For example, cutting or crushing of abdominal organs does not result in a recognizable sensation. The causes of stretching or tension vary. In hollow organs such as the intestine or gallbladder, nociceptive fibers are located in the muscular wall. In solid organs such as the liver and kidney, such fibers supply the capsule and react to capsular stretching. The pain may be accompanied by nausea, vomiting, sweating, pallor, and restlessness.
Patients often move about in bed, occasionally finding relief with a change in position.
Referred pain is usually well localized and appears when noxious visceral stimuli become more intense. The classic example is the localized pain of acute appendicitis. This is obviously abdominal pain that is perceived but without any local cause. Unfortunately, this may be a pain mechanism that some physicians choose to attribute to some chronic hepatitis patients' episodes of pain. However, as cited above, physicians should take the time to explain and concede that there are valid causes for different types and intensities of abdominal pain that arise from our internal organs due to inflammation and toxic conditions.