Talking About Pain: Chronic GI Conditions
You can have me read this article to you instead of reading it yourself…
Or you can read it the old-fashioned way below…
In this new, 5-article series, I will be discussing pain caused by chronic GI conditions:
GI-related pain: What and Why
Alternative therapies for pain
How to be taken seriously when you are in pain
Pain
Pain is an enormous topic. It’s also a very personal and sensitive topic. Everyone experiences pain in different ways – it is one of the most subjective and individualized symptoms that there is. Pain comes in different forms, different intensities, strikes various parts of the body, and responds in different ways to the treatments used to combat it.
And it is also incredibly common. Everyone experiences pain at some point in their lives. Sometimes this is short-lived pain with an easily identified source (surgery, injury, accident, etc). But as much as 12% of the population experiences chronic pain on a daily basis. Sometimes this chronic pain is from an easily identified source, such as a prior car accident that resulted in permanent damage. Other times, chronic pain does not have an identifiable cause.
GI-Related Pain
The pain that comes from a chronic GI condition is often quite different than what most people think of when they hear the word ‘pain’. And it isn’t necessarily always in the GI tract…
Causes of GI Pain
The pain from a chronic GI condition isn’t necessarily limited to the GI tract. Instead, the symptoms of the GI condition can cause pain in other parts of the body. If you are nauseated and vomiting, then the muscles in your body become sore and fatigued, causing a widespread pain across your abdomen and back. If you are unable to absorb nutrients and liquids appropriately, this can cause a severe headache and other forms of discomfort that seem impossible to shake.
The fallout from certain GI symptoms can also cause very defined, targeted pain. Chronic constipation can result in hemorrhoids, which can cause a specific, focused form of pain. Chronic diarrhea can cause soreness in the same area, due to irritation and skin breakdown. On the other end, chronic vomiting can cause soreness in the throat due to acid exposure.
But the most common type of pain in someone with a chronic GI condition is pain in the GI tract. Which also happens to be the most difficult type of pain to “prove”. This type of pain cannot be confirmed by a physical examination. It is sometimes difficult to describe. And worse yet, each person experiences GI tract pain differently. While one person might appear incredibly sick, another person might look otherwise healthy. One person might have very advanced inflammatory bowel disease (IBD) and be in only mild pain, while someone with relatively mild gastroparesis could be in very severe pain. For some people it comes and goes. For other people, it is always there, only waiting to get worse.
Describing GI Pain
GI pain can take many forms. It can strike at any spot in the GI tract, from the throat to the rectum. It can hit hard and fast and leave just as quickly. Or it can linger around, flaring up here and there but never quite going away. Sometimes GI pain can feel like a cramp, while other times it can feel like your internal organs are being ripped apart.
Different GI conditions are also associated with very different forms of pain.
IBD can cause a cramping-type pain in the lower abdomen, and it can occur even in people who are in remission. On the other hand, some people with IBD who have very active disease never feel any pain at all. But even people who have become accustomed to feeling pain relatively consistently should be attuned to changes in pain. Severe pain with IBD is often considered a warning sign of disease progression, which warrants a visit to the doctor.
Irritable bowel syndrome (IBS) pain can be incredibly hard to pin down. Because IBS can involve chronic constipation OR chronic diarrhea (or a flip-flop between the two), the pain caused by IBS can run the full gamut. Some people with IBS only experience discomfort. But others can experience genuine pain that can be constant and dull, brief and sharp, cramp-like, and more. In general, this pain occurs in the lower abdomen.
Gastroparesis pain is also hard to pin down. Although gastroparesis primarily affects the stomach, disruptions in the stomach can cause issues all the way down the GI tract. Eating the wrong food, eating too much, or eating food at all can cause severe stomach cramping. Some people even experience persistent pain in the abdomen that might be described as a pressure-type pain. For those that struggle to keep food down, they might alternate between constipation and diarrhea, which can cause various forms of intestinal pain, much like the range with IBS.
Managing GI Pain
There is no general rhyme or reason to GI-tract pain. And that is why so many GI patients feel that they do not receive the treatments that they need. Many even describe feeling stigmatized and judged by medical professionals when they seek help.
There are a few reasons for this. One common reason is a very real connection between our brains and the pain experienced in our guts. GI-tract pain can often form vicious cycles – pain results in stress and fatigue, which results in more pain, which results in more stress and fatigue, and so on. As a result, many doctors tend to jump to the conclusion that there is a psychological component of GI pain. While this might be true, it’s unfair for them to assume that the psychological component came first – it is just as likely for the pain to be the real culprit. For more information on the connection between the mind and the gut, check out this article.
There is also the societal elephant in the room – the opioid epidemic. Doctors are now hyper-vigilant in their efforts to identify drug seeking behavior. Sometimes this contributes to a very good cause. Other times, it hurts those in genuine need of help. Either way, it is important for all patients to be aware of the environment that they are entering into when looking for pain relief.
And finally, there is often a communication barrier between healthcare professionals and patients. I discuss this and the concerns for drug seeking behavior in more depth in my article on being taken seriously when you are in pain.
But first, every person with chronic GI pain should be fully educated on how to describe, manage, and seek help for their pain.
Whatever the pain that you experience with your GI condition, it might be helpful to know that you are not alone. I hope that it is also helpful to know that we have some real treatment options (holistic and otherwise) that can help. And that other treatments are being actively studied as I type this.
So let’s get started!
Alternative therapies for pain
How to be taken seriously when you are in pain
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