On palpation of the abdomen, hard lumps

What pain occurs in different forms of gastritis of the stomach

Inflammatory processes in the walls of the gastric mucosa are accompanied by pain. Depending on the level of acidity of gastric juice, the type and strength of discomfort is determined, and the degree of the disease (acute or chronic form) also influences this. Gastritis pain is the first sign.

What to do if you suspect gastritis or have a stomach ache?

Differential diagnosis of gastritis

To establish an accurate diagnosis, the doctor talks with the patient and listens to his complaints. Next, he conducts a physical diagnosis of gastritis using palpation of the stomach area. If a person experiences a feeling of discomfort, this may indicate the presence of an inflammatory process, and acute pain may indicate the development of gastritis. The specialist must also examine the patient’s oral cavity. The presence of a yellow tint is a sign of acute corrosive gastritis. An increased content of sulfuric acid is indicated by black spots in the oral cavity, white spots indicate hydrochloric acid. The presence of a grayish-brown film is a sign of alkali poisoning.

During the initial examination, gastritis can manifest itself in the form of elevated temperature, increased muscle tone in the stomach area, as well as the person’s general well-being. But in order to confirm the diagnosis, further examination must be performed.

What are the pains with gastritis?

With this disease, the gastric mucosa suffers, resulting in the gastrointestinal tract with impaired functioning.

More complex forms of the disease have a constant inflammatory process, and abdominal pain with gastritis will become more frequent.

Sector support at the onset of the disease is accompanied in different ways, in most cases the level of secretion of gastric juice oxidation decreases.

Increased or moderate secretion does not affect the atrophy of the gastric glands. Most often occurs in young adulthood or adolescence.

It can be characterized from several sides, depending on the source of inflammation and the cause.

During illness, the following discomfort is most often felt:

• After eating, you feel tightness and heaviness;
• Heartburn increasing in intensity;
• Begins to feel sick, resulting in vomiting;
• Dull pain with gastritis occurs after about two days of inactivity;
• There is an unpleasant taste in the mouth;
• On palpation sensation;
• Progresses to back pain with gastritis;
• Headache with gastritis.

The nature of the pain helps determine whether it is renal colic or gastritis.

Gastritis with reflux esophagitis

In this case, the provoking factor is a condition in which the backflow of bile into the stomach occurs. Regarding how it hurts. This type of gastritis can cause symptoms of varying intensity. A distinctive feature is that unpleasant sensations do not appear immediately after a meal, but after several hours.

In addition, discomfort occurs at night. If there are long breaks between meals, hunger pains appear. In this case, it is important to eliminate the reason why bile is thrown back into the stomach.

Hypertrophic gastritis

There are pressing and aching pains with gastritis and the symptoms depend on the form.

The hypertrophic form is closely related to the pre-ulcerative condition, the second is classified more towards oncology.

Signs of hypertrophic gastritis of the stomach

The hypertrophic type of disease is characterized by:

1. Irritation of the stomach walls, the initial symptoms are not similar to peptic ulcers, so it is easier to diagnose.
2. Complaints about aching sensations become more frequent, symptoms depend on seasonality in the off-season, hunger pains with gastritis are visible: late and early. Diagnosis is prescribed for late hunger pains, especially for suspected duodenitis and duodenal ulcers.
3. In the upper abdomen in the morning, mild pain is felt with gastritis of this type, if there are no clinical symptoms, it may be attributed to a suspicion of a duodenal ulcer or a pre-ulcerative condition. But pain with gastritis lasts longer, without pain relief it can last up to a day, late or early painful sensations are superimposed.

Gastritis of corrosive type

In this case, it is customary to talk about damage to the deep layers of the organ’s mucosa. The main reason for the development of the disease is the penetration of toxic chemical compounds into the stomach, as a result of contact with which healthy tissues get burned.

Regarding how it hurts. Gastritis of this type is characterized by unbearable sensations. The pain is so acute that it is almost impossible to endure. A person tries to take a forced position in order to weaken its manifestations.

Associated symptoms:

1. Headache.
2. Burning in the chest area. It is so strong that the person feels as if he is on fire.

Ignoring warning signs leads to ulcers and internal bleeding.

Treatment of pain due to gastritis

Treatment of the initial stage is carried out at home, it usually does not take more than a month, the chronic form requires more intensive care, this lasts up to 2 years.

