Stomach cramps is a general term used to describe mild discomfort (stomach ache) to pain (gastric pain) in the stomach. It is usually difficult to isolate the pain as originating from the stomach itself. Often any focal or diffuse abdominal pain is attributed to the stomach (refer to stomach location) but may arise from other parts of the gastrointestinal tract, surrounding abdominal structures or referred from elsewhere in the body.
Although the stomach is a muscular sac, there is no conclusive indication that the pain described as stomach cramps is due to actual spasms of the stomach muscles. Stomach cramp is a subjective term that could be attributed to pain elsewhere in the region.
The stomach muscles are almost constantly active to some degree and this increases substantially when hungry, during and just after eating. The orientation of the different layers of the stomach muscle coupled with its shape means that any muscle spasm of the stomach is less likely to cause as intense pain as an intestinal cramp (small or large intestine).
Symptoms Associated With Stomach Cramps
In most cases, stomach cramps describe a tight, colicky pain which is spasmodic and severe in intensity. Even if it occurs in the area where the stomach is located, it may be due to a number of other causes of left upper quadrant abdominal pain. The term stomach cramps is also used to describe pain that may start when hungry, during or after eating that is located in the left upper quadrant of the abdomen. In addition, other concomitant signs and symptoms may also be present :
- stomach bloating – sensation of fullness
- abdominal distension – abdominal enlargement (bloating, swelling)
- excessive gas – belching and/or flatulence
- burning chest pain – heartburn, acid reflux
- nausea and/or vomiting
Most of these symptoms are broadly encompassed under the term indigestion. If the symptoms are significantly relived by passing stool or gas (flatus) then it is more likely due to pain in the large intestine. Stomach cramps associated with menstruation (during ovulation, prior to onset of menses and during menstruation) then the discomfort may be originating from the fallopian tubes or uterus and not the stomach or gut. In pregnancy, it may also be due to the pain in the uterus, pressure of the enlarged uterus on surrounding structures or even contractions. In early pregnancy it could be due to an ectopic pregnancy or threatened abortion while in late pregnancy it is a common occurrence and could be a sign of impending labor.
Causes of Stomach Cramps
The more common causes of stomach cramps include :
- Inflammation of the stomach lining often related to H.pylori infection or the use of NSAIDs. Dull, gnawing pain that is constant and worse when hungry and after eating.
- Peptic ulcer
- Open sore in the lining of the stomach or duodenum (first part of the small intestine) and sometimes involving the esophagus as well. Pain tends to worsen when hungry, ease slightly with eating and increase again shortly after a meal.
- Gastroesophageal reflux disease (GERD)
- Functional dyspepsia (non-ulcer dyspepsia)
- Symptoms tend to start after eating and are typical of indigestion. No evidence of other gastric or gastrointestinal conditions upon proper diagnostic investigation.
Other causes of stomach cramps may include :
- Food intolerance – lactose, gluten
- Irritable bowel syndrome (IBS)
- Inflammatory bowel disease (IBD) – Crohn’s disease
- Chemical poisoning
- Gastric outlet obstruction
- Stomach cancer
- Zollinger-ellison syndrome
Causes of non-gastric pain (cramps) are discussed under :