Exercise Related Transient Abdominal Pain (Stitch)

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Exercise-related transient abdominal pain (ETAP)/‘Stitch’

Well known to those that exercise, but given very little attention in the literature.

Well localised pain/ache in upper right abdomen – maybe left on occasion – may occasionally be referred to shoulder. More common in untrained and is more common after eating a meal prior to exercise.

Cause unknown, but may be result of very vigorous breathing resulting in:
1) Diaphragm muscle cramp
2) Diaphragmatic ischaemia
3) Stress on visceral ligaments
4) Trapping of gas in the hepatic or splenic flexure of colon
5) Irritation of the parietal peritoneum

Avoidance of large meal prior to exercise or longer gap after eating before exercising.
Usually able to manage by slowing down during the activity.
Massaging area often helps.

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