Abdominal pain or colic is a feeling of discomfort along with pain in the part of the body between lower chest and pelvis. The abdominal cavity consist various structures like stomach, liver, gall bladder, small intestine, large intestine, pancreas, kidney, cecum, appendix, ureter, spleen and also possesses abdominal muscles. The whole abdomen is divided in to 9 regions which are, right hypochondrium, epigastrium, left hypochondrium, right lumber, umbilical, left lumber, right iliac, hypogastrium and left iliac. A person can feel pain in any of these regions.
Colic is a condition which is referred as severe pain in abdomen, which can be caused due to spasm, distension, or obstruction of any of the hollow viscera present in the abdomen.
Causes of Colic or Pain in Abdomen
The cause of abdominal pain can be varied and depends upon the organ that is primarily affected. It could be due to a problem with stomach, small intestine, large intestine, liver, gall bladder, spleen, pancreas, kidneys, bladder, ovaries, uterus etc. Some of the common cases of pain in abdomen are:
- Gastric ulcers
- Carcinoma stomach
- Chronic gastric impaction
- Meckel’s diverticulum
- Chronic gastric impaction
- Pyloric stenosis
- Mesenteric abscess condition
- intestinal neoplasia (cancer of intestines)
- illial hypertrophy
- Diaphragmatic hernia
- Bowel displacement
- Cecal mucosa hypertrophy
- Colitis (inflammation of large intestine)
- Bowel displacement
- Acute pancreatititis
- Chronic pancreatitis
- Cholelithiasis (gall bladder stones)
- Helminths or intestinal worms
- Pancreatic neoplasia
- Spleenomegaly (enlarged spleen)
- Midmenstrual rupture of ovarian follicle
- Torsion of undescended testis
- Ruptures ectopic gestation
- Torsion of ovarian cyst
- Intraperitoneal neoplasia
- Pericardial abscess
- Urolithiasis (kidney stones)
- Splenic neoplasia
- Intraperitoneal abscess
- Intraperitoneal neoplasia
The most common pathological causes of abdomen pain include
- Peptic ulcer – mucosal ulceration near the acid bearing regions of the gastrointestinal tract, pain characteristically sharply circumscribed to an area about 1 inch in diameter between xephoid and umbilicus.
- Cholecystitis – attacks of epigastric pain with tenderness over gall bladder.
- Carcinoma of pancreas – mid gastric pain, steady and dull or paroxysmal colicky pain
- Carcinoma stomach – daily discomfort along with pain in the abdomen
- Acute appendicitis – severe colicky pain initially felt in umbilical region and after few hours the pain localizes to the right iliac fossa.
- Acute pancreatitis – severe backache and tenderness in the epigastrium
- Irritable bowel syndrome – post prandial type of pain which is related to meal
- Hiatus hernia – causes epigastric pain.
- Abdominal angina – due to chronic intestinal ischemia in which there is post prandial pain usually cramping and radiates to the back.
- Carcinoma colon – pain in the right side below the level of umbilicus
- Bilateral salping – oophoritis – pain in both side of lower abdomen
- Torsion of the ovarian cyst – produces very severe abdominal pain.
- Other causes – include gastroenteritis, meckel’s diverticulitis, intestinal obstruction, ulcerative colitis, porphyria, pneumonia, indigestion, ruptured spleen, ectopic pregnancy, hepatitis, endometriosis, gastritis etc.
Investigations for Colic or Abdominal Pain
The history of pain is most important. The onset, location and type of pain often helps us to decide the possible cause and recommend appropriate investigations.
- Frequency of pain
- Time interval between bouts
- Previous history of colic
- History of abdominal surgery
- Previous drug intake
- Respiratory infections
- History of weight loss
- Examination of gastro intestinal tract
- Examination of other body systems
- Monosaccharide absorption testes
- Fecal analysis
- Urine analysis
- X ray abdomen – to diagnose renal stone, intestinal obstruction etc
- Abdominal CT scan – to evaluate internal organs and tissues, useful to detect tumor infections, renal stones, appendicitis.
