Painful stomach cramps and diarrhea accompany many digestive system conditions. Pain commonly referred to as stomach cramps generally do not arise from the stomach but rather from the intestines. This fact explains why crampy abdominal pain and diarrhea so frequently occur together. Some causes of these symptoms pose no serious health threat and go away relatively quickly while more serious culprits tend to persist.
Foodborne illnesses occur due to consuming food, water or other beverages contaminated with disease-causing viruses, bacteria or parasites. Common symptoms include stomach cramps and diarrhea as wells as possible nausea and vomiting. According to the Centers for Disease Control and Prevention, foodborne illnesses affect 48 million Americans each year. CDC further reports that the most common infectious agents responsible for foodborne illnesses in the US are norovirus, Salmonella, Clostridium perfringens, Campylobacter and Staphylococcus aureus.
Lactose and Other Food Intolerance
Food intolerance refers to difficulty digesting certain types of foods due to specific nutrients or ingredients, commonly leading to stomach cramps and diarrhea as well as bloating and increased gas. Lactose intolerance is the most common of these conditions. It occurs due to a deficiency of the digestive enzyme lactase, which breaks down the milk sugar lactose. Large amounts of dietary fructose can also overwhelm the small intestine's capacity to digest this sugar, which is found in fruits, fruit juices, full-sugar beverages and many other foods that contain fructose as a sweetener. Sorbitol is another common cause of food intolerance. Sorbitol is used as a sweetener in many sugar-free foods and candies, and occurs naturally in several types of fruit, including plums, prunes and other stone fruits.
Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is a common but incompletely understood disorder that causes digestive symptoms, which sometimes include stomach cramps and diarrhea. Some people with IBS alternate between diarrhea and constipation. The abdominal pain is characteristically related to moving the bowels. Foods high in FODMAPs -- fermentable oligosaccharides, disaccharides, monosaccharides, and polyols -- aggravate IBS symptoms in some people with the condition.
Inflammatory Bowel Disease
Abdominal pain, cramps and diarrhea are hallmark symptoms of inflammatory bowel disease, namely Crohn disease and ulcerative colitis. As the name implies, these diseases are characterized by inflammation of the gastrointestinal tract. Inflammation is limited to the colon with ulcerative colitis but can occur anywhere in the digestive tract with Crohn disease. Although they are chronic conditions, symptoms often wax and wane with inflammatory bowel disease.
Malabsorption of major dietary nutrients -- proteins, fats and/or carbohydrates -- causes diarrhea, abdominal cramps, bloating and increased gas. Weight loss and fatigue also commonly accompany these digestive symptoms. Malabsorption occurs with several medical conditions, including:
- Chronic pancreatitis, ongoing inflammation of the pancreas
- Pancreatic cancer
- Cirrhosis of the liver
- Cystic fibrosis
- Alcohol abuse
- Small bowel bacterial overgrowth
- Whipple disease, a rare infection
Other Considerations, Warnings and Precautions
The conditions discussed represent the most likely causes of painful stomach cramps and diarrhea but additional disorders can also lead to these symptoms. For example, endometriosis involving the bowel can potentially cause abdominal cramps and diarrhea. Bowel and pelvic tumors are other considerations as is diverticulitis, a condition characterized by inflammation of outpouchings of the bowel called diverticula.
Contact your doctor if you experience stomach cramps and diarrhea that persist for more than a few days. Seek immediate medical care in your abdominal pain is severe or worsening, or accompanied by any warning signs or symptoms including:
- Bloody diarrhea
- Fever or chills
- Vomiting for longer than 24 hours
- Decreased urination
- Dizziness, lightheadedness or fainting
- Centers for Disease Control and Prevention: Foodborne Illnesses and Germs
- World Journal of Gastroenterology: Carbohydrate Malabsorption in Patients With Non-Specific Abdominal Complaints
- Merck Manual Professional Version: Carbohydrate Intolerance
- Merck Manual Professional Version: Irritable Bowel Syndrome
- Therapeutic Advances in Gastroenterology: Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols (Fodmaps) and Nonallergic Food Intolerance: Fodmaps or Food Chemicals?
- Mediators of Inflammation: Inflammatory Bowel Disease: An Overview of Immune Mechanisms and Biological Treatments
- Merck Manual Professional Version: Overview of Malabsorption