Hesperian Health Guides

Hesperian Health Guides

Chapter 15: Belly Pain, Diarrhea, and Worms

HealthWiki > New Where There Is No Doctor > Chapter 15: Belly Pain, Diarrhea, and Worms

Everyone gets pain in the belly, nausea, vomiting, constipation, or diarrhea at one time or another. Most belly problems make you feel bad but are not dangerous. If pain or nausea is not severe, wait a few days and see if it gets better. It usually will.

woman kneeling in pain holding her belly

Belly problems can be caused by many things. For example, someone may have a belly ache because of a cold or flu, because she ate bad food, or because she is worried about her children. Every cause requires a different kind of help. (Giving tablets for pain will do nothing to cure any of these causes!)

But the cause of diarrhea, belly pain, or nausea may not be clear. As with all health problems, understanding the cause of the problem is the key to treating it. Begin by asking questions about the general problem, such as diarrhea, and then ask questions to help you learn more.

  
 Danger Signs
Some belly problems are dangerous and should not wait to be treated.
  • Severe pain that gets worse and worse
  • Severe pain when you touch the outside of the person’s belly
  • Diarrhea in small children or people who are malnourished
  • A very large amount of watery diarrhea (cholera)
  • Diarrhea with blood (dysentery)
  • Vomiting that goes on for more than 1 day and 1 night
  • Black stools that look like tar (caused by bleeding in the stomach or upper intestines). Click here.

Questions to ask if there is pain

 woman asking man questions
Is the pain very bad?
Is it getting worse?
Severe pain that gets worse is very dangerous! This is called acute abdomen. Act fast. You may need to go to a hospital.
A woman with these signs could have a serious pelvic infection or an ectopic pregnancy.
Are there bowel movements?
Severe pain with few or no stools is also a sign of acute abdomen.
Is there pain with nausea and vomiting?
This may be from eating spoiled food. Drink plenty of fluids, like rehydration drink.
Does the pain come after eating? Is there a burning feeling in the chest or belly?
 woman holding belly looking uncomfortable
This may be heartburn, or it may be an ulcer.
It could also be a gallbladder problem.
Is there pain on one side of the back? Does it “wrap” around the body to the groin?
This could be a kidney stone.

Questions to ask if there is diarrhea

Diarrhea is explained here. The most important treatment for all diarrhea is drinking fluids. As soon as possible, the person should eat food too.

Has there been a lot of watery, painless diarrhea in a short time?
A very large amount of watery diarrhea could be cholera. So much diarrhea can quickly weaken or kill a person. Helping him drink constantly and eat as soon as possible can save his life.
Is there blood in the diarrhea (called dysentery)?
Dysentery is treated by drinking fluids. Antibiotics can be of use too. Click here for other causes of red blood in the stool.
Is the diarrhea frothy and smelly? Is the person farting a lot?
This could be giardia. Drink fluids. Antibiotics might be helpful.
For how long has the diarrhea been going on?


 man squatting having diarrhea
Certain germs, such as giardia or amebas, tend

to cause long-lasting diarrhea. But diarrhea might also last a long time because the person has another health problem such as:

  • Malnutrition — best treated by providing more foods with protein.
  • Problems digesting milk. Click here.
  • A long-lasting illness, especially HIV. See HIV and AIDS (in development).
Does the person have other signs of sickness — such as ear pain, fever, or a rash?
Diarrhea with fever and vomiting may be typhoid. See Some Serious Infectious Illnesses (in development). Diarrhea in children is sometimes caused by an infection in another part of the body and will go away when that infection heals. For:
Is the person taking antibiotics?
Antibiotics cause diarrhea in many people and should be avoided unless necessary. Click here.
Are a lot of people in the household or community sick with diarrhea at once?
When a lot of people have diarrhea, everyone must be more careful to prevent it spreading. You can do this by washing hands more, washing or peeling vegetables and fruits, making water safe to drink, and building toilets where there are none. See Water and Sanitation. Eat food quickly after preparing it and wash hands and surfaces used to prepare food. If everyone with diarrhea ate the same food, the food was probably bad.

Questions to ask if there might be worms

Worms are explained here. Some worms are big enough to see in the stool. Some can only be seen with a microscope.

If worms are common in your area, treat children for worms regularly.


Have you seen worms in the stool? Are worms common where you live?
If someone has worms, give the correct worm medication.
Is the belly swollen?
 "thin, malnourished boy with swollen belly"
This can have many causes including:
  • a big ball of roundworms.
  • malnutrition. (A child can be malnourished and have roundworms at the same time.)
  • giardia.
  • liver disease.
  • tuberculosis in the gut. See Problems with Breathing and Coughing (in development).
Is there burning, itching, or pain in the anus (the butt hole)?
This is usually a hemorrhoid, or raw, torn skin from rough wiping after bowel movements.
If a child scratches her anus, especially at night, it may be pinworm.

Questions about other problems with the stool (feces)

Is the stool whitish or much lighter in color than normal stool?
This is a sign of hepatitis (liver disease).
Is there red blood in the stool?
This is usually a hemorrhoid or another sore in the rectum. It is usually not dangerous, but it could also be a sign of colon cancer (see Cancer - in development).
Bloody diarrhea with mucus is called dysentery.
Is the stool black and sticky?
This is usually from blood higher up in the digestive system. This is dangerous. Click here.


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