Internal Medicine

Pain in the colon

Synonyms in a broader sense
Healthy colon

Synonyms in a broader sense

Colon pain
Colon pain
stomach pain
stomach pain
Irritable colon
Irritable bowel syndrome (IBS)
Colon spasticum
Irritable colon
Irritable Bowel Syndrome (IDS)
"Nervous bowel"

English

colon pain
irritable bowel syndrome (IBS)

introduction

Pain in the colon can have different causes. Individual diseases that lead to pain in the colon are listed below.

Symptoms

Colon pain can be caused by irritable bowel syndrome. Irritable bowel syndrome is a group of functional bowel diseases that occur very frequently in the population. The patient feels unspecific pain and discomfort in the abdomen. In addition, the bowel habits change. Irritable bowel syndrome can be accompanied by diarrhea (diarrhea-predominant) or from blockages (constipation-predominant).

Constipation and diarrhea can alternate, so that one speaks of irritable bowel syndrome with changing bowel habits. The irritable bowel syndrome is also often accompanied by chronic pelvic pain, as well as fibromyalgia and mental illness. Fibromyalgia is a chronic fiber-muscle pain with variable localization. Patients often mistakenly believe that they have a food intolerance to lactose or starch, since the symptoms can increase when these multiple sugars are consumed. However, in most cases this is an error. The increased symptoms can usually be traced back to a temporary overgrowth in the small intestine.

Illustration Colon pain

Figure pain in the large intestine: location of the abdominal organs around the large intestine and causes of pain (A-F)

Pain in the colon

Liver - Hepar
Colon, ascending part -
Ascending colon
Appendix - Caecum
Appendix -
Appendix vermiformis
Rectum - Rectum
Large intestine, transverse part -
Transverse colon
Large intestine, descending part -
Descending colon
Small intestine -
Intestine tenue
Stomach - Guest
Causes:
A - colon polyps
(Thickening of the mucous membrane
or glandular tissue)
B - Colon Cancer -
Colon cancer
(Malignant tumors of the intestine)
C - appendicitis
(Inflammation of the appendix)
D - colon diverticulum
(Protrusions of the intestinal wall)
E Crohn's disease
(Chronic inflammatory
Bowel disease)
F - ulcerative colitis
(Chronic inflammation
of the colon)
-Food intolerance,
a lot of stress, eating too fast

You can find an overview of all Dr-Gumpert images at: medical illustrations

causes

The causes of irritable bowel syndrome are still partly unclear. One suspects an interplay of psychological and organic factors that cause the symptoms. Important risk factors are sugar disease (Diabetes mellitus) and a Gluten sensitivity.

Healthy colon

View from the point of view of a colonoscopy

Intestinal lumen / intestinal opening
Intestinal lining
Haustren = small “normal” sinks in the area of the large intestine

therapy

Treatment of irritable bowel syndrome is limited to diet advice in the case of mild symptoms. If the cause is poor colonization of the small intestine, high doses can be used Antibiotics administered. Discharge-inhibiting agents can be used to alleviate diarrhea, in order to counteract constipation, if administered accordingly laxative. Psychotherapy is also recommended for psychological causes.

Read more about: Irritable Bowel Drugs.

Conditions that can cause pain in the colon

Pain in the left / upper left abdomen

Many diseases of the colon can cause severe pain in the affected patient, especially in the area of the colon left upper abdomen are localized.
However, pain to the left of the navel does not have to be always indicate a problem with the large intestine. Possible causes for complaints in the left upper abdomen are also diseases of the spleen, of Stomach and the Kidneys.
Nevertheless, diseases of the colon are among the most common reasons for left navel pain. The exact location of the colon pain in the left upper abdomen also allows conclusions to be drawn about the affected parts of this section of the intestine: If the pain mainly occurs to the left of the navel, in most cases it is based on a change in the left colon sections.
Pain in the right upper abdomen, on the other hand, indicates a disease of the right-hand part of the colon.

