addition to determining the position of the greater curvature of the stomach and the pylorus and their features, palpation of the stomach area aims to determine the localization and degree of pain, tension in a certain area of ​​the abdominal wall muscles and the presence of tumors.

Dull pain on palpation The area of ​​the stomach is observed in various diseases of this organ and therefore does not have a certain diagnostic value. But superficial pain limited over any part of the stomach indicates irritation of the peritoneum and is observed, for example, with an ulcer and in some cases of stomach cancer, when the process comes close to the serous cover.

With a stomach ulcer in 30-40% of cases, it is possible to detect the presence of limited areas near the spine, sharply painful when pressed, the so-called pain points. The most typical points are:

1) in the area of ​​the body of the X-XII thoracic vertebrae (Boas's points); pain to the left of the vertebrae indicates the localization of the ulcer on the lesser curvature, pain to the right of them indicates a pyloric ulcer or duodenal ulcer;

2) in the region of the transverse processes of the III lumbar vertebra (Herbst's points);

3). in the region of the spinous processes of the VII-X thoracic vertebrae (Openhovsky points).

Sensitivity and especially the contraction of the abdominal muscles during palpation are of great diagnostic value. This symptom (defense musculaire), which, according to Mackenzie, is an expression of the visceromotor " protective reflex”, is observed at inflammatory processes in limited areas of the peritoneum or in diseases of the stomach itself (gastric and duodenal ulcers).

Concerning palpation of stomach tumors, then tumors emanating from the cardial part of the stomach are almost never palpable. Tumors of the gatekeeper are probed much more often. Tumors of lesser curvature are palpable only in cases of fairly significant spread down the surface of the stomach or with a strongly lowered stomach. It is easier to feel the tumor of the pylorus or lesser curvature in a standing position. In addition to the presence of a tumor, during palpation, attention is drawn to the degree of its displacement of the spine, both due to excursions of the diaphragm and produced by the hand of the examining physician. Palpation displacement of gastric tumors is small, and associated with breathing depends on the relationship of the tumor to neighboring organs and on the condition of the stomach.

Percussion. Percussion of the stomach aims to determine the position, size and shape of it. But this method does not give any practically valuable results, since the stomach is surrounded by organs that also contain gas. Therefore, the tympanic percussion sound of the stomach can be difficult to distinguish from the tympanic sound of the intestine. Most often, however, tympanitis of the stomach has a lower tone than tympanitis of the surrounding parts of the intestine, primarily transverse colon, but it may be higher, it may be the same.

Determination of the boundaries of the stomach. Percussion of the stomach is usually performed with the patient in the supine position and requires the use of very quiet percussion. Percussion is performed along the midline of the body from above, starting with hepatic dullness, down, then along the left nipple line, also from top to bottom. Thus, the upper percussion border of the stomach is determined. The left border (percussed along the left costal arch from the inside outward) is usually located on the anterior axillary line, the right one does not go beyond the right parasternal line, and the lower border along the midline is 2-3 cm above the navel. For more exact definition the lower border of the stomach, if it is empty, give the patient to drink 1 - 2 glasses of liquid; then dullness may appear along the lower border.

A significant and more or less persistent change in these percussion borders of the stomach, i.e., the part of the stomach that is not covered by other organs and directly adjacent to the anterior wall of the abdominal cavity, in one direction or another may indicate an increase or decrease in the volume of the stomach. However, due to the difficulty and unreliability in these conditions, conventional percussion is more often used to determine the boundaries of the stomach, mainly the lower one, special methods - the method of "percussion palpation", or succussion, and the method of "auscultatory percussion", or percussion auscultation.

Of greater importance is Mendel's percussion, which is used to determine the sensitivity of the abdominal wall. It is produced with a percussion hammer or middle finger. right hand. They hit the upper parts of both rectus abdominis muscles with jerky blows, and in pathological cases (fresh gastric or duodenal ulcer) at the site of impact, pain, sometimes sharp, is obtained. Cause of pain in this case is hypersensitivity parietal sheet of the peritoneum in a place corresponding to the diseased organ (Makenzie's viscerosensory reflex).

Succussion. With the help of shaking the stomach area and getting splash noise, you can determine the size of the stomach and the state of the tone of its wall. This method was first proposed by Obraztsov, who called it "percussion palpation". The splashing noise is caused in the patient's supine position as follows: pressing the epigastric region with the left palm or forcing the patient to stick out the stomach somewhat (pushing air from the upper part of the stomach to the lower ones), produce short jerky blows with bent and divorced four fingers of the right hand, without tearing it off the skin. ; in this way they reach the surface of the liquid in the stomach through the covering layer of air, and cause its splash, audible at a distance.

Splash noise is defined from top to bottom, starting from xiphoid process; the lowest point where splashing noise is still heard is the lower border of the stomach. The normal border of this splash does not go beyond the line connecting both upper spines of the iliac crest (linea biiliaca). This method makes it easy to determine the lower border of the prolapsed stomach.