- Abdominal MRI – to diagnose abnormal growth tumors
- Abdominal ultrasound – to assess the structures with in the abdomen, used to evaluate gall bladder stone, renal stone, ectopic pregnancy etc.
- Response to treatment
- Diagnostic laparoscopy
- Exploratory surgery
Pain Abdomen Treatment
The treatment of abdominal pain depends upon the underlying cause. The cause needs to be treated to relieve the pain. In conventional medicine for short term relief, antispasmodic, anelgesic, antiflatulent, antihelminths drugs are usually used.
Homeopathy Treatment of Colic or Pain Abdomen
Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat colic or pain in abdomen but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several remedies are available to treat colic or pain in abdomen that can be selected on the basis of cause, sensations and modalities of the complaints. For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. There are following homeopathy medicines which are helpful in the treatment of colic or pain in abdomen:
Aconite – Colic with intense gripping pains across the lower portion of abdomen, with a preference for right side, before and during stool, which is windy and watery; after stool all pain ceases, leaving the patient bathed in sweat and extremely prostrated; painfulness over the whole abdomen, especially along the sides of the navel, which parts cannot endure being touched; on making a false step a pain in stomach; discharge of much flatus, burning, smelling offensive.
Alumina – lead colic; spasmodic pains in hypochondria and stomach, with dyspnoea almost to suffocation, worse when stooping; pressing in both groins towards sexual organs, like from hernia, with tension as far as the side of the abdomen; pains < sitting bent; > from warm applications.
Arsenicum – violent pains in abdomen, with great anguish, has no rest anywhere, rolls about on the floor and despairs of life; abdomen drawn in; pain day and night with but short remissions; constipation; vomiting of clear water or of mucus and bile with the pain abdomen; violent cutting or spasmodic tearing, gnawing pains, frequently with intolerable burning or with feeling of coldness in abdomen; terrible cutting bellyache with frequent thin stools, fainting and cold sweat, often with icy coldness of hands and feet, periodical pain; desire for cold water, but afraid to drink it. Caused by ice-water, ice-cream, bad sausages, cheese, and lead poisoning; Colic after severe burn.
Plumbum – abdominal pain radiating in all direction, walls drawn in; this, however, is not essentially a nervous colic. There are cramps in the legs and obstinate constipation accompanies but, not flatulence. The abdomen is as hard as a stone, sensation as if the abdominal wall were drawn to back by string, better from rubbing and hard pressure. Lead produces one of the most violent colic of any drug and this pain is sometimes difficult to cure.
Belladonna – pain as if a spot in the abdomen were seized with the nails, a gripping, clutching, clawing; violent cutting pressure in the hypogastrium; now here and there; the pains come on suddenly and disappear just a suddenly, standing and walking aggravate the pain; tenderness to slight pressure, but relieved by hard pressure; pod shaped prostration of the colon, with abatement of the pain on bending backward, or making pressure; loud rumbling and pinching in the belly; congestion of blood to the head; thirst, but drinks but little, as drinking aggravates; copper colic. colic of infants is well met by this remedy. The child bends backwards and screams, and the transverse colon protrudes like a pad. There is congestion of the intestine. It is rather enteritis than an enteralgia.
Bryonia – rumbling and gurling in the abdomen, sudden painful cuttings in the intestines; with a feeling as if one were digging in with his fingers, compelling him to bend double, relieved by profuse pasty evacuations; foul flatulence; great sensitiveness of abdomen; has to keep quiet, most easy when lying on affected side or on abdomen; colic, especially during summer heat after a hot day.
Calcarea carb – frequent colic, with weariness and sickly look of face, fully relieved by cold water applications or bathing in cold water; severe spasms in abdomen, especially evenings and at night, with coldness of thighs; feeling of coldness in abdomen; enlargement and hardness of abdomen, particularly in teething children; diarrheic, clay like stools, smelling sour fetid.
Nux vomica – great remedy for abdominal pain due to indigestion; the pain may be in any part of the abdomen, pains are aching cramping, worse after food, and attended with flatulence. haemorrhoidal colic or colic from accumulation of flatus, pressing up and down; spasmodic colic from flatulence. Deep seated hypogastric pain, abdomen hard and drawn in, not distended. Comic from dietetic errors or in brandy or coffee drinkers; pains worse on motion; pains pinching and contractive, gripping as if intestines were rubbed between stones. Ineffectual urging for stool with pain abdomen.
