In this educational series, we are going to focus on spasmodic or “cramping” abdominal pain that is a mild and less serious form of abdominal pain that can be managed in an out-patient setting. To start, you need a basic understanding of how the gut wall functions to move food through your gastrointestinal tract.


  • Is a common complaint presenting in South African pharmacies - almost 50% pharmacists see more than 20 people with abdominal cramps per week.1
  • More common in women than in males.1
  • Most of the time it is not due to anything serious.2,3
  • Sometimes abdominal pain can be more serious.2 Be sure to read our Red Flags article so you can assess if you need to see a healthcare professional right away.


  • Causes of abdominal pain
  • Red Flags
  • Home Remedies
  • Food and abdominal pain
  • Stress and abdominal pain
  • Abdominal pain in babies (colic)
  • Gastrointestinal infections
  • The gut-brain axis

The gastrointestinal tract (GIT) is made up of the following:4

  1. Oesophagus: carries food from mouth to stomach
  2. Stomach: holds food while enzymes from the pancreas mix with the food to break it down
  3. Pancreas: secretes enzymes needed for digestion
  4. Liver: processes absorbed nutrients and detoxifies harmful chemicals
  5. Small intestine: continues digestion and is mainly responsible for absorption of nutrients
  6. Large intestine: processes waste (stool) left over from the digestive process
  7. Rectum & anus: storage and evacuation of digestive waste (stool)

The wall of the intestine contains two layers of smooth muscle cells (smc): 5

Gut smooth muscle cells are different to skeletal and heart muscle cells.6

When the smooth muscle cells contract, they shorten and this results in the gut wall contracting and the gut lumen getting narrower. When they relax, they lengthen, and the gut wall goes back to its resting state and the lumen gets wider. These muscle contractions are important for peristalsis and food transport in the gut.

Peristalsis is a series of wave-like muscle contractions that move food through the digestive tract. 7It starts in the oesophagus where strong wave-like motions of the smooth muscle moves balls of swallowed food to the stomach. 7Peristalsis also occurs in the small and large intestine, where it assists the absorption of nutrients and water, respectively. 7

Triggers e.g. food, stress, infection

Abnormal and excessive/sustained contractions of the smooth muscle cells in the gut wall

Cramping or spasmodic abdominal pain8