In addition to the size of the stomach, splash noise makes it possible to determine its tone. At healthy person on an empty stomach and 7-8 hours after eating, splash noise does not work. Its presence on an empty stomach should be considered pathological; it occurs with stasis of the contents of the stomach, for example, with narrowing of the pylorus, or with increased secretion of the stomach. On the contrary, the inability to get the noise of the splash of the stomach a short time after eating (1-3 hours) may indicate an increase in motor function stomach and its rapid emptying, for example, with achilia. With the expansion and atony of the stomach, splashing noise can also occur spontaneously with rapid movements and a rapid change in the position of the patient's body.

Auscultation. Normal auscultation of the stomach plays almost no role. Of some value is the method of auscultation, combined with simultaneous palpation of the stomach, which makes it possible to determine the size and position of the stomach. The essence of this method is as follows: a stethoscope is placed on the stomach, and simultaneously with listening, a finger is drawn along the abdominal wall from the stethoscope in all directions; while the palpating finger is over the stomach, rustling sounds are heard in the stethoscope; as soon as the palpating finger crosses the border of the stomach and hits another organ, these rustling sounds disappear.

The general condition of patients with irritable bowel syndrome is usually good and does not correspond to numerous complaints. The nature of complaints is changeable, there is a connection between the deterioration of well-being and psycho-emotional factors.

The main complaints are abdominal pain, stool disorders and flatulence. Irritable bowel syndrome typically has no symptoms at night.

The symptoms of irritable bowel syndrome are extremely varied. The most characteristic symptoms are the following:

Abdominal pain - observed in 50-96% of patients, they are localized around the navel or in the lower abdomen, have different intensity (from slight aching to very pronounced intestinal colic). As a rule, pain decreases or disappears after defecation or gas discharge. Pain in irritable bowel syndrome is caused by nervous regulation motor function of the colon and hypersensitivity of intestinal wall receptors to stretching.

A characteristic feature is the occurrence of pain in the morning or daytime hours(when the patient is active) and subsides during sleep, rest.

Violation of the stool - observed in 55% of patients and is expressed in the appearance of diarrhea or constipation. Diarrhea often comes on suddenly after eating, sometimes in the morning. The absence of polyfecal matter is characteristic (the amount of feces is less than 200 g per day, often it resembles “sheep”). The stool often contains mucus. Intestinal mucus is composed of glycoproteins, potassium and bicarbonates and is produced by goblet cells. Increased mucus secretion in irritable bowel syndrome is due to mechanical irritation of the large intestine due to a slowdown in the transit of intestinal contents. Many patients feel incomplete emptying intestines after defecation. Often the urge to defecate occurs immediately after eating, which is associated with the stimulating effect of gastrin and cholecystokinin on the motor-evacuation function of the intestine. This is especially pronounced after eating fatty and high-calorie foods. It is possible to alternate diarrhea and constipation: in the morning the feces are dense or in the form of lumps with mucus, several times a half-formed stool during the day.

Flatulence is one of characteristic features irritable bowel syndrome, usually worse in the evening. As a rule, bloating increases before a bowel movement and decreases after it. Quite often, flatulence has a local character. The combination of local flatulence with pain leads to the development of characteristic syndromes. BUT. V. Frolkis (1991) identifies three main syndromes.

The splenic flexure syndrome is the most common. Due to anatomical features(high location under the diaphragm, sharp corner) in the splenic flexure in patients with irritable bowel syndrome and motor dysfunction, favorable conditions are created for accumulation stool and gas and development of a syndrome of a splenic bend. Its main manifestations are as follows:

• feeling of fullness, pressure, fullness in the left upper section abdomen
• pain in the left side chest, often in the region of the heart, less often in the region of the left shoulder;
• palpitations, a feeling of lack of air, sometimes these phenomena are accompanied by a feeling of fear;
• the appearance or intensification of these manifestations after eating, especially plentiful, stool retention, exciting situations and a decrease after passing gases and defecation;
• bloating and severe tympanitis in the region of the left hypochondrium;
• accumulation of gas in the area of ​​​​the splenic flexure of the colon (detected by x-ray examination).

Hepatic bend syndrome - manifested by a feeling of fullness, pressure, pain in the left hypochondrium, radiating to the epigastrium, in right shoulder, the right half of the chest. These symptoms mimic the pathology of the biliary tract.