Adsorbent enveloping toxins, drugs that eliminate pain during gastritis, and drugs that can balance the acidity of the gastrointestinal tract are prescribed as medications.

Antibiotics are prescribed to eliminate infection in the stomach area.

There is also alternative medicine, which is often used to treat gastritis in children and for people with weak immunity.

Gastritis pain should also be relieved with special medications that do not affect the condition of the stomach.

Diet

To ensure that gastritis pain does not bother you too often, in addition to drug treatment, some rules must be followed:

• Strict diet for acute forms of the disease;
• Dishes containing a lot of seasonings, fat, spiciness, salt should be excluded or should be eaten in moderation;
• Carbonated drinks are sometimes worse than alcohol, but it should be taken in moderation. Smoking is also harmful;
• Drink plenty of liquids, eat soups and hot liquid foods.
• The temperature of food and drinks should be moderate so as not to harm an already weak stomach;
• Solid food should not be eaten dry; it must be chewed thoroughly;
• Also, meals should be divided into several. You need to eat about 5 times a day.

Drug treatment alone will not achieve results so that the disease does not return or develop into a stomach ulcer; the inflammation should not only be treated, but also healed.

Gastritis in children

Even a baby feeding on mother's milk, if it is not balanced correctly, can feel discomfort, as gastritis hurts without interruption. The gastric mucosa also becomes inflamed due to natural factors.

The child unknowingly swallows toxins (household chemicals, poisons, germs) with the air, and the stomach at this age is weaker to such irritants.

In later years, the cause is poor nutrition. Sweets, fast food, and an unbalanced diet irritate the surface of the stomach walls.

Lack of treatment at this age leads to permanent damage to the health of the stomach.

In acute gastritis, pain in children is accompanied by severe malaise, which does not stop on its own.

Gastritis pain in children according to symptoms

Its intensity depends on the level of inflammation of the intestinal walls:

1. If the inflammation is in the superficial layers of the walls, then the sensations are aching, as gastritis of the hungry type hurts;
2. Deep inflammation of the walls over the entire surface leads to deep hunger discomfort;
3. Erotic changes, caused by an inflammatory process, are accompanied by sharp intermittent pain;
4. A deep destructive-inflammatory change in the walls of the gastric lining brings with it sharp sensations.

Pathological changes depend on the syndromes and manifestations:

• Vomiting. The superficial inflammatory process contributes to short-term nausea and one-time vomiting; with a deeper form, frequent nausea occurs, as the stomach hurts with gastritis with transitions;
• Discomfort. A child almost always has an unpleasant sensation in the stomach area; the upper abdomen suffers; pain with gastritis can be aching, sharp, or hungry. All this can be treated with medication;
• The general condition of the person has changed. Weakness and nausea occur, and in more acute forms the temperature may rise. Even with frequent vomiting, you should consult a specialist.

Causes of lumps in the abdominal area

Lumps in the right side of the lower abdomen in women are most often caused by problems with the kidneys and large intestine. The causes of the appearance of formations on the left are called pathologies of the ureter and omentum. Intestinal pathologies are accompanied by lumps in the lower abdomen or in another part of it. Most often, lumps in the right or left side occur due to the following health problems:

• Appendicitis. Inflammation of the appendix is ​​manifested by acute pain on the right side, fever, and nausea. If this condition develops, a person must urgently contact a surgeon to perform an operation.
• Diverticulitis. The disease is accompanied by protrusion of part of the intestinal walls towards the abdominal cavity. This problem can be caused by helminthic infestations, unfavorable heredity or poor nutrition. The pathology is accompanied by indigestion, pain, and possibly increased body temperature.
• Aortic aneurysm located in the peritoneum. A similar problem arises against the background of hypertension, bad habits, and atherosclerosis.

Painful lumps can also occur with intestinal obstruction. This problem is accompanied by bloating, stool retention, vomiting, and severe pain.

Hydronephrosis is another common cause of lumps in the abdominal area. The disease is accompanied by accumulation of urine in the renal pelvis. It develops against the background of urolithiasis or when women have gynecological problems. In the presence of the disease, obstructed urine outflow, increased body temperature, and severe pain are observed.

Pathological seals can occur in the navel area. The main reasons for their development are:

• hernia;
• umbilical ring fistula;
• cyst;
• metastases formed in the presence of stomach cancer.

