After Jerusalem’s declaration of guilt, she calls upon the Lord. After recognising the justice in her punishment, she returns to the consequences she still suffers, and now makes a heart-touching appeal for God's mercy: Look, O LORD, for I am in distress.
This anxiety is further described by the image of a violent contraction in the intestines. The bowels are always represented in Hebrew as the seat of feeling; the image therefore means to express the fiercest, most profound sorrow (see also Jeremiah 4:19). There is also reference to a distortion of the heart. It signifies the restlessness of the heart.
That this sorrow and unrest does not primarily relate to judgment, but to sin, is proven by the addition because I have been very rebellious
(see also Lamentations 1:18). Jerusalem thereby wants to indicate that she mainly suffers from the sin through which she has incurred judgment.1
20 Eternel, regarde ma détresse! Mes entrailles bouillonnent, Mon cœur est bouleversé au-dedans de moi, Car j'ai été rebelle. Au-dehors l'épée a fait ses ravages, au-dedans la mort.