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Abdominal pain silent signals from within
Published on: Tuesday, September 05, 2023
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Gastritis, characterised by inflammation of the stomach lining, can lead to discomfort, a burning sensation and indigestion. This condition can be triggered by factors such as excessive alcohol consumption, prolonged use of non-steroidal anti-inflammatory drugs and infections, like H. pylori. Dr Nagaraj Sriram (right)
ABDOMINAL pain is a universal experience that can range from a mild inconvenience to a distressing symptom and, in some cases, an urgent warning sign of serious health conditions.

As a gastroenterologist, my mission is to shed light on the often-misunderstood world of AP and the potential diseases of the stomach, colon, liver, gall bladder and pancreas that could be causing it. 

In this article, we will delve into the complexities of abdominal pain and discuss the various gastrointestinal disorders associated with it, emphasising the importance of awareness and proactive healthcare.

AP: Multifaceted nature

The abdomen serves as the central hub of our digestive system, housing vital organs responsible for the intricate process of digestion, absorption and elimination. 

Abdominal pain, when it arises, can stem from a plethora of underlying causes, ranging from simple dietary indiscretions to complex medical conditions.

Its location, intensity and accompanying symptoms often offer valuable clues to the underlying issue, making it essential for individuals to pay attention to these signals.

Exploring stomach-related ailments

The stomach, a muscular sac where digestion commences, can give rise to various conditions contributing to abdominal pain.

Gastritis, characterised by inflammation of the stomach lining, can lead to discomfort, a burning sensation and indigestion. 

This condition can be triggered by factors such as excessive alcohol consumption, prolonged use of non-steroidal anti-inflammatory drugs (NSAIDs) and infections, like H. pylori.

Peptic ulcers, open sores that develop on the stomach lining, can also cause significant pain. 

The pain is often described as a dull ache or burning sensation, commonly occurring on an empty stomach and alleviated by eating. 

Untreated ulcers can lead to complications like bleeding or perforation, emphasising the need of early intervention.

Navigating colon-related concerns

The colon, an integral part of the digestive system, is susceptible to a range of disorders causing abdominal pain.

Irritable Bowel Syndrome (IBS), a functional disorder, leads to abdominal pain, bloating and changes in bowel habits.

While its exact cause remains elusive, triggers may include stress, dietary factors and gut-brain interactions.

Inflammatory Bowel Disease (IBD), comprising conditions like Crohn’s disease and ulcerative colitis, can cause severe abdominal pain due to chronic inflammation in the digestive tract.

These conditions often present with periods of remission and flare-ups, requiring close medical management.

Deciphering liver, gall bladder issues

The liver, responsible for detoxification and metabolic processes, can be afflicted by hepatitis and fatty liver disease.

Hepatitis, inflammation of the liver, can manifest as abdominal discomfort, jaundice and fatigue. Chronic hepatitis can lead to cirrhosis, a condition marked by irreversible scarring of the liver tissue.

Gallstones, solid particles that form in the gall bladder, can cause excruciating pain known as biliary colic when they obstruct the bile ducts. 

This pain is typically located in the upper right abdomen and may radiate to the back or the shoulder.

Acute inflammation of the gall bladder, known as cholecystitis, can occur when gallstones block the flow of bile, requiring prompt medical attention.

Understanding pancreatic predicaments

The pancreas, responsible for producing enzymes critical for digestion and hormones regulating blood sugar levels, can be a source of significant abdominal pain.

Acute pancreatitis, often caused by gallstones or excessive alcohol consumption, results in severe pain that radiates to the back.

Chronic pancreatitis, typically linked to long-term alcohol abuse, can cause persistent pain and malabsorption of nutrients.

Pancreatic cancer, although relatively rare, is known for silent progression.

Abdominal pain, weight loss, and jaundice are potential signs of advanced disease.

Early detection is challenging, underscoring the importance of seeking medical evaluation for unexplained or persistent symptoms.

Shadows of gastrointestinal cancers

Among the most concerning causes of abdominal pain are gastrointestinal cancers affecting the stomach, colon and pancreas. 

Stomach cancer, often associated with chronic gastritis, can cause vague discomfort, bloating and unintended weight loss.

Colon cancer, a result of abnormal cell growth in the colon and rectum, can lead to abdominal pain, changes in bowel habits and blood in the stool. 

Pancreatic cancer, notoriously difficult to detect in its early stages, can cause persistent, dull abdominal pain and significant weight loss.

These cancers highlight the critical importance of early detection and intervention.

Regular screenings, especially for those with risk factors such as a family history of cancer or certain genetic conditions, can significantly improve the chances of diagnosing these cancers at a more treatable stage.

Seeking professional help

The complexity of abdominal pain necessitates a cautious approach to self-diagnosis. While mild, fleeting discomfort may not warrant immediate concern, certain red flags warrant prompt medical attention:

1. Severe or worsening pain: Intense, unrelenting pain that escalates over time.

2. Accompanying symptoms: Symptoms like fever, vomiting, blood in stool or unexplained weight loss.

3. Change in pain pattern: A change in the nature, location or duration of pain.

4. Persistent discomfort: Pain that lingers for hours or days without relief.

5. Personal or family history: A history of gastrointestinal diseases, especially if there’s a genetic component.

Empowerment through awareness

In a world where health information is readily available, empowering oneself with knowledge about potential gastrointestinal disorders is crucial. Abdominal pain is the body’s way of signalling that something requires attention.

By recognising the nuances of discomfort and understanding the organs involved, individuals can play an active role in their healthcare journey.

As a gastroenterologist, my message to the public is clear: prioritise your health, pay heed to your body’s signals and collaborate with medical professionals to decipher and address abdominal pain.

Whether the cause is as straightforward as indigestion or as complex as a chronic condition, early intervention can make a significant difference in managing symptoms and preventing complications.

In conclusion, abdominal pain serves as a potent reminder that our bodies are intricate systems requiring care and attention. 

By fostering awareness about the potential diseases affecting the stomach, colon, liver, gall bladder and pancreas, we pave the way for a healthier future, free from the uncertainties of unaddressed abdominal discomfort. Let us remember that being attuned to our bodies is the first step towards better health and wellbeing.


The colon, an integral part of the digestive system, is susceptible to a range of disorders causing abdominal pain.

# This article was contributed by Dr Nagaraj Sriram who is a Consultant Gastroenterologist, Hepatologist and Interventional Endoscopist at Gleneagles Hospital Kota Kinabalu. 


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