In the lower abdomen under the navel, the appearance of compactions may indicate the presence of inflammatory bowel pathologies and urolithiasis, rupture of the walls of the diverticulum. Tension and pain also appear with increased gas formation in the large intestine.

The occurrence of pain during gastritis and its nature

Almost half of humanity on earth knows well what pain due to gastritis is, but not everyone who suffers from pain knows how to relieve the pain that occurs. Not every person knows what causes these pain sensations.

First of all, you need to understand what gastritis is, what the symptoms of this disease are, and how to protect yourself from this disease. So, let's start in order.

Gastritis is an inflammatory process that occurs in the walls of the stomach. It may be accompanied by certain symptoms. Symptoms of gastritis can be quite varied, ranging from aching pain to a feeling of heaviness. But this disease is not only famous for severe pain; there may also be other symptoms, for example:

• nausea;
• vomit;
• heartburn;
• unpleasant odor and taste in the mouth.

Very often, this disease develops into more complex ailments of the gastrointestinal tract. For example, duodenal ulcers and even stomach cancer.

Therefore, many gastroenterologists warn their patients that they should not ignore the first symptoms, but should seek medical help.

How to recognize gastritis?

In addition to the above symptoms, gastritis can be diagnosed in other ways. These must be specially designated clinical tests and examination using special devices. Often resort to the help of an endoscopic apparatus.

But an experienced doctor will always be able to establish a diagnosis by analyzing the stomach pain that the patient experiences. For each type of gastritis there is a specific list of symptoms that allow you to make the correct diagnosis and prescribe the necessary treatment regimen.

It should be remembered that the main cause of pain in this disease is poor nutrition. It is the consumption of fried, spicy or too fatty foods that can lead to severe pain. If your stomach hurts after eating this food, then you need to categorically refuse this food in the future.

Therefore, the main thing that any diagnosed patient should remember is that he now needs to follow a strict diet and proper daily routine.

Sometimes the cause of pain can be nervous tension. By the way, many doctors claim that it is stress and poor lifestyle that lead to inflammatory processes in the stomach wall.

Therefore, before you allow yourself any nervous experiences, you should think about whether the subject of excitement is worth the consequences that you will have to endure.

Probing

This method of diagnosing gastritis is the most popular. The procedure takes about 2.5 hours and is carried out in several stages. Using a special probe, the stomach is tested for its ability to release enzymes into the gastric juice. First of all, the organ is completely emptied using a special tube. Next, 4 portions of basal secretion are collected every 10 minutes. Probing can be performed not only on an empty stomach. If necessary, check the secretion under the influence of food, introduce broth or decoction. Based on the results of the analysis, as well as color, smell and consistency, a diagnosis is made.

So, to detect the disease, you should undergo a full examination by a gastroenterologist, who will conduct an initial examination and tell you what tests to take for gastritis. A detailed examination will help to identify the nature and causes of the disease. Making a correct diagnosis guarantees effective treatment. Therefore, you should not delay going to the doctor.

Is it possible to stop the pain?

Usually, to relieve pain from gastritis, there is no need to hospitalize the patient. Therefore, such treatment can be carried out at home. But under the regular supervision of the attending physician.

But if we are talking about chronic gastritis, then the treatment period can be delayed several times, up to several years.

The very first drugs that are prescribed to a patient to relieve pain due to gastritis are considered to be adsorbent toxins. Their main task is to normalize metabolism in the body and reduce acidity in the stomach. If the cause of gastritis is an infection, then it must be treated with certain antibiotics prescribed by the attending physician.

But taking medications is not the only sure way to recover from this disease; you should also not forget about maintaining a proper daily routine and a healthy diet. What exactly needs to be done in order to cure gastritis and relieve stomach pain:

1. Eat according to the prescribed diet.
2. Limit yourself in eating spicy, hot, fatty foods.
3. Completely eliminate drinking alcohol and smoking. And also try not to drink carbonated water.
4. Chew food thoroughly and slowly.
5. Try to eat at least 5 small meals a day.
6. Monitor the temperature of the food; it should not be too cold or, conversely, too hot.

A particularly important role in the treatment process is given to diet. It is prescribed by the attending physician, according to the results of the patient’s analysis.

Types of pain due to illness

Before learning how to relieve pain with gastritis, the patient must understand where the stomach hurts with this diagnosis.

There are a certain number of signs that will help describe how the stomach hurts with gastritis, namely:

• the patient feels a feeling of a full stomach, as if it is bursting;
• severe heartburn is felt;
• possibly nausea and vomiting;
• Usually the pain with gastritis is dull;
• pain occurs on palpation.

