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PTSD and Abdominal Pain

Post Traumatic Stress Disorder (PTSD) is an anxiety disorder that results from the experience of undergoing a trauma, such as being a victim of violence or witnessing violence. Abdominal pain is a commonly reported symptom in people who have PTSD.

  1. PTSD Symptoms

    • PTSD symptoms include re-experiencing the traumatic event through flashbacks, vivid memories, distressing dreams, or intense distress when exposed to reminders of the trauma; persistent avoidance of reminders of the trauma; and persistent symptoms of distress that can include sleep problems, anger or irritability, and exaggerated startle response.

    Anxiety

    • People with PTSD typically develop problems with chronic anxiety.

    Abdominal pain

    • Abdominal pain originates from organs within the abdominal cavity, including the stomach, small intestine, colon, liver, gallbladder, and pancreas.

    Primary Physiological Health Effects

    • The constant triggering of PTSD symptoms causes a stress response that includes the stimulation of the hypothalamic-pituitary-adrenal axis. Cortisol and other stress hormones are released and have systemic effects including increase in heart rate, increase in blood pressure, muscular tension, and inhibition of digestive processes (except for release of stomach acids). These physiological actions cause immediate somatic effects such as headaches, gastrointestinal distress, chest pain, and abdominal pain.

    Secondary Long-Term Health Effects

    • Long-term effects of chronic arousal include increased vulnerability to illnesses that cause abdominal pain, often due to immune system dysfunction that causes heightened vulnerability to inflammation. Illnesses that cause abdominal pain that are associated with PTSD include diverticulitis, ulcerative colitis, digestive tract bleeding and irritable bowel syndrome. Chronic anxiety can also exacerbate abdominal conditions that may have other causes, such as pancreatitis and Crohn’s disease.

    Interventions

    • Interventions should focus on therapy to reduce the anxiety and PTSD symptoms, and medical treatment of the underlying somatic problems that resulted from the chronic arousal.

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