Typical changes that provoke pain in the left upper abdomen can be of inflammatory or infectious origin. Especially the so-called "Irritable bowel syndrome“Causes pain in many cases that can be felt to the left of the belly button. In addition, the patients affected by irritable bowel syndrome often feel unspecific as well as pronounced symptoms Abdominal discomfort. In addition, many of those affected suffer from accompanying diarrhea (Diarrhea) or recurring Constipation (Constipation).

Also include Colon diverticulum one of the most common causes of colon pain in the area of the left upper abdomen (see below). In the early stages, diverticula of the colon usually do not cause any discomfort. Pain in the area of the left upper abdomen usually only occurs when the disease progresses. In addition, affected patients typically develop high levels fever, nausea and or Vomit.

Another disease that can lead to pain on the left of the navel is the so-called "Ulcerative colitis". This term means a colon disease that belongs to the group of inflammatory bowel disease (IBD) can be assigned. Depending on which part of the large intestine is affected, there are different localizations of the pain felt. Pain in the left upper structure usually indicates the presence of inflammatory processes below the curvature of the colon on the left (left colonic flexure). In most cases, this disease of the large intestine begins immediately in the area of the Rectum. Starting from there, the inflammatory processes can spread further in the course of failure of a suitable therapy and cause pain to the left of the navel when reaching higher colon sections. The cause of the development of this inflammatory bowel disease is in most cases the body's own immune system. The disease known as "ulcerative colitis" is therefore a disease Autoimmune disease. In addition to the typical pain in the left upper and lower abdomen, the affected patients complain in most cases bloody diarrhea and a pronounced general symptomatology with Fatigue and fever.

Malignant changes in the colon can also lead to pain in the left upper abdomen. Especially the so-called "Colon cancer“(Colon cancer) can cause severe pain in affected patients, localized to the left of the belly button. Colon cancer affects about six percent of the population and is observed in both women and men alike. Other typical symptoms that indicate the presence of colon cancer are irregular stool, blood in the stool, fever, night sweats and unexplained weight loss.

Pain right

In addition to diseases that lead to pain in the left colon, some of the most common diseases manifest themselves in the area of the right colon.
The diseases that are relevant in this context include the so-called "Diverticulitis" (see below). Although most colon diverticula arise in the S-shaped part of the colon, and therefore pain Left such protuberances can also occur on the right side. A diverticulum by itself does not cause any symptoms in most of the affected patients. Pain in the large intestine that is located either on the right or left only occurs when one is present inflammation of these intestinal protuberances.

Another cause of the development of pain in the colon on the right is the so-called "appendicitis."

diarrhea

Most diseases that occur in the large intestine are associated with similar basic symptoms. The typical symptoms in this context include mild to severe pain, nausea, vomiting, diarrhea and Constipation. Depending on which section of the large intestine is affected, the symptoms are different. Diarrhea is one of the most common complaints caused by diseases in the colon. Either inflammatory changes the colon lining, as well infectious diseases can lead to pain and severe diarrhea.
In this context, the color, smell and consistency of the diarrhea can provide a crucial clue as to the underlying condition. The most common cause of pain in the colon that is associated with severe diarrhea is the so-called "Irritable bowel syndrome". This disease is a functional disorder of the large intestine without a pathological change in this part of the intestine. In affected patients, the colon tends to react to certain stimuli. Typically it comes through mental stress, worry and / or certain foods an acute occurrence of the symptoms.
The most common symptoms seen in patients with irritable bowel syndrome are pain in the colon, diarrhea, constipation and nausea. In principle, irritable bowel syndrome patients describe one constant change between diarrhea and constipation. Often, however, one of these two symptoms predominates (Diarrhea or constipation).
It has been observed that women are significantly more likely to suffer from irritable bowel syndrome with pain in the colon and diarrhea than men. The malfunction of the colon in a patient with irritable bowel syndrome is based on one Hypersensitization the nerve fibers of the colon. The causal stimuli cause strong nerve impulses that lead to an involuntary contraction of the muscles in the large intestine. Because of these cramps, the food pulp is transported too quickly inside the intestine. Excess fluid can no longer be adequately withdrawn and people develop diarrhea.
Since there are a number of causes for the development of irritable bowel syndrome with pain in the large intestine and diarrhea occurring at the same time, treatment is often difficult. Affected patients should always be aware of possible Food intolerance to be examined. In addition, the affected patients should carefully observe the occasions when the symptoms arise. In this way, possible stressors can be determined that lead to an acute occurrence of irritable bowel syndrome. In most patients, symptoms can be caused by a Change in eating habits be alleviated.
In addition, can regular exercise help to remedy the causal malfunction of the large intestine and thus effectively treat irritable bowel syndrome. Drug treatment only makes sense in the rarest of cases.