Any patient who suffers from this disease knows what kind of pain occurs with gastritis, and what kind of pain occurs, for example, with a banal indigestion. Therefore, there is no point in explaining specifically what exactly the patient should feel. The only thing that needs to be said is the frequency of occurrence of these sensations. Gastritis pain does not occur instantly; it can increase over 10 minutes and then reach its peak.

Treatment

It is unacceptable to ignore existing symptoms. If your stomach hurts, what should you do? Gastritis is a pathology that is treated by a gastroenterologist. It is he who should be contacted when the first alarming symptoms occur. The specialist will collect anamnesis, conduct a physical examination and issue a referral for comprehensive diagnostics, based on the results of which he will determine further tactics for managing the patient.

Treatment of gastritis directly depends on the form of the disease. But in all cases, adherence to a strict diet is indicated. All food consumed should be as gentle as possible. It is unacceptable to eat food that is too hot or very cold. Food should be warm, pureed, and not contain spices. Only a small amount of salt can be added to dishes. Meals should be fractional. The diet must be followed even during remission.

One of the most important points of treatment is stopping smoking and drinking alcoholic beverages. Not a single diet or even the most effective medication will help cope with the disease if a person does not get rid of bad habits.

Treatment of acute gastritis, accompanied by a pronounced deterioration in health, requires emergency measures. In such cases, it is necessary to call an ambulance. Doctors carry out the following actions:

1. Gastric lavage. This is carried out as long as the vomit contains food particles.
2. Introduction of "Papaverine". The drug eliminates spasms and relieves pain.
3. The introduction of drugs that relieve nausea and vomiting.
4. In severe cases, antibacterial therapy is indicated.

Patients after emergency treatment are shown complete fasting on the first day. Subsequently, it is necessary to follow a gentle diet.

In 90% of cases, the “culprit” of chronic gastritis is the active activity of Helicobacter pylori. In this regard, the main goal of treatment is the destruction of the pathogenic microorganism. In addition to Helicobacter pylori, symptomatic therapy is carried out aimed at relieving pain, heartburn, and belching.

How to relieve pain with gastritis

Gastritis is an inflammation of the gastric mucosa with disruption of its functions - secretory and motor. There are acute and chronic gastritis. Acute refers to the category of “acute abdomen” and requires an immediate call for an ambulance. If pain occurs due to gastritis of the stomach, medications are not given in this case, so as not to blur the clinical picture of the disease.

There are gastritis with increased secretion (hyperacid) and with decreased secretion (hypoacid or anacid).

Why does it hurt

Gastritis of the stomach is, as mentioned above, inflammation of the inner wall of the organ. Unpleasant sensations appear in the epigastric zone approximately 20 minutes after a meal. The most common reason is poor diet. Irritating foods coming into contact with inflamed tissue cause severe pain.

Somewhat less frequently, discomfort is a consequence of smoking a cigarette or drinking strong black coffee on an empty stomach. However, it persists for several hours, significantly worsening the quality of life.

Causes of gastritis of the stomach

The development of chronic gastritis can be caused by a number of factors.

External

Presence of Helicobacter pylori.

Errors in eating and eating disorders (excessive eating with overload of the stomach with mechanically or chemically irritating foods - fatty, hot or spicy), consumption of poor quality food.

Smoking, excessive alcohol consumption.

Long-term and intensive use of drugs - salicylates, sulfonamides, digitalis, oral contraceptives, antibiotics, glucocorticosteroids.

Radiation background increase.

Poisoning with acids, alkalis, poisons.

Domestic

Genetic predisposition, lack of vitamins and enzymes.

The presence of chronic foci of inflammation in the body - cholecystitis, appendicitis, enterocolitis, pancreatitis.

Disorders in the endocrine system (pituitary-adrenal).

Metabolic disorders - obesity, gout, iron deficiency.

Food allergies, infectious diseases.

Deterioration of blood supply to the stomach tissues.

Autoimmune processes, acute or chronic stress.

Eating disorders, as well as nervous and hormonal disorders, can cause functional changes in the activity of the stomach, which subsequently lead to morphological changes in the mucosa.

It develops signs of a chronic inflammatory process - either diffuse or focal with the gradual development of varying degrees of atrophy.

