Thursday, May 19, 2022

What Can Cause Chronic Stomach Pain

How Food Allergies Work

Causes & Treatment of Chronic Abdominal Pain In Children | Dr. Mridul Chandra Das

Food allergies involve two parts of your immune system. One is immunoglobulin E , a type of protein called an antibody that moves through the blood. The other is mast cells, which you have in all body tissues but especially in places like your nose, throat, lungs, skin, and digestive tract.

The first time you eat a food you’re allergic to, certain cells make a lot of IgE for the part of the food that triggers your allergy, called an allergen. The IgE gets released and attaches to the surface of mast cells. You won’t have a reaction yet, but now you’re set up for one.

The next time you eat that food, the allergen interacts with that IgE and triggers the mast cells to release chemicals such as histamine. Depending on the tissue they’re in, these chemicals will cause various symptoms. And since some food allergens aren’t broken down by the heat of cooking or by stomach acids or enzymes that digest food, they can cross into your bloodstream. From there, they can travel and cause allergic reactions throughout your body.

The digestion process affects the timing and the location. You may feel itching in your mouth. Then you may have symptoms such as vomiting, diarrhea, or belly pain. Food allergens in your blood can cause a drop in blood pressure. As they reach your skin, they can trigger hives or eczema. In the lungs, they may cause wheezing. All of this takes place within a few minutes to an hour.

What Do Upper And Lower Abdominal Pain Signify

If the pain is coming from higher up in your stomach, it could be caused by acid reflux or an ulcer. You might also have heartburn and belching and the pain may either be made worse or relieved by food.

If you feel pain right across your stomach area or low down, its probably coming from your bowel. You may also have bloating and wind. If your stomach cramps have started recently and you also have diarrhoea, the cause is probably gastroenteritis. If you are very ill for example, with chills or a fever you may have a more serious condition, such as food poisoning.

Which Food Allergies Are Most Common

In adults, they include:

  • Tree nuts, such as walnuts
  • Shellfish, including shrimp, crayfish, lobster, and crab

For children, the food allergens that most often cause problems are:

  • Milk
  • Peanuts

Adults usually don’t lose their allergies, but children do sometimes. Kids are more likely to outgrow allergies to milk, eggs, and soy than to peanuts, fish, and shrimp.

The foods that you’ll react to are often those that you eat regularly. In Japan, for example, you’ll find rice allergy. In Scandinavia, codfish allergy is common.

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Case #4 Nbs In A Woman With Crohns Disease

A 20 year old female with a 16 month history of prescription narcotic abuse for low back pain was receiving methadone 260 mg/day from a pain clinic. She developed constipation and right lower quadrant pain which led to resection of a 6cm right ovarian cystic teratoma. Post operatively the pain and constipation continued and she was discharged from the gynecology service on her previous methadone and also oxycodone with acetaminophen prn for breakthrough pain. She was readmitted to the gynecology service with obstipation. The methadone was tapered to 230 mg/day and she was given enemas and then released. She returned 3 days later with nausea, vomiting, bloating, and right lower quadrant pain that was worse after eating. An abdominal x-ray and abdominal CT scan demonstrated a short segment of terminal ileum thickening and retained colonic fecal material. Narcotics were re-instituted for what was presumed to be pain from the Crohnâs disease and the pain got worse. Colonoscopy showed a non-obstructing terminal ileum that was congested, and ileal biopsies reported mild chronic active ileitis consistent with Crohnâs disease. A small bowel barium study demonstrated approximately 20cm of thickened but non-obstructing terminal ileum with a few proximal skip areas. It was determined by the GI service that although she had Crohnâs disease, the pain pattern was clinically related to the narcotic bowel syndrome.

