Chronic Abdominal Pain
Stress, gas pains, indigestion, overeating, a killer abdominal workout, all sources of some abdominal pain we may experience from time to time. There is, however, an important distinction between what is called acute abdominal pain (pain that will only last a few hours or a few days at most), and chronic abdominal pain. Recurring or chronic abdominal pain is a nagging to crippling pain in your stomach that may come and go, but never seems to get the hint that it has overstayed its welcome. Chronic abdominal pain can show up intermittently and last for weeks, months, or even years. Unfortunately, the majority of chronic digestive illnesses are characterized to start with abdominal pain. This can make it difficult for health professionals to narrow down the root cause, which leads to many chronic health problems being misdiagnosed or mistreated.
The good news is that this type of pain is your body telling you that something is wrong. This is true in most cases as typically when there is something amiss in the body, your gut will be the first one to tell you. Chronic abdominal pain can be a sign of a number of chronic illnesses from Irritable Bowel Syndrome (IBS) and Gastroesophageal Reflux Disease (GERD) to more serious issues like Ulcerative Colitis and Crohn’s Disease.
What Are The Common Symptoms of Chronic Abdominal Pain?
It is important to listen to this internal distress call from your body and any other accompanying symptoms you may have to diagnose the issue and come to a resolution. Your abdominal pain may qualify as chronic if:
- You feel the same pain recurring weekly
- There is not an immediate or obvious identifiable cause
- There are accompanying symptoms like diarrhea and vomiting — especially if there is blood
Abdominal pain that lasts over 3 months is considered chronic and the conditions that may cause the discomfort are put in a different category than acute abdominal pain. There are many causes of the chronic version of this symptom and sorting out what is behind it is never easy. Other symptoms such as changes in bowel, urinary, menstrual, or neurological symptoms are often helpful in understanding where the pain is coming from.
The reality is, many people live with misdiagnosed abdominal pain because the symptoms are so vague. In most cases, patients will come in with tests run that identify the symptoms (chronic abdominal pain, we already knew that!), but not the specific cause. Typically these patients are given a ‘catch-all’ diagnosis like IBS and are sent on their way with medication to soothe their symptoms.
Rarely do these tests address the root cause of why the pain is happening in the first place. Usually, these tests will address the functioning of your liver, kidneys, and other adjacent organs that may show that overall there is nothing wrong but will not address the problem — your gut! The truth is, if you are not taking a fully holistic and functional approach to your illness, chances are you are not getting the full outlook on your condition and not getting an accurate diagnosis. Without an accurate diagnosis, it is impossible to formulate a plan of action for your path to wellness.
If no other symptoms are present to suggest which physiological system the pain is coming from, there may be associations to suggest its source. If the pain is related to food intake or stress, the likely culprit is the digestive system. The connection to food is logical but what about stress?
Understand That Stress Can Lead To Chronic Abdominal Pain
There is such a close connection between the brain and the gut that they could be seen as one. The gut is sometimes called the second brain because of the similarity in its biochemistry and function. The brain is the center where large amounts of data collected by our sensory apparatus is processed, stored, and available to contribute to thinking, planning, and carrying out actions. The brain must be able to discriminate between lots of information in order to categorize it correctly, store and retrieve it appropriately. The complexity and coordination of actions that the brain commands in response to situations again requires the ability to sort out options and act appropriately as well. Lots of data to sort. The function of the brain depends on complex nerve signaling carried out by a family of chemicals called neurotransmitters.
The gut, too, is a center where vast amounts of information must be received, processed, and appropriate actions carried out. Think of the contents of a meal as a huge amount of data that needs sorting. The gut’s data processing system must direct the appropriate breakdown of large food substances into discrete and absorbable “packets”, and they need to be distinguished from packets that are not ready or should not be absorbed, like toxins. No wonder the biochemistry of the gut depends on the same kind of smart neurotransmitter system. Many people are aware that there is more serotonin (a well-known member of the family of neurotransmitters) made in the gut than in the brain.