Back pain

Some gastrointestinal disorders can cause pain in the large intestine that extends into the back (back pain). Since the affected people perceive the back pain as much more intense in many cases and try to see a specialist in orthopedics, the underlying disease is usually diagnosed very late.

Diseases of the gastrointestinal tract that cause pain in the colon project in most cases directly onto the lumbar spine. Since it is precisely in this area that herniated discs often occur, the symptoms can quickly be misinterpreted.
In this context, inflammatory processes in the large intestine are particularly relevant.

However, pain in the large intestine occurs much more frequently when there are pronounced impairments to the spine. In these cases, the gastrointestinal tract does not cause any radiation of pain to the back, which the affected patients perceive as back pain. Rather, it can be long lasting and or very pronounced back pain has a lasting effect on the gastrointestinal tract.
The affected patients develop pain in the colon, constipation or diarrhea as the back problems persist.

The long-term use of painkillers also plays a crucial role in this context. Patients who increasingly resort to painkillers from the group of non-steroidal anti-inflammatory drugs when they have severe back pain often damage certain parts of the gastrointestinal tract.

Also read the article: Abdominal pain and back pain

Flatulence

Flatulence can be so severe in some people that it causes pain in the colon.
In most cases, flatulence is not a worrying condition. Flatulence (air in the stomach) is often caused by a wrong diet triggered and can therefore be easily accessed via a targeted Change in diet to treat.
Occasionally, however, gas can also go through with pain in the colon area Food intolerance caused. Especially intolerance to fructose (Fructose intolerance), Milk sugar (Lactose intolerance) or gluten (Celiac disease) can lead to severe flatulence in the affected patient. The boundaries to the pathological are fluid with those affected.

One of the most common causes of flatulence and pain in the colon is the so-called "Irritable bowel syndrome“.
In addition, it occurs after consumption flatulent foods to a release of air in the intestines. In many cases, however, such digestive problems can be influenced by the psyche. Especially people who are constantly short of time, a lot stress have or out of habit eat too fast, often suffer from gas and pain in the colon. When eating too hastily, large amounts of air are often swallowed. This air gets over the esophagus in the stomach and can only be partially opened again. In the end, only a small part of this air gets into the intestines. However, this is usually sufficient to cause severe flatulence with pain in the colon in the affected person.

In addition, flatulence can often be observed in:

Pregnant women (The main reason for this is the change in the hormonal balance)
Read more about this at: Flatulence in pregnancy
Infants
People who often take medication (Antidiabetic drugs, anti-inflammatory drugs, Diclofenac, Lactulose)
People who suffer from psychological stress or anxiety

Treatment of flatulence with pain in the colon is only necessary in very pronounced cases.

Colon diverticulum / diverticulitis

In general, a diverticulum is an outward protuberance in the wall of a hollow organ. Colon diverticulum mostly affect people of old age. They mostly arise in the S-shaped part of the large intestine, the Sigma and initially make no complaints. However, when a diverticulum becomes inflamed, that's called one Diverticulitiswhat complaints how stomach pain, fever and causes nausea and is a serious complication of the colon diverticula and causes severe pain in the colon.
Further information on this topic can be found at: Diverticulitis

Appendicitis (appendicitis)

