Abdominal pain is one of the most common complaints seen in emergency rooms and doctor’s offices around the world. While it is often not a serious problem, it can be quite a perplexing symptom for medical professionals. The abdomen has the most amount of organs than any other cavity in the body. Pain on its own without other symptoms or diagnostic investigations can be very difficult to diagnose. The location and nature of the pain only offer some indication but may be due to a problem in any number of the organs within the abdominal cavity.
What is colon pain?
Colon pain is simply pain arising from the colon, the main part of the large intestine. It is synonymous with large intestinal pain or large bowel pain. Although much shorter than the small intestine, the colon is quite a large structure overall and extends across most of the abdominal cavity. The pain arising from the colon can therefore be felt across most of the abdomen if the entire colon is diseased. However, this location alone can be misleading since there are so many other organs around the colon.
Pain is the body’s warning signal that an area is irritated, inflamed or damaged. Specialized receptors are triggered in these cases and signals are sent back to the central nervous system where it is interpreted as pain. Unlike surface structures such as skin, the movement that occurs within the colon as part of normal activity cannot perceived with the same sensitivity as on the skin. However, very strong contractions in the bowel can be felt and even heard at times. It may also be experienced as painful spasms.
Location of Colon
The colon extends from the lower right quadrant of the abdomen where the it starts. The first part known as the cecum connects to the end of the small intestine. The cecum continues into the ascending colon which runs from th lower right abdominal quadrant up to the upper right abdominal quadrant. It then makes a sharp bend, known as the right colic flexure and runs across the upper abdomen from right to left. This is known as the transverse colon.
Another sharp bend known as the left colic flexure leads to descending colon. As the name suggests, the colon then passes from the left upper abdomen to the left lower abdomen. The descending colon continues into the sigmoid colon, a short part which leads to the rectum. Therefore colon pain can be felt anywhere along the right side of the abdomen, across the upper abdomen and along the left side of the abdomen. When most of the colon is diseased, a person may also complain of diffuse abdominal pain.
Although it is difficult to isolate abdominal pain as being due to the colon, there are some accompanying symptoms that may be helpful in confirming a diagnosis of colon pain. The following symptoms may be present when pain is due to a disorder or disease in the colon:
- Altered bowel habits such as constipation or diarrhea.
- Excessive flatulence or even reduced flatulence.
- Rectal bleeding.
- Blood or mucus in the stool.
- Pain when passing stool.
Many of these symptoms may also arise from upper gastrointestinal diseases as well but is more likely to be associated with the colon. Nausea, vomiting, bloating and abdominal distension may also accompany colon diseases. However, these symptoms are difficult to isolate to the colon alone as these are common symptoms for most types of gastrointestinal diseases.
Causes of Colon Pain
Colon pain can occur for a number of reasons. The appendix is a protrusion from the cecum which is technically not part of the colon. However, appendicitis is an important acute cause of abdominal pain. Some of the causes of colon pain are not very serious and will resolve on its own within a short period, like viral infections. At other times, colon pain may be due to serious conditions like cancer and blocked arteries that can lead to death of a portion of the colon.
Among the more common causes of colon pain, bowel infections often present with acute symptoms like diarrhea, nausea, vomiting and abdominal cramps. In severe cases, there may even be bloody stool. Infections may be due to viruses, bacteria, protozoa and in rare cases where there is immune deficiency, fungi can be responsible.
Infectious colitis is the term for an inflamed colon caused by an infection. When it is accompanied by inflammation of the small intestine then it is known as enterocolitis. Pseudomembranous colitis is an inflamed colon that arises with antibiotic use. Sometimes pouches form in the colon and these are known as diverticula. When infected it is known as diverticulitis.
In an autoimmune disease, the immune system attacks specific tissue in the body. Inflammatory bowel disease (IBD) is the more common type of autoimmune disease to affect the bowel. There are two types – ulcerative colitis and Crohn’s disease. Ulcerative colitis is isolated to the colon while Crohn’s disease can affect any part of the gastrointestinal tract. Another type of autoimmune colon disease is microscopic colitis. It can also arise with infections but the exact cause is unknown. Certain medication is also believed to be a contributing factor in microscopic colitis.
A blockage in the colon can cause pain. The obstruction may be due to a growth like large polyps, twisting of the bowels known as a voluvulus, fecal impaction or with dysfunction of the muscles in the colon wall (pseudo-obstruction). An obstruction can lead to stretching of the colon wall (megacolon) and may even cause tears in the colon.
Colon injury can occur through various different ways. Sharp or blunt force injury can occur with an assault, fall or contact sports. However, there are many medical procedures where colon injury can arise. Abdominal surgery, colonoscopy and radiation therapy can also cause colon injury although it is usually unintentional.
While growths like benign tumors and polyps can cause colon pain, it is cancer that is the greater cause for concern among most people. Colon cancer, or colorectal cancer, is among the more common type of cancers seen in the modern world and is very dangerous. Regular monitoring in high risk individuals is strongly advised these days.