Cecum syndrome - occurs frequently and simulates the clinic of appendicitis. Patients complain of pain in the right iliac region, radiating to the region of the right abdomen; the intensity of pain may gradually increase, however, as a rule, it does not reach such severity as with acute appendicitis. Patients are also concerned about the feeling of fullness, heaviness in the right iliac region. On palpation of the abdomen, pain in the region of the caecum is determined. A. V. Frolkis (1991) indicates that abdominal massage in the region of the caecum and palpation towards the colon ascendens contribute to the movement of chyme and gas from the caecum to ascending division large intestine and bring significant relief to patients. Palpation of the area of ​​the ascending colon towards the caecum can cause a significant increase in pain (usually with insufficiency of the ileocecal sphincter).

Non-ulcer dyspepsia syndrome - observed in 30-40% of patients with irritable bowel syndrome. Patients complain of a feeling of heaviness and overflow in the epigastrium, nausea, belching with air. These symptoms are due to a violation of the motor function of the gastrointestinal tract.

Severe neurotic manifestations are quite common in patients with irritable bowel syndrome. Patients complain of headaches (reminiscent of a migraine), a feeling of a lump when swallowing, dissatisfaction with inhalation (a feeling of lack of air), and sometimes they are worried about frequent painful urination.

Spastically reduced areas of the large intestine (usually the sigmoid colon) - are detected by palpation in many patients (the term "spastic colitis" was often used to refer to this condition).

Abdominal pain on palpation. AV Frolkis (1991) describes three situations that may occur during palpation of the abdomen in patients with irritable bowel syndrome.

1. the situation is palpatory soreness of the abdomen of a neurotic type. It is characterized by diffuse palpation sensitivity of the entire abdomen, both during palpation along the intestine and outside it. During palpation, inappropriate behavior of the patient is possible, even slight palpation of the abdomen causes pain, sometimes patients scream, they have tears in their eyes (especially in women). In some patients, there is marked sensitivity to palpation of the abdominal aorta.
2. situation - pain on palpation of the entire colon.
3. situation - palpation determines the sensitivity of individual segments of the intestine, mainly descending sections.

When diagnosing diseases of the gastrointestinal tract, palpation of the intestine is performed. This method allows you to put provisional diagnosis and determine the presence of pathology. When palpating, the localization of symptoms and the degree of pain are detected, the doctor determines the temperature and the presence or absence of seals, checks the general condition of the internal organs, the appearance of the abdomen.

When are they assigned?

It is prescribed in the presence of complaints in the patient in the abdomen. Acute or persistent attacks of pain, delayed or upset stool, gas formation, suspicion of a cyst or tumor, and other pathologies are indications for a primary external examination of the peritoneum. Palpation - main method in the detection of pathological changes in the abdominal cavity and abdominal organs. After an external examination, the doctor prescribes additional tests based on a preliminary conclusion.

Types of palpation

It is divided into 2 types: approximate and deep. First, the doctor conducts an approximate examination, and then proceeds to deep palpation. This pattern of inspection is concretely defined and unchangeable. The doctor moves from one examined organ to another in the required sequence. If the patient has severe abdominal pain, the doctor is very careful when applying pressure. It is carried out on an empty stomach, after emptying the intestines.

Approximate palpation

With its help, the doctor determines the body temperature, the state of the peritoneum - asleep or inflated. Soreness and the location of tense organs, muscle tone, and the level of sensitivity are felt. The procedure is performed with the patient lying down, limbs extended along the body. The patient's breathing is deep and even. The doctor on the right puts his hands on the patient's abdomen and lets him get used to his hand. Superficial palpation is performed with both hands.

In a normal state, the surface of the abdominal cavity does not hurt, it is soft, healthy mobility of organs is felt. With pathologies in the place where the disease is localized, the muscles are tense, involuntary resistance to pressure is felt. With a bulging or protruding anterior wall of the abdomen, the doctor determines the cause of this condition using approximate palpation.

Upon completion of the initial palpation, the doctor proceeds to a deep examination. Using this method, pathologies of internal organs, muscle tissues and the anterior inner wall of the abdomen are determined. In the presence of pathologies, neoplasms, tumors, hematomas and swellings are probed. Such a detailed examination allows you to assess the state of the location of the organs, their displacement. Feeling the hollow organs, the doctor pays special attention to the nature of the sounds - their absence means that the organ is healthy.

When discovered painful swelling or a cyst, its size, location, shape, density, level of pain and other characteristics are determined by palpation. Particular attention is paid to sounds - rumbling, noise, splashing. The technique of the method is complex, probing is carried out, starting from left to right, from bottom to top. The wall of the abdominal cavity with a thick fat layer, swelling or with developed muscle tissue is an obstacle to a full examination.

Technique

Palpation is carried out when the patient lies on his back, arms and legs are extended along the body, breathing is deep and even. The doctor sits to the right of the patient, his hands are dry and warm, the room is warm and quiet. Right wrist puts on left side iliac abdominal region of the patient, making light pressure with straight 4 fingers. This method assesses the tone and degree of muscle tension. The brush moves to the right, and then up to the epistragia, also first to the left, and then to right side abdomen through the intestines.