Centrally Mediated Abdominal Pain Syndrome

Symptoms of Abdominal Pain or Stomach Ache

People with functional gastrointestinal disorders can have a variety of symptoms that range from painless diarrhea or constipation, to pain associated with diarrhea and/or constipation . There is another, less common condition of abdominal pain that is chronic or frequently recurring it is not associated with changes in bowel pattern or with another medical condition. This condition is called centrally mediated abdominal pain syndrome formerly known as functional abdominal pain syndrome .

CAPS is a functional GI disorder. There are no abnormal x-rays or laboratory findings to explain the pain. It occurs because of altered sensitivity to nerve impulses in the gut and brain, and it is not associated with altered motility in the intestines. CAPS is characterized by continuous or frequent abdominal pain that is often severe. It has little or no relationship to events such as eating, defecation, or menses.

For people with CAPS, the pain can be so all-consuming that it becomes the main focus of their life. Not only does it impact quality of life, but it has a major economic impact as well.

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What To Do When Toxic Mold Causes Chronic Stomach Problems

Toxic mold exposure can take you from enjoying an unrestricted diet of your favorite foods to suffering from severe stomach problems no matter what you eat. I have patients who can only eat one or two things without bloating, diarrhea, nausea, vomiting, or other digestive issues.

If you have a history of mold exposure, toxic mold may be responsible for your stomach problems. Thats because mycotoxins, the toxic byproduct of some molds, as well as the immune response to mycotoxins can cause damage to your intestinal lining and harm your gut microbiome, leading to leaky gut. Leaky gut opens the door for a whole host of other health conditions including autoimmune diseases, chronic pain, chronic fatigue, and environmental sensitivities.

Thankfully, with diet and lifestyle changes, its possible to get better. In this article, youll learn how mold causes chronic stomach problems and how you can heal your gut while detoxing mycotoxins from your body so you can reverse the root cause of illness and restore your joy in livingand eating.

The Emotional Toll Of Chronic Abdominal Pain

If you are dealing with functional abdominal pain, likely there are times when you feel alone. You may not know anyone dealing with the same level of pain as you are, and so the support you receive maybe thin.

The problem becomes worse when you visit your general practitioner and they tell you that since they cannot find an identifiable cause for your pain, it is likely that your pain is in your head.

If you have not been able to identify the source of your pain, abdominal pain can affect the way you live. Every bite of food you eat and every beverage you drink builds within you the anxiety that it might be the thing that causes you to have a painful attack. If abdominal pain affects your ability to control your bowels, there is also the stress or frustration that because of the pain you may have an embarrassing moment.

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Key Points About Chronic Tummy Pain In Children

  • Most cases of chronic tummy pain are due to increased pain sensitivity to the movement of food and by-products through the digestive tract. This is referred to as functional abdominal pain.
  • Common functional causes of chronic tummy pain in children are irritable bowel syndrome and functional dyspepsia.
  • Less commonly, an underlying condition may be the cause. Examples of these are coeliac disease and inflammatory bowel disease.
  • If not treated, chronic tummy pain can impact on your child’s wellbeing.
  • If there is an underlying cause, treatment will focus on this. If the pain is due to a functional cause, it can be managed by reassurance and explanation of the source of the pain.
  • Chronic tummy pain in 3050% of children will settle within 6 weeks.
  • Lower Abdominal Pain In Teenage Girls

    Gastroenterology Chronic Abdominal Pain: By Brock Vair M.D.

    A few causes of abdominal pain are specific to teenage girls .

