Why Does My Stomach Hurt When I Cough?

Coughing is a reflex that helps clear the airways, but it can sometimes lead to discomfort in the abdominal area. When we cough, the diaphragm and abdominal muscles contract forcefully, creating pressure that can strain the abdominal tissues. This may activate pain receptors, resulting in discomfort or sharp pain, especially after prolonged coughing fits. Studies show that coughing can increase intra-abdominal pressure by up to 200% compared to normal breathing, significantly straining the abdominal muscles.

In this blog, we will explore the causes of abdominal pain linked to coughing, focusing on the connection between the respiratory system and the abdomen. Understanding these dynamics can help identify why stomach pain occurs during excessive coughing and provide insights into effective management strategies.

Muscle Strain

Coughing can lead to significant strain on the abdominal muscles. It involves the contraction of various muscle groups, including the abdominal and intercostal muscles, which can cause wear and tear over time. Forceful or prolonged coughing may result in small tears in the muscle fibers, leading to pain and soreness, especially during respiratory illnesses like bronchitis or the flu. Research indicates that prolonged coughing from respiratory conditions like chronic bronchitis can lead to muscle strain in 50% of patients, particularly in the abdominal region. 

Symptoms include sharp or dull stomach pain that worsens with movement and discomfort when bending or twisting. To prevent strain, address the underlying cause of the cough and allow the muscles to rest. Applying heat or cold, gently stretching, and avoiding strenuous activities can help alleviate pain and promote healing.

How Does Acid Reflux Contribute to Stomach Pain During Coughing?

Acid reflux, often associated with GERD (Gastroesophageal Reflux Disease) or urinary tract infections, occurs when stomach acid flows back into the esophagus, leading to discomfort and a burning sensation known as heartburn. This backflow can worsen with coughing, as the physical exertion puts pressure on the abdomen, pushing more acid into the esophagus. Individuals with hiatal hernias are especially susceptible to this cycle, where coughing exacerbates acid reflux and vice versa. Symptoms include a burning sensation in the chest or throat, increased stomach pain during coughing, indigestion, and regurgitation.

It is estimated that 20-40% of people in developed countries experience GERD, and 75% of them report that coughing makes their symptoms worse. To manage acid reflux and associated stomach pain, it’s important to avoid trigger foods, eat smaller meals, and elevate the head during sleep. Medications like antacids or proton pump inhibitors can also help reduce stomach acid production and relieve irritation

Hernias

Hernias occur when an organ or tissue pushes through a weak spot in the abdominal wall, often leading to significant pain, especially during activities that increase intra-abdominal pressure, like coughing.

Types of Hernia

Here are different types of hernias and their connection to coughing-related discomfort:

• Hiatal Hernia: Part of the stomach protrudes into the chest through the diaphragm, causing pain during coughing due to increased pressure at the gastroesophageal junction, often accompanied by heartburn and acid reflux.

• Inguinal Hernia: A bulge in the lower abdomen where tissue or part of the intestine pushes through groin muscles. Coughing exacerbates the pain as it increases stress on the weak area.

• Abdominal Wall Hernias: Includes umbilical and ventral hernias that bulge in the abdominal wall. Coughing intensifies discomfort by straining weakened muscles.

Approximately 5% of the population will develop some form of hernia in their lifetime, with inguinal hernias being the most common, particularly in men. Coughing raises intra-abdominal pressure, pushing the hernia further through the muscle wall and causing pain. Surgical repair is often recommended to relieve pain and prevent complications. In the meantime, managing cough triggers and wearing supportive garments can help reduce pressure on the hernia.

Bloating and Gas

Bloating and trapped gas are common digestive issues that can exacerbate abdominal discomfort during coughing. When gas builds up in the digestive system, it expands the stomach, increasing intra-abdominal pressure and making coughing more painful, often resulting in sharp or cramping sensations. Digestive struggles can lead to gas and bloating, causing the upper abdomen to feel tight. Each cough increases this pressure, worsening discomfort as trapped air pushes against the abdominal muscles, leading to pain that can radiate to the chest.