The technique of deep palpation is carried out according to the Strazhesko-Obraztsov method. With its help, the condition of the internal organs and the peritoneum is examined. This palpation is also called sliding and methodical, because the state of the organ is felt at the moment when the researcher's hand slips off it. There are strictly prescribed rules in which order the abdominal organs are examined.

Sigmoid colon

During probing, the surface condition, mobility, intestinal diameter and other characteristics are determined. If the organ is healthy, the intestine is felt as a dense smooth cylinder; when pressed, there are no pain symptoms It slips easily under your fingers. If rumbling is heard, this is a sign of gas formation and fluid accumulation, which usually happens with inflammatory processes. Probing causes pain. At malignant formations or constipation, the bowel feels hard, immobile, and enlarged.

Examination of the caecum

In the groin area, where the navel and ilium are connected, a skin fold is formed with the hands and the caecum is felt with a sliding movement from the navel to the upper part of the ilium. In 80% of cases, the procedure is successful. A healthy gut feels like a smooth, pear-shaped cylinder. Pain and a strong rumbling when pressed indicate inflammation. The mobility of this intestine should normally not exceed 3 cm. If the range is greater, there is a risk of volvulus and obstruction.

1. Ulcer - damage to several layers of the organ wall;
2. Gastritis - inflammation of the mucous membrane, bacterial, stress, fungal, eosinophilic, viral, atrophic;
3. polyps;
4. epithelial atrophy.

• Constipation, indigestion, overeating, overwork, tension in the abdominal muscles, allergies, stress, trauma;
• Angina, pneumonia, acute viral infections;
• Inflammation of the appendix;
• Infection of the urinary organs;
• Psychological stress in children conflict situations, fears, nervous strain.

Numerous diseases have a wide range of clinical manifestations.

Common symptoms of stomach disease

The most common symptoms of stomach problems:

1. Belching;
2. Appetite disorder;
3. Pain syndrome;
4. Heartburn;
5. intestinal pathology;
6. Vomit.

Heartburn is manifested by a burning sensation behind the sternum due to increased acidity. Symptoms are aggravated after taking salty, bacon, sweet, smoked food.

Pain syndrome of the epigastric region - a specific symptom inside gastric disorders. Nosology radiates under the left side, intensifies after eating. If after eating, gastritis or peptic ulcer can be suspected.

Belching occurs after digestion. It is provoked by reflux of bile, hyperacidity, inflammation of the gastric wall.

Appetite disturbance is manifested by an increase, decrease or increased peristalsis.

Nausea and vomiting occur with reflux gastritis, insufficiency of the cardia, increased bowel movement. Specific symptoms of nosology - white or yellow coating on the tongue.

Rare signs of stomach problems

Rare signs of intestinal disorders:

1. Intense thirst provoked by excessive activity smooth muscle, insufficiency of the pylorus, cicatricial stenosis of the pyloric department;
2. Belching of eaten food that occurs 1-2 hours after eating;
3. Belching sour, bitter, with a putrid odor. Bitterness appears in people with pathology of the biliary system, high acidity, intragastric fermentation.

Similar symptoms are observed in cancer, so when the above disorders appear, a thorough diagnosis should be carried out.

Perversion of appetite is seen in cancer education. The disease is aggravated after eating fatty meat.

Prolapse of the stomach (gastroptosis): symptoms and treatment

Prolapse of the stomach is called gastroptosis in medical terms. The disease is more common in representatives strong half. In men, the stomach hurts more often due to the abuse of bad habits (alcohol, smoking). There are cases of organic damage to the organ wall in people with asthenic physique after frequent stress, nervous experiences.

Symptoms of gastric prolapse in women are due to genetic causes, obesity, overconsumption food. The most common etiological factor in the disease is weakening of the ligamentous apparatus of the gastrointestinal tract.

severe weakness abdominal wall musculature is noted during pregnancy, after labor, surgical removal of the tumor, inflammatory descent of the diaphragm, vitamin deficiency, starvation.

The main symptoms of gastroptosis

There are three stages of gastroptosis. At each degree, the stomach hurts specifically.

The first stage of prolapse is characterized by only a slight feeling of heaviness of the epigastrium, a periodic burning sensation behind the sternum. It is problematic to identify nosologies according to these signs.

The second stage of the disease is determined by the following features:

• unstable appetite;
• Craving for spices;
• Aversion to dairy food;
• Periodic nausea;
• Bloating (flatulence).

Symptoms of stomach disease against the background of prolapse are manifested by slowing down peristalsis, bending of the transverse colon, and intestinal obstruction.

The third stage of gastroptosis is manifested by severe pain in the lower abdomen. Pathology increases with a rapid change in the position of the body. The clinical picture is facilitated when the patient is in a horizontal position.

