{"id":11148,"date":"2025-06-11T14:39:00","date_gmt":"2025-06-11T14:39:00","guid":{"rendered":"https:\/\/twojlekarz.net\/?p=11148"},"modified":"2026-04-10T13:23:54","modified_gmt":"2026-04-10T12:23:54","slug":"11-06-bole-brzucha","status":"publish","type":"post","link":"https:\/\/twojlekarz.net\/en\/11-06-bole-brzucha\/","title":{"rendered":"11\/06\/2025 | Abdominal pain"},"content":{"rendered":"

Dariusz Litera
<\/strong>Abdominal pain is one of the most common complaints patients report to doctors. It's estimated that up to 10% of primary care visits are related to this problem. Unfortunately, despite the onset of pain, as many as 40% people don't seek medical help promptly, which can lead to delayed diagnosis of serious conditions. Do you sometimes ignore this symptom, especially when it's not very severe? Today, your doctor is surgeon Dr. Adam Ku\u017ami\u0144ski. Welcome, doctor.<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>Good morning. What are the most common causes of abdominal pain and when should we be concerned?<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>Let's remember one thing: pain is our friend. It's a symptom that tells us something is wrong in our body, that something bad is happening. The abdominal cavity is so innervated that the pain we experience may not necessarily originate there. It could be something quite common, such as an inferior wall heart attack. And this is a very dangerous situation, because ignoring this pain can lead to death.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>But how do you recognize it? Is it a heart attack or perhaps some more severe indigestion?<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>This is a very good question and a very difficult one to diagnose. Therefore, I would always advise consulting a doctor, who will order the simplest test, an ECG.<\/p>\n\n\n\n

Dariusz Litera<\/strong><\/p>\n\n\n\n

Then we'll at least rule out the heart attack. But as for the stomach, we'll probably need a bit longer to diagnose it.<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>Yes, we live in the 21st century, and we have a whole range of different diagnostic tests, from imaging to laboratory studies. Each of these tests contributes to our diagnosis and allows for a diagnosis to be made very quickly, in most cases.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>First, the doctor usually checks the abdomen with his hand.<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>Simply touching a patient can tell us a lot about abdominal pain. This can confirm the symptoms of an acute abdomen.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>I wanted to ask about it. What does it manifest itself in? What exactly is it?<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>Z takiego fizjologicznego punktu widzenia, patofizjologicznego. Jest to podra\u017cnienie zako\u0144cze\u0144 nerwowych, otrzewnej. Kiedy to si\u0119 dzieje? Wtedy, kiedy mamy jaki\u015b stan zapalny w jamie brzusznej, to otrzewna zostaje przez ten „zapalony” w cudzys\u0142owie narz\u0105d podra\u017cniona. Lekarz chirurg k\u0142adzie r\u0119k\u0119 na brzuchu, naciska delikatnie ten brzuch i od razu czu\u0107 napi\u0119cie mi\u0119\u015bni. Napi\u0119cie mi\u0119\u015bni prostych. Jest to jeden z licznych objaw\u00f3w ostrego brzucha.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>And the patient is writhing.<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>Well, not necessarily. We have two types of patients with abdominal pain. One type of patient resembles a caged lion. They pace, fidget, and can't sit still. When asked where the pain is, they can't pinpoint the location. Their stomach simply hurts. They pace. They sit down. They sit down. They pace all the time. They can't find a better position. That's one type of patient.<\/p>\n\n\n\n

The second type of patient is the one who lies curled up in a ball. Don't touch me. You can't touch me. Where does it hurt? I'll point to that exact spot. And this is the patient we're most worried about.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>So we are worried about his health.<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>Because this is a symptom of acute abdomen.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>And this acute abdomen is actually acute appendicitis. It could also be acute cholecystitis.<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>May be.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>And this is all it can be?<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>Virtually everything in the abdominal cavity that becomes inflamed. These two types of patients represent two types of pain. One type of pain is called visceral pain. This is pain associated with dilatation of the tubular organs, such as intestinal distention, dilatation of the bile ducts, and dilatation of the ureters, which is related, for example, to the movement of stones or deposits, or increased content in these ducts.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>So how does a lemon try to get through the plum hole?<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>There's no lever, it has to hurt. And it's visceral pain. This is pain that usually subsides after administering antispasmodics. And such a patient is given antispasmodics in the emergency room. He's diagnosed. You have gallstones, for example, bile duct stones. Goodbye.<\/p>\n\n\n\n

The next day, further diagnostics. And he goes home. The second type of pain, related to irritation of these nerve endings in the peritoneum, is somatic pain. And here we must get to the heart of the matter and begin treating the inflammation, because without it, we won't cure the patient. And delaying diagnosis and treatment for too long can result in the loss of the patient.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>So, there's an immediate, life-threatening situation, and we need to act quickly as a medical team. We have an acute abdomen, and this could be a symptom, as the doctor said, of almost any acute inflammatory condition of the abdominal organs?<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>Yes. And then straight to the operating table!<\/p>\n\n\n\n

