Sudden Severe Abdominal Pain and Diarrhea: Could It Be More than Just a Simple Upset Stomach?

The symptoms of sudden turmoil disorder described in the Donguibogam closely resemble conditions modern medicine calls acute gastroenteritis or acute enteritis. Acute gastroenteritis is primarily caused by viral infections such as norovirus and rotavirus or bacterial infections such as Escherichia coli and Salmonella, or by hypersensitivity reactions to specific foods or toxin ingestion. In response, our digestive organ mounts an acute inflammatory defense against foreign invaders, which leads to vomiting and diarrhea. At the center of this reaction lies our enteric nervous system. Operating independently enough to be called our second brain, the enteric nervous system regulates digestive tract motility, secretion, and blood flow. When foreign irritants or pathogens invade, the enteric nervous system communicates via the vagus nerve connected to the brain, alerting the entire autonomic nervous system to the emergency. The sympathetic nervous system then activates, causing intestinal motility to surge rapidly and stimulating cytokine release to regulate inflammation, producing violent symptoms such as abdominal pain, diarrhea, and vomiting. Modern individuals experiencing high stress can be especially vulnerable, as stress exerts a direct effect on the enteric nervous system through the gut-brain axis. The stress hormone cortisol increases intestinal mucosal permeability, allowing harmful substances to penetrate more easily, and can trigger unfavorable shifts in the gut microorganism environment. This can raise the risk of developing acute digestive diseases like sudden turmoil disorder or worsen their symptoms. Therefore, rather than merely suppressing symptoms, fundamentally improving gut health and managing stress are considered important treatment approaches in modern medicine as well.