There is a special type of nosology - constitutional gastroptosis that occurs with neurotic disorders. The pathology of the autonomic nervous system can be determined by the following signs:

1. Dermographism of the extremities;
2. Profuse sweating;
3. Increased irritability;
4. Rapid heartbeat;
5. Circulatory disorders.

Hypotension occurs pathogenetically with gastric prolapse. With it, there is a decrease in the secretory activity of the organ. Simultaneously with gastroptosis, the liver is often formed. Emptying the gastrointestinal tract relieves the symptoms of the disease. When lowered, the stomach acquires a vertical state. Muscle stretches, so the greater curvature and the pylorus increase in size.

Palpation of the stomach with gastroptosis is not palpable. Contrasting x-ray examination shows the vertical position of the organ, stretching, displacement of the pylorus.

The 3rd degree of prolapse is manifested by vomiting, which has the following features:

• Aggravation after chemical irritation: arsenic poisoning, use of cardiac glycosides (digitalis);
• Gag reflex after pylorospasm (functional narrowing of the pylorus) after 3-5 hours on the background of food intake;
• Vomiting after organic narrowing of the pylorus cancerous tumor, scar, ulcerative defect of lesser curvature.

The vomiting syndrome intensifies against the background of inflammation of the peritoneum, inflammation of the renal pelvis, irritation of the sensitive nerves of the intestine during colitis.

When diagnosing the disease, the following manifestations should be considered:

1. Time of onset;
2. Volume of vomit;
3. Acidity.

Vomit may contain impurities of pus, bile, blood. Qualitative and quantitative composition of vomit allows you to identify the nature of the disease.

Treatment of gastroptosis: folk and drug

The first step in the treatment of gastric prolapse is diet. The patient's diet should be high-calorie, portioned, include foods with low content fats. If necessary, doctors recommend special drugsconsisting exclusively of plant materials with a choleretic effect.

If desired, the diet is supplemented with fiber, laxative products. Patients are engaged in physical therapy, lead an active lifestyle. To increase the effectiveness of therapy, a special massage is prescribed. With severe gastroptosis, it is recommended to wear a bandage, water aerobics is useful.

Classes are held lying on the floor or on the couch. Gymnastic exercises are performed exclusively on a solid foundation. In this position, the stomach assumes a horizontal position. The rhythm of movements is calm. Intense physical activity in nosology is contraindicated. The final stage of the dietary treatment of the disease is a relaxing massage of the abdomen.

If the cause of gastroptosis is fast weight loss, it is rational to gain additional kilograms. The physiological amount of fatty tissue creates a special bed for the stomach.

During pregnancy, prolapse of the stomach occurs when large fruit, toxicosis, the presence of fluid inside the abdomen. After childbirth, the pathological symptoms disappear. The danger is only a sharp loss or rapid weight gain by a woman.

Why does my stomach hurt during pregnancy?

During pregnancy, the stomach hurts with the following diseases:

1. Gastritis with gestosis;
2. Toxicosis;
3. intestinal constipation;
4. Ulcer;
5. Increased acidity;
6. Frequent drug use.

Pathological sensations are provoked by the use of homeopathic remedies. Uncontrolled use of drugs enhances the pathological course of stomach disease.

A specific manifestation of nosology in pregnant women is epigastric pain. To identify the disease, you need to carefully study the patient's history. There are specific signs of gastric disorders:

• Increasing pain after eating;
• The severity of the epigastrium;
• Belching sour;
• signs;
• Increased epigastric pain after stress;
• Relationship of symptoms to diet;
• Exacerbation on the background of allergies.

During pregnancy, signs of gastric disorders appear against the background of toxicosis, congestive changes in the intestine.

Symptoms of gastric pathology in pregnant women

In most cases, symptoms gastric pathology during pregnancy are not acute. Sudden onset, rapid flow. Pathology appears with severe toxicosis, the threat of miscarriage, severe nervous stress.

Diagnosis is difficult due to the similarity with the pain syndrome of the gastrointestinal tract. Initial stages pathologies are characterized by unpleasant sensations below the navel, pain syndrome of the sacro-lumbar zone.

Diseases of the stomach during pregnancy are not characterized by severe pain. Common symptoms of stomach disease:

• Vomit;
• Diarrhea;
• blood in stool;
• Depression;
• Fatigue;
• lethargy;
• Deterioration of well-being.

During pregnancy, the stomach hurts not only in the epigastrium. Gastric pain syndrome is localized behind the sternum, on the left, at the top of the abdomen. There are unique forms that doctors consider to be other diseases. For example, sometimes there is a pathological form with irradiation of pain sensations to the right iliac region. Pain syndrome localized at the projection site of the appendix suggests appendicitis. An erroneous diagnosis leads to an emergency termination of pregnancy due to the danger of acute peritonitis.

