A range of conditions can cause chronic abdominal pain, often referred to as chronic gastrointestinal (GI) pain. The pain may be accompanied by:
These symptoms can be mild to severe. The following page will briefly discuss the most common conditions that cause gastrointestinal pain, including inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), stomach ulcers, diverticulitis, and atrophic gastritis.
Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is used to describe conditions that cause chronic gastrointestinal inflammation. There are two types of IBD:
- Crohn’s disease
- Ulcerative colitis
The cause of inflammatory bowel disease is unknown, although doctors believe that the immune system and stress may play a role. Additionally, research suggests that genetics, diet, and environmental factors may aggravate the condition.1
Crohn’s disease can affect any part of the gastrointestinal tract, from the mouth to the anus. It usually causes inflammation at the end of the small intestine and the beginning of the large intestine. Inflammation can cause the intestinal wall to thicken and change.
Symptoms of Crohn’s disease include:
- Abdominal pain
- Abdominal cramps
In addition, a person with Crohn’s disease may experience:
- Reduced appetite
- Weight loss
Crohn’s disease often goes through periods of active illness (when symptoms are present) and remission (when they are not).
Ulcerative colitis is a chronic disease of the large intestine (colon and rectum) and causes the intestinal lining to become inflamed and develop open sores (ulcers). The combination of inflammation and ulcers leads to symptoms, including:
- Rectal bleeding
- Rectal pain
- Abdominal pain and cramping
People with ulcerative colitis may typically experience periods of remission and exacerbation.
Irritable Bowel Syndrome (IBS)
IBS refers to a group of gastrointestinal symptoms, including abdominal pain, constipation, and diarrhea. What makes IBS unique from other stomach conditions is that the symptoms generally occur without evidence of damage or disease in the GI tract.
Recently, a condition called small intestinal bacterial overgrowth (SIBO) has been identified as the underlying problem for some people with IBS. Many GI Doctors now test for this in their office and offer treatment specific to this problem. SIBO is an imbalance in the gut microbiome, the name given to all the beneficial bacteria that live in the gut, and is a focus for much of the IBS research that is currently being done.
Some doctors believe that IBS is related to the way the brain, gut, and nervous system interact with one another.2
IBS does not develop into IBD, however, some people may be diagnosed with both conditions at the same time. Symptoms are often unpredictable and may get better or worse over time.
It used to be thought that there was no known cure for IBS, but this is changing with our improved understanding of the gut microbiome and SIBO. Many people are now able to control symptoms through treatment, medication, and nutritional support.3
Stomach ulcers, also called peptic or duodenal ulcers, are open sores that develop within the esophagus, stomach, and/or small intestines.
When ulcers develop a person may exhibit mild to severe symptoms such as burning stomach pain, indigestion, nausea, heartburn, and changes in appetite. Spicy foods and stress may aggravate symptoms.
Ulcers develop for a number of reasons including:
- The bacteria Helicobacter pylori (H. pylori)
- Frequent use of NSAIDs, such as aspirin or ibuprofen
- Smoking cigarettes
Medication, along with lifestyle changes, will typically be used to treat stomach ulcers. Depending on the type and cause of ulcers this may be an antibiotic, prescription, or over-the-counter medication.
Diverticulitis occurs when small pouches, called diverticula, form around weak spots in the gastrointestinal tract and then become inflamed or infected. These pouches typically form when there is an increase in pressure in the intestinal walls, such as from gas or waste (especially chronic constipation). Diverticula occur most often in the colon.
Diverticulitis symptoms usually go away with treatment, which typically includes a course of antibiotics and a change in diet to increase fiber and prevent constipation. However, once a person has had one attack he or she is at risk for more. Generally, chronic or long-term diverticulitis attacks become more serious.
In more serious attacks a person may experience signs of infection like:
- High fever
- Changes in heart rate or blood pressure
- High white blood cell count
Serious attacks often require hospitalization for hydration and intravenous (IV) antibiotics.
Atrophic gastritis develops after prolonged inflammation of the stomach lining. It is usually the result of an untreated Helicobacter pylori (H. pylori) bacterial infection.
The inflammation is usually found in the mucous membrane of the stomach lining. Symptoms may include:
- Abdominal pain
- Weight loss
Atrophic gastritis is typically treated with antibiotics to eliminate the underlying bacterial infection.
Because abdominal pain can be the result of many things, such as anxiety or diet, it is recommended that a person visit the doctor in order to get a proper diagnosis and treatment.
- National Center for Chronic Disease Prevention and Health Promotion, Center for Disease Control and Prevention (CDC) website. What is inflammatory bowel disease (IBD)? March 22, 2018. https://www.cdc.gov/ibd/what-is-IBD.htm
- National Institute for Diabetes and Digestive and Kidney Diseases, Symptoms and Causes of IBS. November 2017. https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/symptoms-causes
- Dukowicz AC, Lacy BE, Levine GM. Small intestinal bacterial overgrowth, A comprehensive review. Gastroenterol Hepatol (NY). 2007; Feb; 3(2):112-122. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3099351/