gut-wrenching anguish; deep grief; heartbroken thoughts
Literary and somewhat archaic expression for intense emotional pain, as if one's intestines are being twisted. Often used in classical or poetic contexts.
See also: 九回 (きゅうかい)
His betrayal felt like my guts were being torn apart.
In classical literature, deep sorrow is sometimes expressed as 'nine-twisted intestines'.
From the Classical Chinese expression 腸一日而九回, “the intestines turn nine times in one day,” in 司馬遷’s 「報任安書」, describing intense anguish.