Treatment of gastric disease in pregnant women

Treatment of gastric disease of pregnant women with folk and conservative means possible only after consultation with a qualified specialist. Sometimes doctors prescribe homeopathic remedies, but such treatment of stomach disease during pregnancy is fraught with serious problems.

When carrying a child, diet therapy helps to eliminate diseases of the stomach:

• Exclude spicy, fried, salty, smoked foods;
• Fractional nutrition;
• Eat cookies or bananas in the morning and evening.

Exist serious reasons gastric disease, which can be eliminated only by conservative drugs. The stomach against the background of viral or bacterial infections hurts a lot. Vomiting often occurs during pregnancy, so inflammation should be treated in a timely manner. Conservative treatment against the background of gestation, it requires taking into account the danger of medications on the health of the child.

Constant pain in the lower abdomen during pregnancy requires immediate diagnosis, adequate therapy.

Be attentive to gastric diseases in order to prevent unwanted complications or even fatal outcome. During pregnancy, you should take care not only of your health, but also do not forget about the condition of the fetus. Symptoms of stomach disease are not safe enough to delay treatment.

Gastralgia (stomach pain)- cramping pains in the stomach that occur with diseases of the stomach itself, as well as with autonomic neuroses and some other diseases. Pain in the stomach, as a rule, is felt in the 4th left intercostal space.

The stomach, located above the horizontal line passing through the navel, under the costal arch of the chest (this place is called the epigastric region).

What diseases cause stomach pain

1. Intensity of stomach pain.
The intensity of gastric pain in diseases of the stomach can be different. In patients with chronic gastritis, pain in the stomach is not very intense. Therefore, the patient may not pay attention to it for a long time. A little intense pain can also be observed with gastric ulcer, with stomach cancer. However, with gastric ulcer, and especially with duodenal ulcer, the pain is severe, sometimes very severe, forcing the patient to immediately take measures to alleviate the condition. With a perforated ulcer, the intensity of pain is so high that the patient may develop pain shock. In patients with duodenitis, the intensity of pain can also be very significant. It is difficult to judge the nature of the disease by the intensity of pain, since this characteristic of pain is largely determined by the individual, personal perception her. It has been noted that in patients who have undergone gastric surgery, the intensity of pain, even with an exacerbation of peptic ulcer, may not be large. In these patients, with an exacerbation of peptic ulcer, pain may be absent altogether.

2. Character of gastric pain.
The nature of gastric pain in diseases of the stomach may indicate not only a particular disease, but also the presence of complications. So the appearance of stubborn burning pain in patients with gastritis, peptic ulcer may indicate the addition of solarite. In patients with chronic gastritis with reduced secretion, heaviness, a feeling of fullness in the epigastrium are usually noted. A feeling of fullness in the epigastrium also appears with pyloric stenosis. The cause of intense pain in these patients will most likely be the addition of cholecystitis, pancreatitis, colitis. In patients with chronic gastritis with preserved secretion, the pain is often dull, aching in nature. With gastric ulcer, the nature of the pain is usually the same, but it can also be cramping, sharp. Intense cutting, stabbing, cramping, sucking pain is characteristic of duodenal ulcer and exacerbation of chronic duodenitis. "Knife" pain occurs when the ulcer is perforated.

3. Causes of stomach pain.
This characteristic of the pain syndrome has a very important diagnostic value. First of all, it is necessary to pay attention to the relationship of pain with food intake and with the character food taken. In chronic gastritis, the early onset of pain is usually noted - almost immediately after eating, especially if the food is rough, sour. With gastric ulcer, the same pain occurs after eating, but no later than 1-1.5 hours after eating. With an ulcer of the pylorus canal, pain appears 1-1.5 hours after eating. With the localization of a peptic ulcer in the duodenum, late pain usually occurs - later than 1.5-2 hours after eating. However, this characteristic is closely related to the quality of the food taken. Food with a high alkaline buffering capacity (boiled meat, dairy products, except for sour-milk products) causes a later onset of pain. Coarse plant foods, vegetable marinades, brown bread, canned food cause an earlier onset of pain. The so-called early pains can cause the patient to fear eating. Patients begin to refuse food. A different picture is observed in patients suffering from duodenitis, duodenal ulcer. Their pain is “hungry”, nocturnal in nature and is relieved by taking liquid (milk) or soft (porridge, mashed potatoes, minced meat or fish) food, taking soda.
In addition, the appearance of gastric pain can be associated by the patient with the performance of physical activity, neuropsychic overload. Patients with duodenitis and peptic ulcer disease sometimes associate the appearance of pain with these causes, and not with food intake.
Patients suffering from stomach cancer often cannot associate the appearance of pain with any specific causes.

4. Factors that increase stomach pain.
They often coincide with the causes of pain. In diseases of the stomach, as mentioned above, the pain is usually not constant. Therefore, the reasons for the increase in pain are discussed only when the pain is permanent.

