By Marzia Khan
Reviewed by Danielle Ellis, B.Sc.
Understanding Stomach Cramps and Diarrhea
Common Causes
Serious Medical Conditions
Diagnostic Tools and Techniques
Treatment Options
When to Seek Medical Advice
Conclusion
References
Further reading
Stomach cramps include the experience of a dull ache in the abdomen, which typically does not last very long and is often not deemed to be serious, with common causes comprising food sensitivities, bacterial or viral infections, or medication. However, more severe abdominal pain can be a serious concern.
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This article will provide an overview to help distinguish between common and serious causes of stomach cramps and the potential next steps to resolve these issues.
Understanding Stomach Cramps and Diarrhea
Understanding how the digestive system works is critical to understanding why an individual experiences stomach cramps and diarrhea.2
The digestive system consists of a long tube that can be measured from the back of the mouth to the anus. The entire length of the gastrointestinal tract consists of nerves and muscles that work to pass food through the body using peristalsis.
However, this process can be disrupted if the nerves or muscles in a section of the intestines are absent or dysfunctional.2
An unhealthy digestive system can also cause diarrhea, which can be described as increased water levels in the stool due to an imbalance in the normal functioning of physiologic processes of both the small and large intestines. These organs play key roles in absorbing different types of ions, substrates, and water.3
What is Diarrhea?
Acute diarrhea includes an acute onset of three or more loose or water stools a day, which can last up to 14 days. However, if it lasts longer than 14 days, this is categorized as chronic diarrhea.3
Interestingly, diarrhea can also be categorized as infectious or non-infectious, with acute diarrhea usually being caused by an infection, predominantly viral, while chronic diarrhea is typically non-infectious.3
Common Causes
Acute stomach cramps, along with diarrhea, can be due to a stomach bug known as gastroenteritis, which is an infection of the stomach and bowel. It can be caused by close contact with an infected person or through contaminated food. Gastroenteritis can be either viral or bacterial and should resolve without treatment after a few days.1
Repeated incidences of stomach cramps and diarrhea may be a sign of a long-term condition called irritable bowel syndrome (IBS).1
Chronic diarrhea can be categorized into three groups: (i) watery, (ii) fatty (malabsorption), or (iii) infectious.3
Watery diarrhea can be due to lactose intolerance, causing increased water secretion into the intestinal lumen. Patients who experience lactose intolerance usually have symptoms such as bloating and flatulence.3
Fatty diarrhea can be due to celiac disease or chronic pancreatitis, with the latter causing insufficient enzyme release, disrupting the necessary breakdown of food and digestion of fats, carbohydrates, and proteins, which results in malabsorption.3
Bacterial and viral infections can also cause chronic diarrhea, with watery stool being caused by injury to the gut epithelium, which reduces water absorption from the intestinal lumen, causing loose stool.3
Serious Medical Conditions
More serious conditions that can present with stomach cramps and diarrhea include inflammatory bowel disease (IBD), IBS, as well as some bacterial infections caused by Salmonella or E. coli.3,4
IBD and IBS are both common causes of gastrointestinal distress, and while they sound similar, there is a critical difference, which is inflammation.4
Inflammation is a critical response, consisting of how the immune system defends the body. However, too much inflammation can be harmful.4
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IBD comprises a group of autoimmune diseases, including Crohn’s disease and ulcerative colitis, where the immune system attacks the body to cause chronic and destructive inflammation.4
IBS is not considered to be a disease but rather a group of symptoms or a syndrome. IBS impacts the digestive tract and how fast food passes through the intestines. However, it doesn’t cause physical symptoms across the body.4
While these two conditions have different pathophysiologies, they are both digestive conditions that share some symptoms, including abdominal pain and stomach cramps, bloating, gas, diarrhea, constipation, and the feeling of urgent bowel movements.4
Distinguishing between the two conditions may include exploring whether abdominal discomfort or pain lasts for at least 12 weeks during the past 12 months, whether symptoms are relieved after pooing, or if they have experienced frequent changes in either the frequency or the form of their bowel movements.4
Consuming raw or contaminated food can be associated with infectious diarrhea, such as through Salmonella found in dairy or egg products or enterohemorrhagic E. coli found in ground beef.3
Diagnostic Tools and Techniques
Common diagnostic approaches used to investigate the root cause of persistent or severe stomach cramps and diarrhea include a physical exam, blood tests to measure electrolytes and kidney function, and stool tests to check for bacteria or parasites.5
For more serious investigations, a colonoscopy, flexible sigmoidoscopy, and upper endoscopy can be performed to monitor the inside of the colon, stomach, and upper small intestine, and a biopsy can be taken for analysis.5
No test or scan can confirm IBS; even a colon exam does not show signs of disease or abnormality, but it can be used to rule out other conditions and diseases.4
Diagnosing IBD is simpler as inflammation causes damage to the intestines, and tests and imaging can be used to find this evidence.[4]
Treatment Options
Acute diarrhea can usually be cleared without treatment within a few days; however, if that does not work, antibiotics or anti-parasitics can be used to treat diarrhea.[5]
Self-care measures, including staying hydrated and maintaining electrolyte levels, can also be used as a treatment.5,6
IBD and IBS are both treatable. However, they are not curable. IBD treatment consists of controlling inflammation and treating damage from inflammation, while IBS treatment consists of treating the symptoms and avoiding triggers.4
IBS treatment can also comprise anti-diarrheal and constipation medication, as well as dietary changes such as a low FODMAP diet, which eliminates food groups that are known to be triggers.4
IBD treatment includes anti-inflammatory medication, antibiotics, and even surgery to remove damaged tissue.4
When to Seek Medical Advice
If you are experiencing gastrointestinal symptoms frequently for six months or longer, it is critical to make an appointment to see a healthcare provider.4
Additionally, other persisting symptoms that may be essential for medical attention include losing weight without trying to, changes in urination, bleeding from the anus, or persistent diarrhea that does not resolve after a few days.1
Conclusion
Understanding common and serious causes of stomach cramps and diarrhea is essential to help you understand your own body, be aware of your symptoms and gut health, and when to contact a healthcare provider to ensure appropriate management and treatment.1,4
References
Stomach ache and abdominal pain . NHS INFORM. Accessed May 28, 2024. https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/stomach-ache-and-abdominal-pain/.
How our digestive system works and keeping it healthy. NHS choices. Accessed May 28, 2024. https://www.gosh.nhs.uk/wards-and-departments/departments/clinical-specialties/gastroenterology-information-parents-and-visitors/how-our-digestive-system-works-and-keeping-it-healthy/.
Nemeth V, Pfleghaar N. Diarrhea. [Updated 2022 Nov 21]. StatPearls. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448082/
Cleveland Clinic. IBD vs. IBS: What’s the difference? (plus, how to treat them). Cleveland Clinic. April 30, 2024. Accessed May 28, 2024. https://health.clevelandclinic.org/ibd-vs-ibs.
Diarrhea. Mayo Clinic. August 22, 2023. Accessed May 28, 2024. https://www.mayoclinic.org/diseases-conditions/diarrhea/diagnosis-treatment/drc-20352246.
Viral gastroenteritis (stomach flu). Mayo Clinic. Accessed May 28, 2024. https://www.mayoclinic.org/diseases-conditions/viral-gastroenteritis/diagnosis-treatment/drc-20378852.
Further Reading
All Diarrhea Content
What is Diarrhea?
Diarrhea Treatment
Diarrhea Symptoms
Diarrhea Causes
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