Thursday, 11 September 2014

Bad Belly Aches

For sufferers of IBD and/or IBS, stomach aches and abdominal pain are an extremely common phenomenon, and very often taken as a given. For many, including myself, there is often a silent struggle to manage the pain, while also not letting it take over our lives. However, not all belly aches are the same.

This week, I would therefore like to share the different types of belly aches I have experienced.


As the below image shows, there are numerous causes of abdominal pain. For our purposes, however, I am just going to discuss the ones that are directly related to the digestive tract.

According to this 2012 article, there are two main types of abdominal pain that occur with IBD: visceral, and somatic. Visceral pain is categorised as occurring within internal organs, and the exact cause is often difficult to identify as it is often a dull and inconsistent sensation. Somatic pain, on the other hand, usually has musculoskeletal sources, and tends to be a much more intense pain.

I feel, though, that these two categories are insufficient to cover all of the types of abdominal pain I have experienced, particularly because they are very general categories. Instead, I prefer to identify my types of abdominal pain based on what I believe has caused them, and how they feel:

Indigestion pain – This pain often occurs if I eat foods that contain too much fructose or fructans, and often starts very quickly after eating. It is a quite intense pain, and is located in the area of my stomach, directly below my ribs. Depending on what I have eaten, it can last between 30 minutes and 2 hours.

Bloating pain – This type of pain often follows indigestion, and is localised lower down in my abdomen, in the area of my intestines. When I am bloated, I often find that the pain quickly increases if I am wearing form-fitting pants, due to the pressure on my belly, so I have to switch to tracksuit pants if possible. Sometimes the bloating can be improved through passing wind, but it can often take some time before it settles down completely, perhaps 2-3 hours on average. Additionally, the pain can ebb and flow as the gas moves through the bowel, so it is not a constant pain.

Hunger pain (1) – This type of pain is a strange one, and appears to be less common among those with IBD and IBS, but I have noticed happening to me a few times over the last 2-3 months. I believe I have experienced two different types of hunger pain: hunger pain that happens before meals, and hunger pain that happens after meals. The first type of hunger pain seems to happen because I have not eaten quickly enough after starting to feel hungry. This is often because I am meeting others for a meal, and have to wait for them to arrive and for our food to be prepared. This type of hunger pain feels similar to indigestion, but seems to be caused by hunger instead, as my stomach was always empty when it happened. It can sometimes last for 1-2 hours, and is not immediately helped by eating. Therefore, I am now very careful to have a precise eating schedule as much as possible.

Hunger pain (2) - The second type of hunger pain I have experienced was much more intense, and occurred with other symptoms. The first (and so far, only) time I noticed this pain was late one night when returning home after dinner, and although I had tried to be careful with what I was eating earlier that night, I started feeling very bloated while driving, and also slightly light-headed. Thankfully, I was able to get home safely, but by that point I was also feeling nauseous and unsteady on my feet. I had thought that it would be fixed by sitting on the toilet, but if anything, this made the pain and dizziness worse. The pain was very intense, and it felt like my stomach was being squeezed and twisted like a wet towel. I went to bed, and when I woke up 3-4 hours later, it was as if nothing had happened! I now believe that perhaps I had not eaten enough for dinner earlier that night, hence I quickly became very hungry again. To avoid this, I try to have little snacks with me to eat during the day if I start to feel hungry, and am also very conscious of eating enough at meal times.

Diarrhea pain – This pain often happens when I feel diarrhea coming on, and sometimes happens with nausea as well. The pain is felt lower in the abdomen, in the area of the colon, and bowel movements can be very uncomfortable. Depending on what has caused the diarrhea, it can last for 30 minutes or 24 hours.

Constipation pain – This type of pain occurs when constipated, and usually happens when I am attempting to have a bowel movement. There are usually be short, stabbing pains in the anal region as the pressure builds, and there is also some residual pain in the area following the bowel movement (if successful).


There are many methods to manage and treat abdominal pain, which mainly fall under three categories: pharmacological, behavioural, and procedural. Firstly, pharmacological methods include anti-inflammatory medications, such as those commonly taken by people with IBD, and general painkillers. Behavioural methods are largely focused on promoting relaxation and reducing stress, so as to help reduce symptoms. Finally, procedural methods involve treatments such as acupuncture and nerve blockers, which aims to directly treat the pain. If these methods are insufficient, however, surgery may be also necessary, such as a colectomy.

In my experience, my IBD medication seems to somewhat lessen the abdominal pain, but does not completely prevent it. Therefore, I manage my pain in two stages: prevention, and treatment. In other words, I do the best I can to avoid being in situations that will cause abdominal pain or make it worse, such as being careful with my diet and avoiding stressful situations. Additionally, as previously discussed, it is recommended that people with IBD have smaller meals and snacks throughout the day, as this can make it easier for the body to digest the food. If the pain still occurs, however, I then do what is necessary to treat it, and thereby help it to alleviate quickly. This can include sitting on the toilet, passing wind, or using a heat pack. My favourite type of heat pack is a wheat bag, like the one in the photo below:

Do you have any tips for managing abdominal pain? Please share below.

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