Dariusz Litera
<\/strong>And then surgeons know what they're doing. They're saving the patient's life. Yes, but only if the pain is severe and chronic. How do we distinguish between chronic and acute pain?.<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>Every chronic pain begins at some point with a sudden onset of pain. This is obvious. Chronic pain is a condition that requires double our vigilance, because it's the information our body constantly transmits: Something's wrong, something's changed, something's wrong with me. Do something about it.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>And since pain is our ally, we have to react.<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>Ignoring these symptoms can later lead to irreversible changes in our body and really big problems.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>How can the location of pain initially indicate its cause? That is, can a doctor determine more precisely based on its location and location?<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>Not always. The location of abdominal pain is very deceptive. Sometimes, what a patient feels can lead us down very wrong paths. It's generally believed that epigastric pain is pain associated with some stomach condition, or pain, for example, under the right hypochondrium, is associated with gallbladder disease. This is related to the location of these organs, and that's obvious. But for example, if we have appendicitis, the pain in early inflammation begins in the epigastrium. Only as the situation progresses, the inflammation develops, does this pain initially become visceral pain. Only later, when the gallbladder becomes inflamed and touches the peritoneum, does inflammation develop in this area, and we progress to somatic pain. So, first, we have pain in the epigastrium, which slowly descends towards the right iliac fossa, where the underlying disease occurs.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>What can we advise people who do not experience acute pain, but such ailments,
which may become more severe?<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>This is a very difficult question. I have many patients who postpone seeing a doctor, and then it gets really bad. Then we have a lot of problems. Then the procedures we perform are fraught with a very large number of possible complications, because adhesions form, because the entrance to the abdomen is difficult, and so on. We live in the 21st century, so we have access to a multitude of painkillers and antispasmodics, and unfortunately, these are over-the-counter medications, meaning we can take them without any supervision. Don't delay. Generally, don't delay seeing a doctor. The most important thing in all of this is a diagnosis. If we know what we have, what's wrong, we can do it.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>In the family history too?<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>Well, yes, but let's focus on the pain, on this situation now. Not on genetically related diseases, but on what hurts now. So if we know, we have a diagnosis, and this pain persists. We can use painkillers, we can alleviate these pain symptoms, because we know what's wrong with us.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>But first we need to find out.<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>That's the way it is, and that's where diagnostics come in. And this is where the entire diagnostic process that we must conduct is very important to us.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>What are the most common mistakes patients make? As the doctor said, we have a whole range of over-the-counter medications we can purchase and use. It's just that we probably overuse them a bit, and as the doctor said, there are problems with patients who come to the doctor when it's already very late and the disease has progressed.<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>And there are two problems here. On the one hand, patients take too many medications, mixing different medications that are actually the same drug, just in different forms and under different brand names, thus accumulating the dose of the drug.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>And sometimes they even irritate their digestive tract.<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>That's another matter. Not only does it exercise the digestive system, but it also exercises the liver, which has to process all this, right? And the second type of patient is those who use homeopathic doses of these medications, which won't help, and the liver has to process all this anyway.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>So we do not delay and we do not overdo it when taking medications on our own.<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>Exactly.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>Doctor, how does lifestyle and diet generally affect the occurrence of abdominal pain?<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>This is an issue we could discuss for hours, as it's related to our overall lifestyle. In today's fast-paced world, our meals are too irregular. We live under enormous stress.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>We sit on one side.<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>We live under a lot of pressure. We lack exercise. Car, desk, car, desk, and that's it.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>What preventive measures should we take to ensure that abdominal pain only indicates a potential disease?<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>It's impossible to answer this question. If we led a truly healthy lifestyle, introduced physical exercise, regular meals, and something virtually impossible these days\u2014a stress-free life. That's utopia. Then perhaps a stomach ache would mean something is seriously wrong.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>Do women or men come to a surgeon's office with abdominal pain more often?<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>The ratio of men to women is essentially the same. However, we have a bigger problem with women, because women, as the weaker sex, endure pain longer. Therefore, they don't pay attention to it. Men are more sensitive to these ailments and see a doctor sooner, which sometimes saves their lives. When it comes to illnesses, a large number of illnesses are gender-related. Gallstones are a female disease, stomach ulcers are a male disease. Here, the ratio of women to men is the same.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>Doctor, abdominal pain as a symptom is no longer somatic, but psychosomatic, because here we're touching on a completely different field of medicine. That is, there are people who experience severe pain, and even if we diagnose it for a very long time, it turns out there's no somatic basis for them to feel it.<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>There are such patients. We need to realize that we have two nervous systems. One system is responsible for our emotions, and the other nervous system is responsible for not having to remember to inhale, exhale, inhale, exhale, and so on. And it is precisely disturbances in this autonomic system that can cause various strange symptoms in a patient. These can be symptoms related to intestinal peristalsis. They can be associated with various strange pains that pass, that reappear, correlated with emotions, or even without any correlation. These patients often go to a doctor, a primary care physician, or even paramedics because the pain is so intense and causes such significant distress for these patients. They actually feel it. It's not a situation where the patient is hysterical, or has a headache, or so on. No. They actually hurt. You have to go through the entire diagnostic procedure to determine that someone has a problem like globus hystericus. You can't neglect anything, you can't underestimate anything. And the golden rule is to always trust the patient.<\/p>\n\n\n\n

Dariusz Litera
<\/strong>Dr. Adam Ku\u017ami\u0144ski, a surgical specialist, said in the podcast "WHAT DOES YOUR DOCTOR SAY?" Thank you very much, doctor.<\/p>\n\n\n\n

Dr. Adam Ku\u017ami\u0144ski
<\/strong>Thank you very much.<\/p>\n\n\n\n

<\/p>","protected":false},"excerpt":{"rendered":"

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