Causes

The reasons that provoke the development of neoplasms include:

1. Exposure to radiation or toxic substances that lead to DNA mutation and weakened immunity. The fusion of these factors leads to the formation of malignant tumors.
2. Infection with the bacterium Helicobacter pylori. It leads to the formation of ulcers and gastritis, which in turn provoke the growth of tumors.
3. Poor nutrition. Affects the integrity of the mucosa, on which fibrous tissue is formed due to frequent injury.
4. Hereditary factor. Increases the risk of developing cancer by 20%.

Symptoms of chronic gastritis

With reduced secretory function (acidity)

Patients are concerned about nagging pain with gastritis of the stomach and heaviness in the epigastrium, loss of appetite, changes in food preferences, metallic taste in the mouth, belching of air, nausea, and during exacerbation - vomiting.

There is also sleep and bowel disorder. If measures are not taken to normalize nutrition, weight loss, deterioration of skin, nails and hair, hypotension, dizziness, and headaches occur.

With increased acidity

Pain is felt in the epigastrium, most often occurring after eating: there is a characteristic relationship between the quality of food and the intensity of pain.

Also - heartburn, rotten or sour belching, sour regurgitation, a feeling of burning and pressure in the epigastric region, a feeling of fullness in the stomach even after small portions, diarrhea, and sometimes vomiting mixed with bile or mucus. Deterioration of night sleep – occurs due to pain in an empty stomach.

The diagnosis of the disease is made based on the study of gastric juice and endoscopy and histology (after biopsy). Treatment is complex and includes relieving pain, spasms and normalizing the acidity of gastric juice.

Women's problems

Doctors often discover a lump in a woman’s lower abdomen. In some cases, the lump deviates towards the middle. Experts recommend seeking help when the pathology is accompanied by severe colic, nausea, and bleeding.

A tumor in the abdomen occurs:

• with adhesions in the uterine cavity;
• when twisting the appendages. Then a lump appears on the left or right side of the abdomen near the navel. There are additional signs such as nausea, vomiting, throbbing pain;
• with cyst formation in the ovaries. The tumor can reach large sizes and interfere with the normal functioning of organs;
• for menstrual irregularities.

Therapeutic measures will directly depend on the cause of the pathology, the age of the patient and the size of the formation.

Hardening of sutures is often observed in women who have had a caesarean section. This is explained by the fact that the seams in the recovery stage are covered with scar tissue, as a result of which growths appear. If the tumor is not removed in time, this will lead to tissue infection and the development of a pustular process.

Lumps can also occur during pregnancy. As the unborn baby grows, the skin begins to stretch, which leads to tension in the peritoneum. This process does not pose any particular danger and goes away on its own after childbirth. But the reasons may also be hidden in serious pathologies: appendicitis, gastroduodenitis, cystitis.

How and how to relieve pain with gastritis of the stomach

Helicobacter

If Helicobacter is detected, antibacterial therapy is carried out, prescribed by a specialist (Omeprazole, Amoxicillin).

For hyperacid gastritis

A significant effect is observed from taking alginates - drugs that form a film on the surface of the stomach by interacting with gastric juice, thereby preventing contact of hydrochloric acid with the mucous membrane.

The drugs begin to act five to ten minutes after administration, so the pain is relieved quickly. Available in the form of suspensions and gels. Such drugs include Gaviscon and Laminal. Valid for up to four hours.

Anticholinergics - atropine and its drugs: Bellalgin, Bellastesin - also relieve pain well.

For hypoacid gastritis

• taking natural gastric juice,
• Abomina,
• Acidin-Pepsina.

A good effect is provided by drugs that enhance the production of hydrochloric acid - Plantaglucid, Limontar.

Enzyme preparations - Mezim, Festal, Digestal - are also effective, especially in the presence of concomitant pancreatitis.

Medicines and tablets that relieve pain in gastritis of the stomach

Bismuth-based preparations also work well:

When they interact with hydrochloric acid, bismuth citrate and insoluble oxychlorides are formed, which protect the mucous membrane.

They also promote the restoration of stomach tissue and have bactericidal activity against Helicobacter, and have an astringent and anti-inflammatory effect.

Cerucal will help with nausea, vomiting and heartburn.

Antispasmodics of myotropic action - No-shpa, Drotaverine, Papaverine and neurotropic - Buscopan. They not only relieve spasms, but also normalize the activity of the stomach.

In the presence of mucosal defects - Solcoseryl.