Up to 30% of adults report experiencing bloating regularly, especially after large meals or consuming gas-producing foods like beans and carbonated drinks. To alleviate pain during coughing, it’s important to address these digestive issues by reducing gas-producing foods, staying hydrated, and engaging in gentle movement. Over-the-counter remedies for gas relief can also help decrease trapped gas and ease coughing discomfort.

Appendicitis

Appendicitis affects about 7% of people at some point in their lives, and prompt medical attention is necessary to prevent rupture. Appendicitis is a medical condition where the appendix becomes inflamed, leading to severe lower abdominal pain. One of the key symptoms of appendicitis is a sharp stomach pain that worsens with movement or pressure, and coughing can significantly exacerbate this pain.

Signs of Appendicitis

Common symptoms of appendicitis include:

• Sharp pain in the right lower quadrant of the abdomen, which often starts near the belly button and shifts to the lower right side.
• Fever and chills.
• Nausea and vomiting.
• Loss of appetite.
• Sensitivity to touch in the lower right abdomen.

How Coughing Intensifies Appendicitis Pain

When you cough, the increased pressure in the abdominal cavity pushes against the inflamed appendix, intensifying the pain. This sharp, stabbing pain is a sign that the appendix is highly sensitive to any physical stress or movement. For individuals with appendicitis, even a slight cough can cause the pain to spike, especially as the inflammation worsens.

Coughing can also be a useful diagnostic indicator for appendicitis. Medical professionals often use a test called the “cough test” where patients are asked to cough, and if pain increases significantly in the right lower quadrant, it may suggest appendicitis.

The Role of Diaphragm and Respiratory Muscles in Stomach Pain

The diaphragm plays a crucial role in breathing, and its repeated contractions during coughing can lead to abdominal pain. This dome-shaped muscle separates the thoracic and abdominal cavities and helps expel air when it contracts. During coughing, the diaphragm’s forceful contraction increases intra-abdominal pressure, putting strain on both the diaphragm and abdominal muscles, which can result in discomfort.

Prolonged or violent coughing can lead to diaphragm strain, causing muscle fatigue and soreness in the respiratory muscles, including the intercostal and abdominal muscles. As the diaphragm contracts, the pressure on the abdominal region can stretch muscles or tissues, leading to pain, especially in individuals with pre-existing conditions like muscle weakness.

To manage diaphragm and cough-related abdominal pain, it’s important to address the underlying cause of coughing and consider resting the diaphragm through cough suppressants or breathing exercises. Additionally, avoiding excessive strain on the thoracic cavity can help prevent further diaphragm strain.

Post-Surgical Pain

Recovering from abdominal surgery can be challenging, especially when actions like coughing intensify discomfort. Coughing increases intra-abdominal pressure, pulling at the surgical wound and disrupting the healing process. This pressure causes the weakened abdominal muscles to contract sharply, resulting in sharp pain or pulling sensations near the incision.

During the initial recovery stages, the healing of the incision is delicate, and coughing can stretch newly repaired muscle tissues, potentially leading to pain, delayed healing, or even suture separation. Proper postoperative care is crucial to prevent severe symptoms from coughing-induced pressure.

To manage pain related to coughing after surgery, patients can support the surgical area with a pillow or their hands, a technique known as “splinting,” which helps minimize movement and ease discomfort. Additionally, cough suppressants and gentle breathing techniques are recommended to reduce coughing frequency and severity during recovery.

Pregnancy and Coughing-Related Abdominal Pain

Pregnancy brings significant changes to a woman’s body, particularly affecting the abdominal muscles and ligaments. As the uterus expands, it exerts pressure on surrounding structures, leading to discomfort, especially during activities like coughing. The abdominal muscles stretch to accommodate the growing uterus, while round ligaments that support it may also stretch, causing sharp or stabbing sensations, particularly during sudden movements like coughing.

Coughing can worsen this discomfort, as the contraction of abdominal muscles and sudden increase in abdominal pressure can intensify the pain. This is especially common in the third trimester when the uterus is the largest.  During pregnancy, round ligament pain affects approximately 10-30% of pregnant women, particularly in the second and third trimesters.

To manage coughing-related abdominal pain during pregnancy, women can try several techniques: supporting the abdomen with a pillow or hands during coughing, staying hydrated to soothe the throat and reduce cough urges, and practicing gentle breathing exercises to minimize coughing fits and promote relaxation.

