Tummy troubles It could be too much coffee, a slipped disc… or even diabetes



22:49 GMT, 7 May 2012

Often a tummy ache is the result of something fairly obvious — a long-term condition such as irritable bowel syndrome, a simple case of indigestion or maybe, for a woman, it could be that time of the month.

But for some of us, the cause isn’t quite so apparent. ‘Many of us think the cause of stomach pain, not illogically, originates from within the tummy,’ says Dr Anton Emmanuel, a gastroenterologist at University College Hospital, London.

‘But there are many conditions that can lead to it. The abdomen is an area fed by nerves, so pain elsewhere in the body — such as the heart, throat or lungs — can also manifest itself there.’

A belly full of facts: Experts reveal the possible causes of a sore tummy

A belly full of facts: Experts reveal the possible causes of a sore tummy

Fortunately, most causes of abdominal pain are totally treatable, he adds. ‘However if you suddenly have acute, severe pain or a long-standing pain accompanied by the passing of blood, or coughing or vomiting, you should go straight to A&E.’

Below, experts reveal the less obvious causes of your sore tummy.

Feeling bloated when you eat

Possible cause: diabetes

In ONE study of 136 diabetics at the University of Sydney, Australia, 35 per cent suffered abdominal bloating and 27 per cent abdominal cramping, constipation and diarrhoea.

This could be the result of autonomic neuropathy, a condition that affects the nerves controlling the bowel and digestion.

‘It occurs because the high levels of glucose associated with diabetes trigger changes within the body, causing nerves to break down,’ says Richard Ross, professor of endocrinology at the University of Sheffield. ‘In the case of the stomach, it slows up the digestive process.’

Between 10 and 20 per cent of people newly diagnosed with diabetes suffer from neuropathy. Treatment involves bringing blood glucose levels under control.

Coughing or sneezing hurts

Possible cause: slipped disc

The discs act as the spine’s shock absorbers. Each disc has a tyre-like outer band — if this cracks, the gel-like substance inside leaks out, putting pressure on the spinal canal and causing pain with any sharp movements.

‘Nerve roots in this area branch out to the abdominal area, mid-back and ribs, so any compression on them can cause pain in these areas,’ says Dr Tariq Iqbal, gastroenterologist at the University Hospital Birmingham and BMI Priory Hospital, Birmingham.

Spinal tip: A painful sneeze could mean you have a slipped disc

Spinal tip: A painful sneeze could mean you have a slipped disc

It generally takes around four to six weeks to recover using a combination of physical therapy (such as exercise and massage) and medication to help relieve the pain. In severe cases, surgery may be necessary.

Going to the loo helps

Possible Cause: diet drinks/gum

Diet cola or sugar-free gum may help you lose those extra pounds, but it might also have a rather unpleasant side effect.

In a study at Charite University Hospital, Berlin, they found as little as 5g of the sweetener sorbitol could cause bloating and cramps — one stick of gum contains around 1.25g.

‘Sorbitol — which is a type of carbohydrate — simply isn’t well absorbed into the intestine,’ says Peter Whorwell, professor of medicine at Manchester’s Wythenshawe Hospital.

‘It acts as food for the tummy’s bacteria, which release gas, causing flatulence, bloating and pain.’

Burning under skin

Possible cause: shingles

Shingles is caused by the same virus that causes chickenpox.

Many of us have this in childhood, but the virus then moves into the nervous system where it lies dormant.

Generally, our immune system keeps things in check. However, the virus can be reactivated later in life if the immune system is compromised — such as when we’re tired or have been unwell.

‘Quite simply this virus attacks areas where there are large amounts of nerve roots such as the abdomen,’ says Steve Mowle, vice chair of the Royal College of General Practitioners. ‘And two or three days after the pain it develops into an itchy, blistery rash.’

Typically, this occurs around your middle. Although it will go on its own, asking your GP to prescribe antivirals as soon as possible (within three days of the onset of the rash) should ease the symptoms within seven to ten days.