One speaks of appendicitis in one Inflammation of the appendix (Appendix vermiformis) of Appendix, this is also amateurish and not entirely correct as "Appendicitis" designated. This disease is presented with Pain in the right lower abdomen, nausea, Vomit and fever. Even now, the diagnosis is still a challenge for medical professionals and requires quick action in the form of an operative appendage removal (Appendectomy). A dreaded and serious complication of appendicitis is the breakthrough (perforation) of the appendix associated with a life-threatening Peritonitis (Peritonitis) can go hand in hand.
Read more on the topic Appendicitis

Crohn's disease

This chronic inflammatory bowel disease (IBD) can theoretically affect the entire gastrointestinal tract from the oral cavity to the anus. However, Crohn's disease preferentially affects the lower small intestine (terminal ileum) and the Colon. Crohn's disease often appears with symptoms such as cramping stomach pain and slimy diarrhea (Diarrhea). The characteristic of this autoimmune disease is that segmental (in sections) infestation the intestinal lining.
Further information on this topic can be found at: Crohn's disease

Also read more on the topic: Diagnosis of Crohn's disease

Ulcerative colitis

Ulcerative colitis is also a disease from the group of inflammatory bowel disease (IBD) Which Pain in the colon trigger. This is particularly characterized by the infestation of the Colon and usually starts with the Inflammation of the rectum, but can sometimes also affect the small intestine in the form of a so-called "grown-in" small intestinal inflammation ("Backwash ileitis"). Ulcerative colitis is also autoimmunologically triggered and participates stomach pain and bloody diarrhea (Diarrhea) noticeable.
Further information on this topic can be found at: Ulcerative colitis

Colon cancer (colon carcinoma)

This common cancer affects about 6% of the population and affects both women and men second most common cancer The main causes of colon cancer are Eating habits discussed. In most cases, the tumor causes symptoms such as Stool irregularities and hidden Blood in the stoolwhich are rather unspecific. Since colon cancer grows slowly compared to other cancers, it gives the person enough time to remedy it Colonoscopy diagnose and thus fight early.

You can also find more information under our topics: Colon cancer and colon cancer

Congenital megacolon

Synonyms

Hirschsprung's disease, Hirschsprung's disease, congenital megacolon, anganglionotic megacolon, congenital megacolon.

Symptoms / causes / treatment:

Hirschsprung's disease is a disease of the large intestine, which belongs to the group of aganglionoses. In general, it is a congenital lack of nerve cells in the intestinal wall. The colon is particularly often affected. This results in a disturbed peristalsis of the intestine and a massive enlargement, which is known as a megacolon. The disease is named after the person who first described it, the pediatrician Harald Hirschsprung, and has a prevalence of 1 in 5000. Boys are more often affected than girls.

The lack of nerve cells, also called ganglion cells, leads to massive hyperplasia (enlargement) of upstream nerve fibers. These increasingly release the messenger substance acetylcholine, which leads to a very strong contraction of the intestine. Possible causes are a malformation in the embryonic development or a viral infection of the embryo. The disease also occurs more frequently in families in which relatives have children together. The constant contraction of the intestine leads to constipation a few days after birth. There is a risk of bowel obstruction.

Other symptoms are vomiting and nausea. The intestinal obstruction is of course accompanied by pain. Hirschsprung's disease is less common in adults, but it also causes chronic constipation and possibly pain. However, since the symptoms are not so pronounced here and the nerve cells are usually only missing in a very short section of the intestine, the diagnosis is often made very late.

A biopsy (tissue sample) of the intestinal wall usually provides certainty. Treatment is surgically possible, in which an artificial anus is placed in newborns before the operation. Then a piece of the malformed intestine is surgically removed if possible.

Read more on this topic: Hirschsprung's disease

Adenomas / polyps

Adenomas are thickenings of the mucous membrane or glandular tissue that can generally occur anywhere. They can be found in almost every organ system. However, they are particularly common in the intestines as so-called Polyps.

Polyps are benign changes that have the potential to mutate malignantly.

The finding is often incidental, as most patients are symptom-free. But there can also be complaints such as mucus secretion and Diarrhea, Pain, bleeding and constipation occur. Adenomas are dangerous when they degenerate. Due to the frequent occurrence, a cancer screening examination is recommended from the age of 45. Surgical removal is performed for very large polyps and severe symptoms.