Abdominal pain accompanies a host of short- and long-term medical conditions, some more serious than others. Most directly involve the digestive system. The presence of fatigue along with abdominal pain helps narrow the list of possible culprits. In general, fatigue accompanying abdominal pain might occur as a primary symptom of the underlying medical condition, result from malnutrition or both.
Infectious gastroenteritis describes inflammation of the lining of the stomach and small intestines caused by a viral, bacterial or parasitic infection or preformed toxins present in food. Also known as a foodborne illness or food poisoning, typical symptoms of infectious gastroenteritis include crampy abdominal pain, diarrhea and possibly nausea and vomiting as well as fatigue. Leading causes, such as norovirus and staph food poisoning, usually clear up within 1 to 3 days. Other culprits, such as Campylobacter jejuni and _Cryptosporidium_, often cause more protracted diarrhea with ongoing fatigue and possibly weight loss.
Inflammatory Bowel Disease
Inflammatory bowel disease includes ulcerative colitis and Crohn disease. These chronic conditions are characterized by ongoing inflammation of the digestive tract, usually with episodic symptom flareups. Inflammation can occur anywhere in the digestive tract with Crohn disease but is limited to the large bowel and rectum with ulcerative colitis. Abdominal pain and fatigue characterize both types of inflammatory bowel disease, particularly during flareups. Other symptoms might include bloody and/or mucousy stool, poor appetite, fever and weight loss.
Bleeding Peptic Ulcer
With peptic ulcer disease, areas of the lining of the stomach or first part of the small bowel undergo erosion and form ulcers. This usually occurs due to infection with Helicobacter pylori bacteria or use of nonsteroidal anti-inflammatory medicines, such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve) or celecoxib (Celebrex). Ulcers frequently cause gnawing or burning pain in the upper abdomen, although many people experience no pain. Fatigue can develop due to slow bleeding from peptic ulcers, eventually leading to anemia. Other possible symptoms include bloating, nausea and decreased appetite.
The pancreas produces blood-sugar-regulating hormones as well as digestive enzymes that empty into the small intestine. With inflammation of the pancreas, or pancreatitis, production of these digestive enzymes substantially decreases leading to reduced breakdown and absorption of food nutrients. Characteristic symptoms include boring pain the central area of the upper abdomen along with fatigue, nausea, vomiting and greasy stools. Pancreatitis most frequently develops as a complication of gallbladder disease or excessive alcohol use. Tumors of the pancreas can also cause symptoms similar to pancreatitis.
Many other conditions can trigger abdominal pain, which might be accompanied by fatigue -- although other coexisting signs and symptoms tend to be more prominent or common. Examples include:
- Kidney infection (pyelonephritis)
- Diverticulitis, an inflammatory condition of the colon
- Liver inflammation (hepatitis)
- Abdominal or pelvic cancer
- Heart disease
- Pelvic inflammatory disease (PID)
- Sickle cell crisis
Warnings and Precautions
Abdominal pain and fatigue accompanied by diarrhea and lasting only a few days usually represents a foodborne illness, which generally does not require medical care. If your belly pain and fatigue persist for longer than a week, see your doctor. Seek immediate medical care if you experience any warning signs or symptoms, including:
- Severe or worsening abdominal pain
- Vomiting blood or material that resembles coffee grounds
- Passing bloody or maroon stool
- Fever, chills or clammy skin
- Shortness of breath or difficulty breathing
- Lightheadedness, dizziness or fainting
- MMWR: Diagnosis and Management of Foodborne Illnesses A Primer for Physicians and Other Health Care Professionals
- Merck Manual Professional Version: Overview of Pancreatitis
- Surgery: Basic Science and Clinical Evidence,2nd Edition; Jeffrey Norton, et al.
- Merck Manual Professional Version: Overview of Inflammatory Bowel Disease
- American Family Physician: Evaluation of Acute Abdominal Pain in Adults
- American Family Physician: Diagnosis and Treatment of Peptic Ulcer Disease and H. pylori Infection