Could It Be a Lung Condition? When Coughing Refers Pain to the Stomach

Coughing can sometimes lead to abdominal pain, which may seem unrelated to lung issues. However, certain lung conditions can cause referred pain in the abdomen.

Lung Conditions That Can Cause Abdominal Pain

• Pleurisy: Inflammation of the pleura around the lungs can intensify sharp pain that radiates to the abdomen, as both areas share nerve pathways.

• Pneumonia: This lung infection can cause significant coughing, leading to abdominal pain due to forceful contractions of the abdominal muscles, especially if the infection is in the lower lobes.

• Bronchitis: Inflammation of the bronchial tubes results in persistent coughing, which can trigger abdominal discomfort as chest pressure leads to pain signals perceived in the abdomen.

The Mechanics of Referred Pain

Referred pain occurs when discomfort in one area is caused by issues in another. The lungs and abdominal organs share nerve pathways, so irritation in the lungs can manifest as abdominal pain.

Recognizing Lung Condition Cough Pain

Coughing accompanied by abdominal pain may indicate an underlying lung condition. Watch for symptoms like:

• Shortness of breath
• Chest pain
• Fever or chills
• Mucus production

Pelvic Floor Dysfunction

Coughing is common, but for individuals with pelvic floor dysfunction, it can lead to significant abdominal discomfort. Understanding the connection between coughing and pelvic floor health is essential for managing symptoms.

How Coughing Affects the Pelvic Floor?

The pelvic floor supports the pelvic organs, and coughing generates increased abdominal pressure that strains these muscles. For those with pelvic floor dysfunction, this added pressure can exacerbate symptoms, causing severe pain and discomfort.

Mechanism of Pressure Transfer

• Coughing and Intra-Abdominal Pressure: Coughing forces the abdominal muscles to contract, creating pressure that impacts the pelvic floor.

• Weakness in Pelvic Muscles: Weak pelvic muscles, often due to pregnancy, childbirth, or aging, struggle to support this pressure, leading to discomfort.

• Pelvic Organ Prolapse: Increased coughing pressure can contribute to pelvic organ prolapse, causing feelings of heaviness or bulging.

Symptoms During Coughing

Those with pelvic floor dysfunction may experience pelvic pain, increased urgency or difficulty controlling urination, lower abdominal pressure, and pain during sexual activity.

Management Strategies

To alleviate discomfort, individuals can try:

• Pelvic Floor Exercises: Strengthening exercises like Kegels can improve muscle tone.

• Breath Control: Practicing controlled breathing can lessen coughing intensity.

• Consulting an Immediate Medical Attention: A pelvic floor physical therapist can provide tailored strategies and exercises for effective symptom management.

Home Remedies and Medical Treatments for Stomach Pain from Coughing

Coughing can cause abdominal pain, which can be uncomfortable and disruptive. Fortunately, various home remedies and medical treatments can help alleviate this discomfort.

Home Remedies for Stomach Pain from Coughing

• Rest: Allowing your body to rest can reduce strain on abdominal muscles and aid recovery.

• Warm Compress: Applying a warm compress to the abdomen can relax muscles and relieve tension.

• Hydration: Staying hydrated is essential. Warm fluids like herbal tea or warm water with honey can soothe the throat and may help reduce coughing.

• Natural Remedies: Ginger and chamomile tea can alleviate stomach pain and inflammation, with ginger known for its anti-nausea properties and chamomile for relaxation.

• Muscle Relaxation Techniques: Gentle stretching, yoga, and breathing exercises can relieve muscle tension, strengthen abdominal muscles, and promote relaxation.

Over-the-counter (OTC) Pain Relievers

If home remedies are insufficient, OTC pain relievers can be effective:

• Anti-Inflammatory Drugs: NSAIDs like ibuprofen or naproxen can reduce pain and inflammation from muscle strain.

• Acetaminophen: An alternative for those who cannot take NSAIDs, providing pain relief without anti-inflammatory effects.

Frequently Asked Questions 

– Disclaimer –

This blog is for informational & educational purposes only, and does not intend to substitute any professional medical advice or consultation. For any health related concerns, please consult with your physician, or call 911.