Abdominal pain is one of the most common symptoms seen in doctor’s rooms but it is also vague when there are no other accompanying symptoms. Trying to identify the cause of abdominal pain on its own is difficult and often requires additional investigations. However, some characteristics of abdominal pain, like the nature of the pain and location, can help with identifying possible causes.
Most of us use everyday words and non-medical terms to describe pain. To some extent this description can be helpful but it is not always a reliable indicator of the cause. Abdominal pain may be described as cramping, sharp, stabbing, gnawing or as a dull ache. Another possible description is a twisting pain in the abdomen. This is often seen as the same as squeezing pain and may be correlated with a cramping abdominal pain.
Read more on squeezing stomach pain.
Causes of Twisting Pain in the Stomach
The abdomen is often referred as the stomach. This is anatomically incorrect as the stomach is a specific organ in the abdominal cavity. It is located in the upper left quadrant of the abdominal cavity and stomach conditions usually cause pain in this region. However, it is not uncommon a twisting abdominal pain to instead be described as a twisting stomach pain.
There are many possible causes of this type of abdominal pain. It is also important to remember that sometimes the nature of the pain may differ among people with the same condition. Pain is a highly subjective symptom. Therefore one person with a certain condition may experience a stabbing pain while another person with the same condition may report a twisting pain.
Some of the possible causes of a twisting abdominal pain have been discussed below. Pregnant women should always be cautious of labor pains that may sometimes seem twisting in nature towards late pregnancy. Similarly a heart attack that may present with the a constricting or squeezing pain in the chest can in some rare instances present with a twisting pain in the upper abdomen.
Always seek immediate medical attention if the pain is severe, worsening, accompanied by blood loss, dizziness, diffculty breathing or loss of consciousness.
Gastroenteritis and Food Poisoning
These conditions are caused by viruses, bacteria or protozoa, or the toxins produced by the infectious agents. Most of the time it is spread through contaminated food and water. Nausea, vomiting and diarrhea may be accompanied by abdominal pains that are often described as cramping, squeezing or twisting in nature. These pains may at times be relieved by vomiting or diarrhea, but only temporarily.
Food Allergies and Intolerances
Food allergies and food intolerances are two separate conditions despite being triggered or caused by food. In food allergies, the bowel wall becomes inflamed due to abnormal immune activity (allergic reaction) to the presence of certain foods, for example celiac disease. In food intolerances the digestive system is unable to digest certain foods, for example lactose intolerance. Symptoms start a short while after eating the trigger food. Nausea, diarrhea and bloating are other common symptoms.
Any blockage in the bowel can obstruct the movement of food and stool. This obstruction may be partial or complete. There are many ways in which bowel obstruction ariss. First there may be a mass within the bowel that obstructs the lumen. This mass may be an abnormal growth from the bowel wall. It can also be a foreign object that may have been ingested. Sometimes the bowel can become twisted, telescope within itself or become trapped in a hernia.
Secondly a mass outside of the bowel may press against the bowel thereby causing a narrowing and obstruction. This may be seen with an intra-abdominal mass like a tumor or with adhesions around the bowel. Lastly, weakness or paralysis of some of the bowel muscles may prevent food and stool from moving any further. The bowel wall may also distends as food or stool becomes backed up. This is known as a pseudo-obstruction.
Although constipation is more likely to occur with a twisting abdominal pain, sometimes there can be small volume watery diarrhea. Nausea, abdominal distension, a sensation of fullness and sometimes vomiting may also arise.
Read more on bowel obstruction.
Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome (IBS) is a functional bowel disorder where there are episodes of abdominal cramps for no clearly identifiable reason. There is no underlying disease process, hence the term functional. It appears that IBS is an abnormality with movement through the bowels and this may cause the bowel muscles to go into spasm and cause abdominal pain.
Apart from the cramps and pain, there is also an alteration of bowel habit. This may either be diarrhea or constipation. Often the abdominal cramps or pain are relieved with a bowel movement. The abdominal cramps or pain may at times be described as a twisting pain. Irritable bowel syndrome (IBS) should not be confused with inflammatory bowel disease (IBD), where abdominal cramps and pain may also occur.
Gallstones and Gallbladder Inflammation
Gallstones are solid masses that form from the bile in the gallbladder. This is a relatively common condition and tends to affect middle aged women more often. When the stones become stuck in the bile duct, it can cause a colicky pain. The pain is often felt in the middle of the upper abdomen, below the breastbone, and may also be felt in the back and right shoulder. Inflammation of the gallbladder (cholecystitis) is another condition where there may be a type of twisting abdominal pain. This inflammation may be due to gallstones, infections or other causes.
Menstrual cramps is another common cause of a twisting pain in the lower abdomen. For some women this may feel like mild discomfort while for others it can be severe pain. These very painful menstrual cramps during periods (menstruation) is also referred to as dysmenorrhea. It usually only lasts during the course of the period and resolves thereafter.
Some women may experience cramps or pain mid-cycle. This pain is known as mittelschmerz or ovulation pain since it occurs with ovulation. Menstrual cramps may be accompanied by other symptoms like nausea and irritability. Severe casesare often associated with gynecological conditions like polycystic ovarian syndrome (PCOS), endometriosis and uterine fibroids.
Read more on differences between PCOS, endometriosis and fibroids.
An ectopic pregnancy is a serious condition that can be life-threatening to the mother. In an ectopic pregnancy, the fertilized egg does not implant in its normal position within the uterus, but at sites outside the uterine cavity. The most common site is within the fallopian tubes. The pain eventually becomes severe and is accompanied by vaginal bleeding. There may also be lightheadedness and shoulder pain.