So what about abdominal pain and stress as a link in understanding the pain? The body has two main ways of being – action and rest. They always exist together simultaneously but one predominates and the other one is quite recessed. In sleep, our “action” state is in retreat. In an argument, our “rest” state is all but evaporated. In the active state, our body is configured primarily for action: all resources go to the heart, lungs, muscles, sensory apparatus and brain information processing and decision making. Little resources are given to digestion. In the rest state the heart, lungs, muscle, sensory gear, and brain get a bit of a rest and resources go to digestion, immune function, tissue repair, and detoxification.
This relationship between stress produced by “outside” conditions and gut function is pretty easy to grasp. But what about the relationship between a “happy gut” and the experience of feeling stressed? An unhappy gut flora can lead to deterioration in mood, attention, and decreased resilience to stress. The health of the digestive system and of our entire bodies depends on a symbiotic relationship with the trillions of bacteria that live there. We have two articles here on our website that describe this relationship: one on bloating and another called dysbiosis. To find out more about the origins and cures for conditions related to disruption in this symbiotic relationship, see those articles. Much of what we describe on those pages applies to what is going on with chronic abdominal pain especially in the context of experiencing stress.
A happy flora depends on a variety of things aside from the absence of external mental or physical conflict. It depends on good food. Fruits and vegetables – our intestinal bugs like these things. Processed foods, antibiotics are taken for infection or in the food itself, pesticides, and other toxins disrupt our flora and can set up a sequence of breakdowns in our brain and gut that leads to chronic pain. Our flora depends to an amazing extent on regular physical activity. Less physical activity leads to poor flora leads to decreased stress resilience leads to depressed mood leads to increased anxiety leads to less restful sleep leads to more fatigue leads to less physical activity. You see where this is going.
The reduction of support devoted to the gut that occurs in conditions of chronic stress — the chronic ‘action’ state turned on — will not only disrupt the health of the microbial flora, it will also disrupt the gut’s ability to move gut-contents smoothly through the long tube that is the intestine. A condition of stagnation or poor motility or a condition of exaggerated motility may both result. This is why constipation and diarrhea are so often associated with chronic abdominal pain coming from the digestive system. Decreased intestinal motility is associated with an aching or pressure kind of abdominal pain often associated with distension. Increased intestinal motility is associated with a cramping kind of abdominal pain often associated with discomfort during the act of having a bowel movement.
So what does this relationship between the brain, exercise, toxins, stress, diet, sleep, and abdominal pain have to do with getting relief?
Because of the complexity of these relationships, it is not surprising that most people with chronic abdominal pain have difficulty in both understanding and successfully treating the condition. More conventional physician practices rarely take the time to try and understand which of these factors may be playing a role.
At Plum Spring Clinic, we take a functional approach to your unwellness. Through a series of tests with our Medical Director, Dr. Michael Sharp, we will look past the symptoms that are making your feel unwell. Instead, our focus is to determine the whys of these symptoms. Without knowing why your symptoms are occurring in the first place, it will be impossible to create a plan to treat them. It is amazing what our bodies can do with the right support. Once we have identified the cause of the breakdown, the purpose of functional medicine is to then nurture the body’s own natural ability to heal and care for itself without the intervention of medication. With the help of a Specific individualized diet, exercise, and stress resiliency plans from our in-staff professionals, supplements, and looking at ways to minimize exposure to toxins, successful removal can be more powerful than medications. This approach also creates more lasting effects on the overall health and well-being of the individual and leads to less reliance on expensive medical procedures and technology.
If you are or have been experiencing chronic abdominal pain with no luck from prior traditional medical approaches, you can call the clinic or fill out a contact form and arrange to have a welcome call with either our Health Coach Kathleen Williams or our Clinic Director – Nate Kelly, RD. They would be happy to discuss how this approach would work for you and to answer any questions you have about how we can help you solve your chronic abdominal pain. From there they will formulate a plan for how they might support you on your path to lasting wellness.