The Star : 15 October 2006 

MOST people tend to use the term “stomach ache” for various types of stomach or abdominal discomfort.  

There are various causes of this “stomach ache” symptom such as stomach cramps, abdominal pain, and abdominal bloating. 

Stomach cramps

A precise interpretation is stomach muscle spasms coupled with pain, but many people use the term “stomach cramps” loosely to represent any kind of stomach discomfort, stomach ache, abdominal discomfort or abdominal pain.  

People may say “stomach cramps” when they are really cramps of the intestines. 

The following medical conditions are some of the possible causes of stomach cramps: diarrhoea, constipation, digestive infection, viral infection, irritable bowel syndrome, lactose intolerance, diverticulosis, food poisoning.  

There are likely to be other possible causes, so ask your doctor about your symptoms. 

Abdominal pain 

Abdominal pain is pain that you feel in the abdominal area (the area between your chest and groin), often referred to as the stomach region or belly.  

Even when you feel pain there, it may actually originate from somewhere else – like your chest or pelvic region (the area just below the abdomen that houses the reproductive organs). 

The abdomen is made up of various organs. Hence, pain in the abdomen can originate from any one of them, including: Organs related to digestion (the stomach, the end of the oesophagus, the small and large intestines, the liver, the gallbladder, and the pancreas); the aorta (a large blood vessel that runs straight down the inside of the abdomen); and the appendix (an organ in the right lower quadrant that no longer serves much function). 

The intensity of the pain does not always reflect the seriousness of the condition causing the pain. Severe abdominal pain can be from mild conditions, such as gas or viral gastroenteritis (a virus that causes inflammation along the lining of the stomach and intestines). On the other hand, relatively mild pain (or no pain) may be present with life-threatening conditions, such as cancer of the colon or early appendicitis. 

The severity of the condition has more to do with the abruptness of the pain, in particular if it is sharp and localised to one region, rather than spread throughout your abdomen. 

Abdominal bloating 

Abdominal bloating makes the abdomen feels full and tight. It is usually caused by intestinal gas.  

Common causes include overeating, lactose intolerance and other food intolerances; air swallowing (a nervous habit); irritable bowel syndrome (IBS); partial bowel obstruction and constipation. Important but uncommon causes of abdominal bloating include ascites and tumours, such as those arising from ovarian, colon, or liver cancer. These are just some examples and do not include all possible reasons of abdominal bloating. 

Visit your doctor if the discomfort or pain does not go away.  

Medical treatment 

By looking at your medical history and performing a physical examination, your doctor will try to establish the cause of your abdominal pain.  

Knowing the location of pain and its time pattern will help, as will the presence of other symptoms like fever, fatigue, general ill feeling, nausea, vomiting, or changes in stool (colour and texture). 

Your doctor may ask the following questions about your abdominal pain: