Chronic abdominal pain affects a lot of people. For people suffering from it, their daily life gets affected. Our brain shares a close relationship with our gut. We have often used or heard phrases such as, ‘gut feeling’, ‘knot in the stomach’ ‘butterflies in the stomach. This indicates that what happens in our stomach can be directly related to what goes in our heads. This article explores the mental causes of chronic abdominal pain and how to live with chronic abdominal pain.

In chronic abdominal pain, people suffer from recurring abdominal pain. The reason can be physiological such as food poisoning or irritable bowel syndrome. This can lead to symptoms such as constipation, diarrhea, vomiting. However, when the reason is mental, people experience recurring stomach aches which are severe in nature with no apparent cause. For instance, we often experience a slight stomach ache before an interview. Some people experience this on a daily basis and more intensely.

Symptoms of Chronic Abdominal Pain

Every individual suffering from the condition may face different symptoms. Additionally, these symptoms may also change from episode to episode. Below is the list of some common symptoms.

• Sharp or dull pain in the abdominal area
• Pain around the belly button or anywhere near it
• Stomach aches which may cause vomiting, headaches, sweaty palms, pain in the limbs or shivering
• Pain in the stomach not apparently related to eating or type of food
• Disturbed eating patterns for instance, loss of appetite, not eating enough or skipping meals

Psychological Causes of Chronic Abdominal Pain

The Vagus nerve which starts at the brain and runs till the abdomen is a connection between our head and our gut. Nerve impulses flow from the abdomen to the spinal cord, then to the brain’s different sections. Our brain has two areas specific to pain perception. One of the brain areas is related to pain location and intensity of pain. The other is deals with memories or emotions. This interrelation is the reason why our emotions and life events can influence pain perception in the abdomen for some of us. Repeated abdomen injuries can make nerve receptors in the stomach extremely sensitive.

In chronic abdomen pain, even routine abdominal activity might be very painful. This is due to hypersensitivity of the gastrointestinal tract. In this condition, the brain’s ability to soften pain signals from the gastrointestinal tract is decreased. This means that even minor intestinal discomfort can be exaggerated and cause significant pain. That is to say, these individuals have a dysfunctional ‘brain-gut’ axis where the brain cannot regulate even normal nerve activity which leads to increased pain.

Effects of Chronic Abdominal Pain

Chronic abdominal pain can cause extreme discomfort to people who suffer from it. As people suffering from this condition receive continuous signals from their gut, their brain is also sending a secondary responses that magnify the negativity. This interaction between the brain and the gut leads to anticipatory anxiety. This makes it difficult for people to think about anything else except their pain. Given below are some of the effects of chronic abdominal pain:

• Under-Eating– People may fear that the type of food they are eating is leading to pain. Therefore, they may begin to avoid food items. This can lead to malnutrition, vitamin deficiency, and other physical symptoms such as weakness, dehydration, and fatigue.
• Hyper-vigilance– As people have experienced extreme pain in the past, they may constantly worry about the future. They may constantly feel anxious about it.
• Absenteeism– Children may refuse school if school stress is areasonfor their abdominal pain. Adults may fear that the pain may start at their work hence they take more sick leaves. They may start avoiding social events which involve food or eating.

  An understanding of how our brain changes our pain perception can help us manage the symptoms of chronic abdomen pain. This knowledge helps in the course of treatment. People suffering from chronic abdominal pain perceive pain more intensely when they are depressed or anxious. Pain is also intense when we focus more on it. Relaxation training or therapy can help people focus on something other than their pain.

Additionally, when we feel that we are in control of pain, the symptoms are less intense. Social support plays an important role in managing the pain. There is still a lack of clarity in determining the exact cause of this condition. Therefore, therapists and individuals should aim at controlling the symptoms. These steps help understand how to live with chronic abdominal pain. Some of the steps include:

Tracking

Individuals suffering from this condition can maintain a thought diary. This diary can contain a record of their feelings before and after the painful episode, the frequency and duration of the episode. Such records help them notice emotions that deteriorate their symptoms. They can work on these thoughts accordingly.

Stress Relief Measures

Chronic abdominal pain is due to the brain’s mistaken and elaborated pain perception. Therefore, people can use relaxation techniques to focus attention on things other than their pain.

Our brain has an ability to sense pain and it can also block pain.For example, in a race we tend to block the sensations of cramps until we complete the race. simple example is of giving an athlete finishing a match despite leg cramps. Breathing and relaxation techniques can send signals to the brain to minimize pain perception and focus on pain control. This can over time reduce the over sensitivity of the ‘brain-gut’ axis. Mental imagery and positive thinking can be used in the process.

Thought diary or record can help in understanding which technique is working and which one is not. Many smartphone applications offer relaxation or meditation practices. These exercises can help to focus on something other than your pain or negative emotions.

Cognitive Behavior Therapy

This form of psychotherapy can help people with chronic abdominal pain challenge their negative thought patterns, feelings, and emotions related to their trauma and past painful experience.

Social Support

It is important to have a network of people who can understand a person’s perception of pain. Therapists or support groups can help individuals stay consistent on their thought-transforming journey. It can help people get a better understanding of their problems. They help them create a better narrative around their experiences. This narrative is in turn an important step in formulating any kind of treatment plan.

Parents can play a role in helping children overcome their fear. They can help children to become independent. They can do this by guiding them to take up small and manageable tasks.

Medical treatment

People can seek help from a psychiatrist who will prescribe anti-anxiety or anti-depressants to reduce mood-related symptoms. A team of medical practitioners such as dieticians, counselors habit coaches can come together to help a suffering person manage the symptoms and effects.

On one hand, dieticians can look after the vitamin and mineral deficiencies on the other, counselors can manage the therapy aspects such as exploring the feelings and helping people cope with them. Habit coaches can help in motivating people and helping them stay consistent in their efforts.

Different combinations of techniques will work differently for different people. Usually, changing or rewiring thought patterns requires consistent efforts. Additionally, when the problem is persistent for a long time, professional help can make the process of change easier.

Since our brain has a tremendous capacity to change, concrete and concentrated efforts may help individuals live with symptoms of chronic abdominal pain. These days, help is just one web search away.

Epsychonline offers curated courses and self-help guides to aid individuals cope with chronic pain. Experts put in intense research and efforts to create the best resources on this website. Have a look at them to gain more insights on this problem and how to live with it.