Abdominal pain can be caused by a number of health conditions and anyone suffering from ongoing abdominal pain should seek medical advice in the first instance. For those who have suffered with abdominal pain for some time they will be all too familiar with the feelings of nausea, bloating and stomach cramps as symptoms they have endured for some time. Medical conditions often associated with abdominal pain include irritable bowel syndrome (IBS) and Crohns disease which are diagnosed by a medical health professional.
For sufferers of these conditions the constant pain and feelings of discomfort can be a source of great anxiety and be a major disruption to their daily lives.
In this post I’d like to talk about some of the common causes of abdominal pain and how the stresses and strains of our daily lives can often contribute to a worsening of symptoms.
It must be stressed again that this post is not intended as a way to self diagnose or to use as an alternative to medical advice but as a source of information for those who already have a diagnosis and are looking for ways in which to find lasting relief from their symptoms.
Causes of chronic abdominal pain
Chronic abdominal pain can be due to a number of digestive conditions including Crohns disease and irritable bowel syndrome (IBS). During an acute flare of these conditions, symptoms can include nausea, bloating and diarrhoea…as well as pain.
Many digestive conditions are also associated with stress and symptoms can be more intense when stress levels are increased…more on this later!
Another potential cause of abdominal pain can be as a result of scar tissue following surgery. Many abdominal procedures are often performed using key hole surgery (laparoscopy); keyhole surgery is performed by making smaller incisions and using small surgical instruments to perform the procedure. Surgeries such as to an appendices or caesareans are performed via open surgery.
Often, when scar tissue is seen as the cause of abdominal pain, the recommendation is usually to have further surgery to have it removed.
Chronic abdominal pain is often treated by the use of medications but these can potentially have unwanted side effects.
Finding alternative ways to reduce pain and other symptoms can be difficult but with an understanding of the fascial system, it is possible to find a more holistic way to help.
As mentioned earlier, heightened stress levels can be the cause or the cause of an increase in symptoms to those who suffer from abdominal pain.
To understand this link, it’s important to know a little about how our nervous system works…it’s a bit technical but won’t take too long and it’s actually quite interesting so try to stick with it!
Stress and abdominal pain
The link between stress, anxiety and gastric issues has been known for some time; have you ever had to make a “gut wrenching decision” under pressure? Or were you ever so anxious you had butterflies in your stomach? Then you will know how stress can affect the digestive system. But how does this happen and how can ongoing levels of stress and anxiety have a longterm impact upon our digestion?
Well, to help us understand this a little further, we’ll first take a quick look at the workings of the nervous system…
The Human Nervous System
The nervous system is split up into the central nervous system and the peripheral nervous system. The central nervous system includes the brain and spinal cord, while the peripheral nervous system is split up into the somatic and autonomic nervous systems.
The somatic nervous system is involved in the movement of our skeletal muscles. The autonomic nervous system – is then further split up into the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS).
These two systems are activated in times of arousal or recovery. Put simply, the SNS activation leads to a “fight or flight response” response, and PNS activation leads to a “rest and digest response”
The fight or flight response involves the SNS changing activity in the body to help prepare for a perceived threat. These changes include: increases in heart rate, expansion of the lungs, momentary increases in muscular strength the release of epinephrine/norepinephrine.
These increases are to enable the body to be in a better position to either run away from the perceived threat or to fight back.
As part of the defence mechanism, as well as increasing activity to area needed for the fight or flight response (increased awareness, expansion of lungs and muscular strength) the sns will also reduce activity in areas of the body which are not required whilst we are in immediate danger; one of those areas is the digestive system (for example, we do not need to digest food whilst we are in a highly stressed state and needing to run away or fight to survive). The increased tone of the sns will momentarily ‘switch off’ the digestive system in order to use the energy elsewhere.
These processes are meant to optimise functions in the body when it’s under attack – you won’t benefit from digesting food, but you’ll likely need more oxygen from the lungs.