The main causes of stomach pain:
1. Gastritis.
Allocate:
- Bacterial gastritis (not so long ago, a microorganism - Helicobacter p., which, settling in the stomach, causes a number of disorders, has become a common cause of gastritis).
- Acute stress gastritis (stress of various etiologies, severe injuries, diseases).
- Erosive gastritis (from prolonged use drugs, alcohol, spicy food etc.).
- Viral, fungal gastritis (we should talk about a decrease in immunity).
- Eosinophilic gastritis (due to allergic reactions), but there are other significant factors
- Atrophic gastritis (thinning, atrophy of the gastric mucosa, etc.).
2. Peptic ulcer of the stomach and / or 12 duodenal ulcer.
3. Cancer of the stomach.
4. Polyps of the stomach.

Other causes of stomach pain:
- Stomach pain can be caused by overeating, indigestion, constipation, physical overwork, or slight tension in the abdominal muscles. It can also indicate a disease or infection, damage or injury, allergies, emotional stress or other unknown factors that remain undiagnosed.
- Stomach pain in combination with cramps, nausea, vomiting or diarrhea may be caused by viral or, less commonly, bacterial infections, the symptoms of which persist for 24-72 hours. food poisoning usually present with stomach pain and diarrhea. Common infections such as pneumonia and tonsillitis can be accompanied by stomach pain.
- Sometimes stomach pain develops in constant pain and tension in the lower abdomen. These symptoms may be caused by appendicitis. In this case, you should immediately consult a doctor.
- Any organs of the gastrointestinal tract: liver, gallbladder, pancreas, as well as urinary system(kidneys, ureters and bladder) and the reproductive system may be infected. Injury to the abdominal organs can cause stomach pain, which goes away as it heals.
- Some people are intolerant to milk, especially its sugar (lactose). When they drink milk, they develop stomach pain accompanied by. Various types of food allergies can cause stomach pain when eating related foods or.
- Sometimes kids try to avoid going to school by saying, "My stomach hurts." Such complaints may have physical and emotional causes. "Schoolphobia" - the fear of school or something else related to school - is commonly thought to be the cause of these complaints. However, no further studies have been conducted to determine the causes of these pains. Stomach pain probably has an emotional origin: fears, quarrels with peers, conflicts in the family are really annoying. These causes deserve attention, appropriate study and possible treatment.

Which doctors to contact if there is stomach pain

Probably not to find a person who has never experienced the symptoms of stomach diseases. This body has a huge load, and if there is a failure in its work, it causes a lot of unpleasant, various symptoms. What are the most common symptoms, how do they manifest themselves in men and women, and what do they mean? When should you see a doctor immediately?

The main symptoms and signs of gastric diseases

If malfunctions occur in the work of the stomach or its defeat occurs, then this is manifested large quantity symptoms. The main signs of stomach disease and the symptoms that may appear are described below. Among the most common are pain, heartburn, loss of appetite, unpleasant belching, bloating, stool disorders, nausea with vomiting, and so on.

Painful sensations

This is perhaps the first and one of the most common symptoms that serious problems have occurred in the work of the stomach. Most often, pain sensations appear in the chest, but they are not always localized and can wander throughout the abdominal cavity, giving to the right or left side. Other pains may appear, which can sometimes be confused with heart pain, tachycardia, dizziness may appear, the patient sweats. The pain can manifest itself strongly, it can be dull, cutting, cramping. Pain appears as a result awkward position, for example. after eating, however, severe acute pain can be caused by a stomach ulcer that has formed.

The appearance of heartburn

Burning in the chest is a common symptom of stomach disease and indicates that the acidity is increased, while there is strong salivation may develop stomatitis. The burning sensation is accompanied by a painful sensation in the esophagus, as if it were burning there, often there is a reflux of the acidic contents of the stomach through the esophagus into oral cavity, this is heartburn with reflux, there is also a strong salivation. At acute attacks the patient has a chest pain, a feeling of pressure, tachycardia, cough, a yellow coating appears on the tongue.

With heartburn, you should not try to overcome the disease yourself, because increased acidity can cause damage to the mucous membrane and cause peptic ulcer. With discomfort and burning sensation, it is better to contact a gastroenterologist, who, having identified the cause of the disease, will determine the list of medications. If the body does not leak serious pathologies, then the diet will help get rid of the burning sensation without the use of medications.

Problems with appetite and taste

Often diseases of the stomach are accompanied by a change taste sensations patient, often there is a bad taste in the mouth with bad smell. The tongue of the patient is covered with a thick coating of yellow or gray color which is difficult to remove. These spots on the surface of the tongue are the cause of changes in taste buds and the appearance of bad breath, and a complication such as stomatitis can also occur. With diseases of the stomach in men and women, appetite and interest in food disappear. More often this happens when the acidity in the stomach is lowered. Food in this case is poorly digested and evacuated from the stomach. This causes pathological processes of fermentation, gas formation, anemia develops, dizziness, tachycardia.