  • Dysmenorrhea : This condition is associated with painful cramps during menstruation and is the most common problem in girls among all age groups. Characteristic symptoms may include pain in the lower abdomen, pelvic pain, pain that radiates to the lower back and thighs, nausea, vomiting, and headache. This pain usually lasts for eight to 72 hours and occurs with the start of the menstrual flow .
  • Mittelschmerz : This pain occurs in the lower abdomen around mid-menstrual cycle and is associated with an increase in luteinizing hormone levels. It is usually felt in the lower right part of the abdomen and the intensity may vary from mild to severe .
  • Endometriosis: The symptoms of endometriosis often start during adolescence. The condition is defined as the presence of endometrial tissue outside of the uterus. It can present symptoms such as back pain, flank pain, nausea, headache, fatigue, and urine urgency .
  • Ovarian torsion: This condition occurs mostly due to ovarian tumors or cysts and can cause acute abdominal pain. The pain usually occurs on one side and right-sided pain is more common than left-sided pain. Other symptoms can include nausea, vomiting, fever, and presence of palpable mass .
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    Is It Really A Food Allergy

    A differential diagnosis is the process of telling the difference between a food allergy, a food intolerance, and other illnesses. When you go to the doctor’s office and say, “I think I have a food allergy,” they have to consider a list of other things that could cause similar symptoms and be confused with a food allergy. These include:

    • Other diseases
    • Psychological triggers

    Foods can get contaminated with bacteria and toxins. Tainted meat sometimes mimics a food allergy when it’s really a type of food poisoning.

    Histamine can reach high levels in cheese, some wines, and in certain kinds of fish, especially tuna and mackerel, if it hasn’t been refrigerated properly. When you eat foods with a lot of histamine, you could have a reaction that looks like an allergic reaction. It’s called histamine toxicity.

    Sulfites are made naturally during the fermentation of wine, and they’re added to other foods to enhance crispness or prevent mold growth. High concentrations of sulfites can pose problems for people with severe asthma. They give off a gas called sulfur dioxide, which the person breathes in while they’re eating the food. This irritates their lungs and can trigger an asthma attack. That’s why the FDA banned sulfites as spray-on preservatives for fresh fruits and vegetables. But sulfites are still used in some foods.

    Yellow dye number 5 can cause hives, although that’s rare.

    What Causes Chronic Pain

    Chronic pain can be caused by many different factors. Often conditions that accompany normal aging may affect bones and joints in ways that cause chronic pain. Other common causes are nerve damage and injuries that fail to heal properly.

    Some kinds of chronic pain have numerous causes. Back pain, for example, may be caused by a single factor, or any combination of these factors:

    • Years of poor posture
    • Improper lifting and carrying of heavy objects
    • Being overweight, which puts excess strain on the back and knees
    • A congenital condition such as curvature of the spine
    • Traumatic injury
    • Sleeping on a poor mattress
    • No obvious physical cause
    • Ordinary aging of the spine

    Disease can also be the underlying cause of chronic pain. Rheumatoid arthritis, osteoarthritis and fibromyalgia are well-known culprits, but persistent pain may also be due to such ailments as cancer, multiple sclerosis, stomach ulcers, AIDS, and gallbladder disease.

    In many cases, however, the source of chronic pain can be a very complex and even mysterious issue to untangle. Although it may begin with an injury or illness, ongoing pain can develop a psychological dimension after the physical problem has healed. This fact alone makes pinning down a single course of treatment tricky, and it is why health care providers often find they have to try a number of different types of curative steps.

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    What Are The Characteristics Of Abdominal Pain

    Abdominal pain may include any of the following, or a combination of these characteristics:

    • cramping
    • bowel obstruction
    • causes of heart pain

    If you are experiencing abdominal pain, the exact location of the pain and any other symptoms you might have may suggest the cause.

    If you feel pain right across your stomach area or low down, its probably coming from your bowel. You may also have bloating and wind. If your stomach cramps have started recently and you also have diarrhoea, the cause is probably gastroenteritis. If you are very ill for example, with chills or a fever you may have a more serious infection such as food poisoning.

    If the pain is coming from higher up in your stomach, it could be caused by acid reflux or an ulcer. You might also have heartburn and belching, and the pain might be made worse, or relieved, by food.

    If the pain is in the middle of your stomach and extends to your back, it could be a sign of gallstones. Pain in the lower right part of the stomach, along with fever, nausea and vomiting, could be appendicitis.