Phytotherapy

Oils that have a good effect are flaxseed, sea buckthorn and olive. Take one teaspoon twice a day (in the morning on an empty stomach and before bedtime). You can drink it with a small amount of water.

In case of high acidity, prepare an infusion of two teaspoons of flax seeds, pour a glass of boiling water over them and let them stand overnight. Drink strictly before meals.

For low acidity, use wormwood infusion at the rate of one teaspoon of dry herb per glass of boiling water. Drink this glass in several doses throughout the day.

Mineral water. For high acidity – Borjomi, Essentuki, Jermuk. When low - Mirgorod.

Folk remedies for pain with gastritis

For hyperacid gastritis, juices that contain little organic acids - potato and pumpkin - are useful. Potato take 30-50 ml on an empty stomach. Pumpkin – 100 ml once a day. The course of treatment is ten days.

For hypoacid gastritis, freshly squeezed blackcurrant juice in the morning on an empty stomach is useful. Take within a week. Whipped raw egg whites have a good effect half an hour before meals. For low acidity, dissolve one teaspoon of honey in a glass of hot water. Drink 30 minutes before meals.

The main thing is to follow a diet and adhere to a diet. Food should be boiled or steamed and thoroughly chopped. Meals should be frequent and fractional - in small portions.

Fatty, pickled and spicy foods, spices, alcohol, coffee, tea, butter, margarine, processed foods, and sausages are contraindicated.

Shown are various milk porridges, jelly, puree soups, crackers, omelettes.

How and where the stomach hurts with gastritis, causes of pain and methods of treatment

One of the main clinical signs of gastritis is pain, varying in duration, nature and location. Gastritis is an inflammatory-dystrophic disease that affects the gastric mucosa. Leads to disruption of regenerative ability, which entails death and replacement of normal cells with connective tissue.

Pain in the stomach, discomfort in the epigastric region, nausea, sometimes vomiting, dyspepsia, a feeling of heaviness in the abdomen - these are just generalized symptoms of gastritis.

Why does my stomach hurt?

Pain syndrome is a complex feeling based on nociception. In simple terms, this means the pain receptors perceive various stimuli. Pain syndromes of epigastric localization, including pain in the stomach, are generally called abdominal pain.

There is a division of pain in the abdomen into several types:

• constant abdominal pain - the stomach hurts for a long time, patients often characterize their sensations as “hungry, aching pain in the stomach”, sometimes this includes distension syndrome caused by stretching of the hollow organs of the peritoneum;
• spastic – colic occurs, a common cause of which is increased intestinal activity;
• peritoneal abdominal pain, developing as a result of pathological processes in the gastrointestinal tract;
• vascular.

In medical practice, it is generally accepted that pain in a certain area corresponds to the location of the affected organ.

Most often, pain with gastritis is localized in the epigastrium; it seems to the patient that it is located precisely in the stomach area. There are acute, sharp symptoms or prolonged, unpleasant pain.

Prolonged, aching pain that increases after eating will be characteristic of chronic gastritis.

Palpation of the abdomen

The abdomen is a part of the body that is the abdominal cavity, where the main internal organs are located (stomach, intestines, kidneys, adrenal glands, liver, spleen, pancreas, gall bladder). Two methods of palpation of the abdomen are used: superficial palpation

and
methodical deep, sliding palpation
according to V.V. Obraztsov and N.D. Strazhesko:

• Superficial (approximate and comparative) palpation allows us to identify tension in the muscles of the abdominal wall, localization of pain and enlargement of any of the abdominal organs.
• Deep palpation is used to clarify symptoms identified during superficial palpation and to detect a pathological process in one or a group of organs. When examining and palpating the abdomen, it is recommended to use clinical topography diagrams of the abdomen.

The principle of the superficial palpation method

Palpation is carried out by applying gentle pressure with the fingers of the palpating hand placed flat on the abdominal wall. The patient lies on his back on a bed with a low headboard. Arms are extended along the body, all muscles should be relaxed. The doctor sits to the right of the patient, who must be warned to let him know about the occurrence and disappearance of pain. Approximate palpation begins from the left groin area. Then the palpating hand is moved 4–5 cm higher than the first time, and further into the epigastric and right iliac region.