Cramps after coffee

Possible cause: Caffeine

‘Caffeine works as a stimulant — elevating heart rate, increasing blood flow and raising body temperature,’ says Dr Mowle. ‘It also increases the natural contraction and relaxation of the colon that moves food through the digestive system. In addition, coffee can irritate the tummy lining.’

Constant ache

Possible cause: a sore throat

Strep throat, caused by the streptococcus bacteria, is the most common bacterial throat infection — particularly prevalent in children between five and 15.

Although a sore throat isn’t usually accompanied by abdominal pain, in one study at the Michigan State University College of Human Medicine, it affected 27 per cent of 190 patients suffering from strep throat.

‘One theory is that some of the bugs get into the bloodstream and cause reactive swelling of the lymph glands in the abdomen,’ says Henry Sharp, an ear, nose and throat surgeon at East Kent Hospitals.

‘Generally, it clears up without the need for medication, but in worse cases, a course of anti-biotics is usually enough to clear up the problem.’

Women with abdominal pain and bloating should see their GP, as in rare cases this can be ovarian cancer.

Nausea after meals

Possible cause: angina

Mention angina and we think of chest pain caused by a restricted blood supply to the heart.

But this ‘blockage’ of blood flow can also occur to the major arteries that supply the intestines.

‘The lack of blood flow can lead to pain, and nausea — typically just after eating when the intestine is working harder to digest the food,’ says Dr Iqbal.

Generally, surgical intervention is needed to open up the arteries (such as with a stent); statins may also need to be taken.

Upset bowel

Possible cause: stress

Stress is a common trigger for IBS, a common condition of the digestive system.

‘When faced with life-threatening situations, the brain slows digestion so the body can focus on the threat,’ says Dr Mowle.

‘However, even in non-life-threatening times of stress, such as during an argument or driving in traffic, it can be affected. This can result in changes in bowel habits (such as constipation and diarrhoea), and the tummy pains associated with them.’

Breathing is painful

Possible cause: pneumonia

Although a hacking cough and difficulty in breathing are the more obvious symptoms of pneumonia, it can cause tummy pain in around 1 in 100 patients.

Pneumonia is an inflammation of the tissue in one or both lungs, generally caused by an infection. ‘Stomach pain can occur when the lower lobes of the lung are affected,’ says Professor Stephen Spiro, deputy chairman of the British Lung Foundation.

‘This can cause inflammation on the bottom lining of the lungs, which go on to rub on the diaphragm (a thin muscle directly beneath).’ Treating the pneumonia itself will ease the tummy pain — with antibiotics or hospitalisation if it’s severe.

Agony on one side

Possible cause: twisted testicle

The thought of this is enough to make a chap’s eyes water, but a twisted testicle affects around 2,500 men in England every year, usually aged under 30.

‘The stomach pain occurs, quite simply, because the nerves to the testicle descend down from the lower back past the stomach,’ says Suks Minhas, honorary senior lecturer at the Institute of Urology, University College Hospital, London.

‘It can occur due to trauma to the testicle, such as a sporting accident, though most cases happen for no apparent reason.

‘The pain is usually accompanied by a swollen scrotum, nausea and vomiting.’

Seeking urgent treatment — within six hours — is important to prevent any permanent damage. An operation to untwist the blood vessels is usually enough to solve the problem.

Hours of discomfort

Possible cause: Tummy Migraine

It sounds bizarre, but abdominal migraine affects around 4 per cent of young people; it can also affect adults.

The attacks, which are thought to be caused by swollen blood vessels, come on without warning and subside after one to two days; they tend to occur at least once or twice times a month.

A family history seems to play a part, according to a study at the Children’s Hospital of the King’s Daughters in Virginia, U.S.

Children, whose nerves in the gut are more sensitive to stresses and dietary triggers, generally outgrow them, though many do go on to have migraine headaches as adults.