Carbo veg – colic from flatulence, abdomen full to bursting; pinching and pressive pain in lower abdomen; pain worse about bladder of left epigastrium; from least food, from riding in carriage or car, ameliorate from passing flatus or hard stool; sensation of constant downward pressure in abdomen, so that the patient tries to support it with hands or a bandage, relieved from passing flatus upward and downward; belching, tasting sour or rancid.
Dioscorea – pain in the umbilical region; which is continuous and constant; bilious rheumatic and neuralgic colic; regurgitation sour, and bitter belching. Pain is better lying on back or bending backwards.
China – colic from gall-stones; pain in hepatic region, as from subcutaneous ulceration; worse from touch; violent colic, of pinching character, with nausea and thirst, relieved by bending double, returning every afternoon or at night; tympanitic distension of the abdomen or spasmodic constrictive pains with incarceration of flatulence and pressure towards the hypochondria; gastro-duodenal catarrh and pressure of fluids towards severe illness, brought on by eating fruit or drinking new beer.
Cocculus – nervous colic, worse at night, accompanied by flatulence, but discharge of flatus gives no relief, as more is constantly formed. Same pain in right hypochondria, worse bending forward. Constipation is an accompaniment. Menstrual colic, pain in lower part of abdomen with a disposition to relapse. Hysterical colic.
Chamomilla – suits especially pain abdomen in women and children, colic with hot cheeks, red face, and perspiration presiding an attack of intestinal catarrh. Colic from anger, worse from warmth, flatulent colic. There is atony of the digestive apparatus and digestion is at standstill; the neuralgia is peripheral and the abdomen distended like a drum.
Cuprum met – cramps in the abdomen; violent, colicky, drawing-cutting pain in the abdomen; abdomen drawn in; colic not increased by pressure; violent spasms in abdomen and upper and lower limbs; with penetrating distressing screams; intussusceptions of the bowels; violent colic, stercoraceous vomiting, and great agony; spasmodic movements of the abdominal muscles; cramps of the stomach and bowels, with vomiting and purging, and cutting pains in umbilical region as if a knife were thrust through to the back, with piercing screams; abdomen hard as a stone; constipation succeeded by watery, greenish or bloody stool; spasmodic vomiting relieved by a drink of cold water; collapse with great prostration and lack of reaction; pulse soft, moderately frequent; skin warm and dry.
Colocynth– lead colic, cutting in abdomen as from knives, abdomen distended and painful; violent, cutting, constricting, spasmodic pains; with pinching, gripping, cutting, emanating from a central point, often umbilical region, and radiating from there all aver abdomen and chest; sensation as if the bowel were squeezed between stones; the patient doubles up or seeks relief by pressing the belly against the bed-post or any hard object, or by lying on belly. Aggravation from coffee, tobacco smoking, by passage of flatus and by a stool; gastric and abdominal pains aggravate by eating; the pain in abdomen is caused by flatus, anger, cold, undigested food.
Lycopodium – renal colic when right kidney is involved,
Ipecauc – flatulent colic from acids, with frequent loose stools; with every movement cutting almost constantly running from left to right; gripping, as from hand, each finger seemingly sharply pressing in to the intestines; much worse by motion, better during rest; colic of children.
Mag phos – pains are burning and throbbing and are relieved by pressure and warmth. The patient passes wind during the pain; baby folds his legs over his abdomen.
Pulsatilla – colic from cold; with diarrhea, from getting feet wet, from fruits, ices, pastry, flatulent colic evening, after supper, or at night; oppressive flatulence in upper abdomen and hypochondria; shifting of flatus; colic, with nausea, ceasing after vomiting; restlessness; heaviness and fullness of the abdomen, with unpleasant distension; the pains are worse when sitting or lying, with chills; relief by walking. Flatulent colic of hysterical females and colic of pregnant women, accompanied with frequent desire to urinate.