    If the pain is made worse by exercise it could be heart pain. Read more in the chest pain section. If you are experiencing this type of pain, call triple and ask for an ambulance.

    Some medicines, such as aspirin and anti-inflammatory and anti-dementia drugs, can cause stomach pain as a side effect.

    You can find more information about the underlying causes of abdominal pain here.

    Menstrual Cramp Causes And Risk Factors

    Symptoms of Common Stomach and Digestive Problems

    Menstrual cramps happen because of contractions in the uterus, or womb, which is a muscle. If it contracts too strongly during your menstrual cycle, it can press against nearby blood vessels. This briefly cuts off oxygen to the uterus. Itâs this lack of oxygen that causes your pain and cramping.

    You can also have cramps because of:

    • Endometriosis, a condition in which the tissue lining the uterus grows outside of the uterus
    • Fibroids in your uterus
    • Adenomyosis, when your uterine lining grows into nearby muscle
    • Pelvic inflammatory disease , an infection caused by bacteria that starts in the uterus and can spread to other reproductive organs
    • Cervical stenosis, or a narrowing of the lower part of your uterus, caused by scarring, as well as a lack of estrogen after menopause

    Certain things put you at a higher risk of menstrual cramps. Youâre more likely to have them if you:

    • Are under 30

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    Treatment Strategies For Centrally Mediated Abdominal Pain Syndrome

    Given what we currently know about CAPS, the aim of treatment is to help you gain control over your symptoms and improve daily function, rather than totally eliminate symptoms, which usually is not possible.

    One way to start is to keep a diary to record symptom flare-ups, and to identify possible triggers . This kind of information may be used by you or your physician to help develop better strategies to control the symptoms.

    The brain not only affects how you sense pain, it is also able to block pain. Think about the basketball player who sprains his ankle during a game and continues to play without awareness of pain. Then, when the game ends, he collapses to the floor, unable to walk. He was able to block the pain by focusing his attention on the game.

    When nerve impulses travel up from the abdomen to the spinal cord, some of them go through a kind of gate that is controlled by nerve impulses coming down from the brain. These impulses from the brain can block or inhibit pain signals going from the abdomen to the brain by closing the gate. Alternatively, they can increase signals to the brain by opening the gate.

    Because the brain has such a strong influence on the sensation of pain, psychological treatments can relieve symptoms of CAPS by sending signals that close the gate. Different techniques include relaxation, imagery, hypnosis, and cognitive-behavioral therapy.

    Urinary Tract And Bladder Infections

    Urinary tract infections are most often caused by bacteria, primarily E.coli species, that colonize the urethra and bladder, causing a bladder infection or cystitis.

    Symptoms include pain, pressure, and bloating in the lower abdominal area. Most infections also cause painful urination and cloudy, strong-smelling urine.

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    How Can I Treat Abdominal Pain

    If you have abdominal pain, keeping warm and placing a heat pack or hot water bottle on your stomach may help.

    If your abdominal pain does not require you to stop eating and drinking, stay well hydrated by drinking plenty of clear, non-alcoholic fluids. If you have a medical condition that restricts your fluid intake, check with your doctor about how much fluid you can have.

    Eat small meals and – foods such as rice, dry toast or bananas. Avoid spicy foods, alcohol and caffeine until 48 hours after the pain has gone away.

    Several medicines can help if you have non-acute abdominal pain, including:

    • paracetamol to ease the pain
    • charcoal tablets or similar for wind pain
    • medicines to ease spasms
    • medicines to stop diarrhoea

    Avoid aspirin or anti-inflammatory medicines, such as ibuprofen and naproxen since these can irritate your stomach. A pharmacist can advise you about the most appropriate medicine for your abdominal pain.

    In more serious cases, the treatment recommended will depend on the cause and severity of the abdominal pain, and how long you have had it. Treatment may include following a particular diet in the long term getting more exercise taking medicines or having surgery.

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