For comparative palpation, studies are carried out in symmetrical areas, starting from the left iliac region, in the following sequence: iliac region left and right, periumbilical region left and right, lateral abdomen left and right, hypochondrium left and right, epigastric region left and right of the white belly lines. Superficial palpation ends with examination of the linea alba (the presence of a hernia in the linea alba, separation of the abdominal muscles).

In a healthy person, upon superficial palpation of the abdomen, pain does not occur, and tension in the muscles of the abdominal wall is insignificant. Severe diffuse soreness and muscle tension over the entire surface of the abdomen indicates acute peritonitis, limited local soreness and muscle tension in this area indicate an acute local process (cholecystitis in the right hypochondrium, appendicitis in the right iliac region, etc.). With peritonitis, the Shchetkin-Blumberg symptom is detected - increased abdominal pain when the palpating hand is quickly removed from the abdominal wall after light pressure. When tapping the abdominal wall with a finger, local pain can be detected (Mendelian symptom). Accordingly, local protective tension of the abdominal wall is often detected in the painful area (Glinchikov’s symptom).

Muscular protection in duodenal and pyloroantral ulcers is usually determined to the right of the midline in the epigastric region, in case of an ulcer of the lesser curvature of the stomach - in the middle part of the epigastric region, and in case of a cardiac ulcer - in its uppermost section at the xiphoid process. According to the indicated areas of pain and muscle protection, zones of Zakharyin-Ged skin hyperesthesia are identified.

Principles of deep sliding palpation

The fingers of the palpating hand, bent at the second phalangeal joint, are placed on the abdominal wall parallel to the organ being examined and, after the formation of a superficial skin fold, which is subsequently necessary for the sliding movement of the hand, carried out in the depths of the abdominal cavity along with the skin and not limited by the tension of the skin, they sink deeply when exhaling into the abdominal cavity. This must be done slowly without sudden movements over 2-3 inhalations and exhalations, maintaining the achieved position of the fingers after the previous exhalation. The fingers are immersed to the back wall so that their ends are located inward from the palpated organ. The next moment, the doctor asks the patient to hold his breath as he exhales and performs a sliding movement of the hand in a direction perpendicular to the longitudinal axis of the intestine or the edge of the stomach. When sliding, the fingers bypass the accessible surface of the organ. Elasticity, mobility, pain, the presence of compactions and lumpiness on the surface of the organ are determined.

The sequence of deep palpation is: sigmoid colon, cecum, transverse colon, stomach, pylorus.

Palpation of the sigmoid colon

The right hand is placed parallel to the axis of the sigmoid colon in the left iliac region, a skin fold is collected in front of the finger, and then, during the patient’s exhalation, when the abdominal muscles relax, the fingers gradually sink into the abdominal cavity, reaching its posterior wall. After this, without weakening the pressure, the doctor’s hand slides along with the skin in a direction perpendicular to the axis of the intestine, and rolls the hand over the surface of the intestine while holding the breath. In a healthy person, the sigmoid colon is palpated in 90% of cases in the form of a smooth, dense, painless and non-rumbling cylinder 3 cm thick. In pathology, the intestine can be painful, spastically contracted, lumpy (neoplasm), strongly peristaltic (obstruction below it), motionless during fusion with mesentery. With the accumulation of gases and liquid contents, rumbling is noted.

Palpation of the cecum

The hand is placed parallel to the axis of the cecum in the right iliac region and palpation is performed. The cecum is palpated in 79% of cases in the form of a cylinder, 4.5–5 cm thick, with a smooth surface; it is painless and slightly displaceable. In pathology, the intestine can be extremely mobile (congenital elongation of the mesentery), immobile (in the presence of adhesions), painful (in inflammation), dense, lumpy (in tumors).

Palpation of the transverse colon

Palpation is carried out with both hands, i.e. using the method of bilateral palpation. Place both hands at the level of the umbilical line along the outer edge of the rectus abdominis muscles and palpate. In healthy people, the transverse colon is palpated in 71% of cases in the form of a cylinder 5–6 cm thick, easily dislocated. In pathology, the intestine is palpated dense, contracted, painful (with inflammation), lumpy and dense (with tumors), sharply rumbling, increased in diameter, soft, smooth (with narrowing below it).

Palpation of the stomach

Palpation of the stomach is very difficult; in healthy people it is possible to palpate the greater curvature. Before palpating the greater curvature of the stomach, it is necessary to determine the lower border of the stomach using the ausculto-percussion method or the ausculto-affriction method.