Loss of appetite may be evidence of the presence of a malignant neoplasm in the organ, a malfunction of the pancreas. Painful sensations with an ulcer can cause the patient to refuse to eat food, since its entry into the stomach causes acute pain. It is worth alerting if the patient has a complete aversion to meat products. The fact is that a disease such as stomach cancer can cause an aversion to certain foods, in particular, meat. If the patient has such a symptom and has pain in the stomach, it is urgent to visit the hospital.

The occurrence of belching

Belching in itself is not dangerous and is common. physiological process. However, if severe belching torments, it brings discomfort and pain, causes coughing, then this is evidence of the course of pathological processes in the organs of the gastrointestinal tract. It is worth alerting those whose belching is accompanied by an unpleasant odor rotten eggs, which is a consequence of the breakdown of proteins. Most often, the rotten smell of eggs occurs during the development chronic gastritis, with problems with timely emptying of the stomach, the work of the pancreas. If such an eructation occurs in the morning, it is safe to say that the patient develops pyloric stenosis. If belching is accompanied by bitter or sour taste accompanied by salivation, this is evidence of increased acidity and ingestion.

Nausea, vomiting

Nausea is a faithful companion of all diseases of the gastrointestinal tract:

1. With the development of pyloric stenosis, most often vomiting appears some time after eating, in addition, the patient may develop a stomach ulcer, profuse salivation and of hydrochloric acid.
2. Organic damage to the pylorus is accompanied by vomiting at night, in the evening. In this case, vomit may have a different taste. With a sour taste in a patient, most often hyperacidity, and if the vomit has a putrid taste, then this is evidence of the development of oncological processes in the organ.

If nausea and vomiting reflex often accompany the patient, while the stomach also hurts, anemia develops, in which case this is a reason to visit the doctor. Following the relevant diagnostic measures(tests, instrumental diagnostics), the doctor will make a final diagnosis and prescribe the correct treatment, which will certainly bring relief to the patient.

Treatment of intestinal disorders

In diseases of the stomach, other organs of the digestive system also suffer. Phenomena such as stool disorder, constipation and gas formation are evidence that the organs of the digestive system have failed. With flatulence, pain occurs in the abdomen, it becomes large. Abundant gas formation is a symptom of diseases such as pancreatitis, gastric and duodenal ulcers, inflammation or cirrhosis of the liver, and infectious diseases.

With constipation, a person is not able to empty the intestines in time, which causes the accumulation of feces, as a result of which the patient's symptoms appear with painful and uncomfortable sensations in the lower abdomen. Constipation may indicate the presence of stomach ulcers, cancerous growth in the large intestine, pancreatitis, dysbacteriosis.

During a stool disorder, a person experiences frequent emptying of the stomach, the feces have a liquid consistency, and the emptying process causes pain, streaks with blood can be seen in the feces. Often, an irritated intestine with blood can disturb people who are subject to frequent psychological and nervous stress, during times of stress. At first, it is worth going on a therapeutic diet, and if the stool does not improve, apply medication.

increased thirst

Thirst may indicate the development of hypersecretion, is the cause of insufficient motor activity.

Such a pathology in diseases of the stomach is rare, and indicates the development of hypersecretion, is the cause of insufficient motor activity. During a strong release of hydrochloric acid, saliva is poorly produced, you want to drink heavily, cold water allows you to dilute the gastric contents and bring down the concentration of hydrochloric acid. However, if the patient is sedentary, water cannot be absorbed normally by the stomach, which causes intense thirst may develop stomatitis.

In diseases of the gastrointestinal tract, patients are advised to exercise light medical physical education, since with certain movements the stomach and nearby organs are massaged, which as a result favorably affects both the functioning of the organs and well-being in general. This will alleviate the condition, make the organs work correctly.

intestinal bleeding

Intestinal bleeding is evidence of the occurrence of serious pathologies in the digestive organs. If the blood does not appear immediately and there are no obvious signs, the patient may be tormented by deterioration in health, loss of strength, anemia, dizziness, the patient throws it into heat, then into cold, spots in the form of bruises appear on the body. It is necessary to observe the stool, you can notice impurities of blood and mucus in it, the patient may experience a feeling of pain in the abdomen, diarrhea or constipation.

For diagnosing this disease the patient is referred for fibrogastroduodenoscopy, colonoscopy, intestinal CT, to determine whether there is swelling of the stomach. Based on the conclusion of the diagnostic results, the doctor immediately selects the necessary course of treatment to eliminate bleeding. As you can see, the symptoms of stomach diseases are varied, if at least 2 of the above appear, you should not hesitate to visit the doctor, as some symptoms may be evidence of the development of serious diseases in the body, in which delay is dangerous and risky for life.