Be careful of "stomach pain"

This is the 3513th article of Da Yi Xiao Hu

"Nurse, I have a stomachache."

This is the most common complaint I hear from patients at the pre-examination desk recently. After the holidays, many patients go to the hospital for "stomach pain". During the holidays, many people have irregular meals, excessive hunger or overeating due to holiday gatherings, which leads to stomach discomfort. Today we will briefly talk about "stomach pain" which is very popular among young people nowadays.

What we usually call "stomach pain" is usually caused by acute or chronic gastritis, peptic ulcer, etc. It is located in the middle or left side of the xiphoid process, or in the middle or right side of the upper abdomen; the pain range is the size of the palm; the pain is mostly dull pain, distending pain, burning pain, dull pain, severe pain or hunger-like discomfort, usually accompanied by symptoms such as acid reflux, belching, nausea and vomiting.

What are the causes of stomach pain?

①The most common cause is Helicobacter pylori infection

Epidemiological studies have shown that my country is a country with a high infection rate of Helicobacter pylori, with an estimated infection rate of 40%-70%; a large number of studies have also shown that Helicobacter pylori infection is the main cause of peptic ulcers.

② Gastric acid and protease

The final formation of peptic ulcer is caused by the self-digestion of gastric acid and pepsin. Pepsin is only active when the pH is less than 4 and is dependent on gastric acid. Therefore, gastric acid plays a key role in the occurrence of peptic ulcer and is the direct cause of ulcer formation.

③ Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs are another common cause of peptic ulcers. NSAIDs damage the mucosal barrier, impairing the mucosal defense and repair functions, leading to the occurrence of peptic ulcers.

④Autoimmunity

Dietary and environmental factors (high salt and lack of fresh food and fruits in the diet are closely related to gastric mucosal atrophy and intestinal metaplasia); smoking; genetic factors; long-term consumption of irritating foods and drugs, etc.

What health care measures and precautions can we take in our daily lives?

(1) First of all, patients in the acute phase should get enough rest if possible. Patients in the recovery phase should lead a regular life, avoid excessive fatigue, and combine work and rest.

(2) Pay attention to eating easily digestible food, and eat small and frequent meals to relieve stomach discomfort. Avoid eating too cold, too hot, or irritating food to avoid increasing upper abdominal pain. Patients with peptic ulcers should eat alkaline foods such as milk, porridge, and noodles; eating small and frequent meals can neutralize stomach acid and reduce hunger-related peristalsis of the stomach.

(3) For acute pain, the patient can be relieved of tension and distracted; or a hot water bottle can be used to apply heat to the upper abdomen to relieve spasms and pain.

(4) Note: If conditions permit, a Helicobacter pylori test should be performed. This test is of guiding significance in the selection of treatment options for gastritis or peptic ulcer.

Finally, I would like to remind you, and this is the most important point: upper abdominal pain is not necessarily stomach discomfort, it may also be caused by bile duct cholecystitis; pancreatitis; or even coronary heart disease and other diseases. Patients with the first attack must choose a regular hospital to determine the cause of the disease, eliminate the pathogenic factors, control symptoms, promote healing, and do not take medicine without authorization. Patients who have been diagnosed with the disease and have relapsed should also seek medical treatment as appropriate and receive symptomatic treatment to prevent the disease from becoming serious and causing related complications.

During holiday entertainment and gatherings, do not overeat, or you may get stomachache.

Author: Emergency Department, Shanghai Sixth People's Hospital (Lingang Campus)

Chen Danhua