• Ausculto-percussion
  is carried out as follows: a phonendoscope is placed over the epigastric region and, at the same time, quiet percussion is carried out with one finger in a direction radial from the stethofonendoscope or, conversely, to the stethoscope. The border of the stomach is located by listening to a loud sound.
• Ausculto-affriction
  - the percussion blow is replaced by a light intermittent glide over the skin of the abdomen. Normally, the lower border of the stomach is determined 2–3 cm above the navel. After determining the lower border of the stomach using these methods, deep palpation is used: a hand with bent fingers is placed on the area of ​​the lower border of the stomach along the white line of the abdomen and palpation is performed. The greater curvature of the stomach is felt in the form of a “roller” located on the spine. Pathology reveals prolapse of the lower border of the stomach, pain on palpation of the greater curvature (with inflammation, peptic ulcer), and the presence of a dense formation (stomach tumor).

Palpation of the pylorus

Palpation of the pylorus is carried out along the bisector of the angle formed by the linea alba and the umbilical line, to the right of the linea alba. The right hand with slightly bent fingers is placed on the bisector of the indicated angle, a skin fold is collected in the direction of the white line and palpation is performed. The pylorus is palpated in the form of a cylinder, changing its consistency and shape.

How and where can the stomach hurt with gastritis?

Dividing the disease into types will make it possible to understand where and how the stomach hurts:

• with type A gastritis, dull, aching, wave-like, and sometimes hungry pains are observed;
• Type B gastritis is characterized by cramping, sharp, short-lived, stabbing pains that radiate to places adjacent to the epigastrium;
• Pastic pain with heartburn, belching, and a burning sensation in the chest occurs after eating with type C gastritis.

To diagnose the disease, the time at which pain occurs is important. For the most part, discomfort and signs of gastritis are observed after eating, heaviness appears in the epigastrium area. It is provoked by overeating, too cold or hot food, soda, alcohol, marinades, pickles.

Sometimes the pain is localized in the left hypochondrium, at the location of the stomach. It occurs due to nervous tension, inflammation of neighboring organs, and exposure to external negative factors. With chronic gastritis, the pain lasts for at least a week and gradually subsides with proper treatment.

Drug therapy for gastritis

The question “what to take if your stomach hurts” is within the competence of the doctor, because the list of drugs used in the treatment of gastritis is extensive. There are medications that affect the antacidity of the stomach and medications that have an analgesic effect. Antacids will help relieve the feeling of fullness in the stomach and relieve heartburn, gently enveloping the mucous membrane of the organ. Maalox, Almagel, Phosphalugel, Rennie, Tams are known.

The first assistants in relieving pain symptoms are:

• antispasmodics (Mebeverine, Drotaverine, Halidor, Driptan, Spazoverine, Besalol);
• anticholinergics (Histodil, Gastrozem, Platifilin, Gangleron, Atropine).

Injections of Baralgin and No-shpa will help relieve severe stomach pain effectively and in a short time.

If your stomach hurts for a long time, decoctions of herbs are recommended: chamomile, valerian, yarrow, calendula, elderberry, linden, lemon balm, knotweed. Special gastric preparations are of great help: No. 1 is indicated for diseases with hypoacidity, No. 2 is more often prescribed for gastritis with high acidity, and No. 3 for constipation and hyperacidity.

In the chronic stage of gastritis, it is important to know its nature, which is associated with insufficient or excessive secretion of gastric juice. In case of deficient excretory function, taking enzymes is recommended. The most famous representatives of this series of drugs: Mezim, Pancreatin, Pancreazym.

Chronic gastritis requires periodic monitoring and constant adherence to dietary recommendations, as well as drug therapy.

When should you see a doctor?

If you have bothersome pain in the stomach or other unpleasant symptoms, you should consult a specialist. Only a doctor will be able to correctly determine the nature of the pain, its location, and distinguish it from signs of disease in other organs.

Pain in the epigastric region sometimes indicates the presence of other diseases. The same symptoms (stomach pain, nausea, diarrhea, bloating) are characteristic of diseases of the duodenum and esophagus. Even with myocardial infarction, pyelonephritis, pleurisy, lower lobe pneumonia, the stomach hurts, the abdomen hurts, the pain radiates to the epigastric, peri-umbilical areas, and the patient often mistakes these signs for an exacerbation of gastritis. It is the prerogative of a gastroenterologist to differentiate sensations based on the patient’s testimony and correctly diagnose the disease.