To facilitate the rest and digest response, the PNS alters a number of functions in the body to help it recover. These functions are largely mirror opposites of SNS activation, and include: stimulation of the digestive and immune systems, decreases in pupil size and heart rate, and contraction of the lungs. These processes optimise functions in the body at rest, and allow it to focus on maintenance.
These functions appear in not only moments of life-or-death, but also with more common emotional responses. As anyone who has felt the fear of public speaking knows, you don’t have to come face-to-face with a physical threat to feel a fight or flight response.
If we are subjected to the ongoing stresses of everyday life such as family responsibilities, a demanding job or personal issues then this will trigger the fight or flight response; if these stresses are occurring regularly then this can result in our SNS (fight or flight response) becoming overstimulated and begin to suppress the PNS (rest and digest response) resulted in increase in heart rate, lung capacity and prepare the muscles for the fight or flight response whilst decreasing input into other parts of the body which are not needed immediately – such as the digestive system.
This can lead to increased tension in the muscular tissues and due to the overstimulated SNS discarding the digestive system – sluggish and poorly functioning digestion.
The Vagus nerve
The vagus nerve is the longest nerve in the human body. Originating in the brain, the Vagus nerve descends from the brain, down through the neck and then into the abdomen. The vagus nerve acts as a communicator between the brain and the gut. When stress levels are increased the body switches into fight or flight mode and in turn (as we discussed previously) will switch off the digestion. Due to the close association between the digestive system and the vagus nerve – the vagus nerve will also begin to ‘switch off’ and it’s ability to regulate the digestive system will be reduced.
Image above illustrates the connection between the vagus nerve (in yellow) and the various organs of the body.
As part of any treatment for abdominal pain/ digestive disorders it is important not to only focus on the area of pain but to also look to stimulate the vagus nerve. This is usually achieved by releasing the area around the neck – just below the skull at the back of the head. Gentle sustained pressure in the area will help to free up the tissues which can potentially be causing restriction on the nerve. This can also be achieved by using slow, sustained stretches, which can be done at home.
Scar tissue and abdominal pain
Another potential cause of abdominal pain can be as a result of scare tissue within the abdomen. Following surgery, fascia within the abdomen will often attempt to repair the any areas of scarring by laying down collagen to try and add more strength to the weakened area. This increased tissue creates a natural restriction. There are occasions when the body will react by creating too much collagen, resulting in adhesions and the formation of scar tissue; these newly formed tissues can then cause the internal structures of the abdomen, such as the organs, to begin to stick to one another. Even where keyhole surgery has been performed, unintentional scarring can occur as although the incision to the tissues is much smaller than in open surgery the tools used have to travel through the tissues to reach the area where the problem is located, therefore creating a tunnel of scarring.
It is possible to help to reduce the effects of scarring by way of fascial manipulation and this is also an area where the client themselves – under guidance – can work on at home with light, sustained stretches to help release ‘stuck’ tissues.
So there we have it, an of overview of abdominal pain, some of it’s causes and potential treatment strategies. It’s a big subject to try and discuss in a short post but hopefully this has been useful information for those of you who suffer from ongoing abdominal pain. I know from treating clients over the years the amount distress and disruption these conditions can have on peoples daily lives.
The aim of the post was to help to enlighten those sufferers that there are approaches which can help to reduce and manage their symptoms in a more natural, holistic way.
Often myofascial release techniques to the abdomen along with guided stretches to do at home can be enough to help manage symptoms. Treatment is gentle and non invasive (often, there is no need to apply the techniques direct to the skin and treatment is normally applied over clothing). Other treatment strategies include help to improve breathing technique and improving awareness the role stress plays in symptom management.
In the coming weeks and months my intention is to include some of the exercises mentioned on the facebook page so keep a look out for those. Also, lookout for some of my follow up blogs where I will be discussing other health/ fascia related issues.