Abdominal Pain

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Overview

Abdominal pain is a very common symptom, and may be an indication of both minor ailments such as indigestion and constipation, or major diseases such as ulcers, cancers and intestinal obstruction. It may arise from problems with from the digestive system including the stomach, the colon, the appendix, liver, gallbladder, pancreas. It may also arise from kidney or bladder problems such as kidney stones. Sometimes the problem lies with the female reproductive organs, or from diseases affecting the skin and layers of the abdominal wall, e.g. shingles and hernia. Sometimes, pain felt over the abdomen may be due to diseases arising not within the abdomen, but elsewhere, e.g. heart attack and pneumonia. Occasionally, no physical abnormality is found despite a very comprehensive evaluation. In such a situation, the abdominal pain may be functional in nature.

Evaluation

What are the some of the questions the doctor may ask you to determine the cause of the pain?

Where is the pain located? Is there a change in location of the pain? Is the pain over a confined area or is it felt throughout the entire abdomen?
How long has the pain been present?
What is the nature of the pain: is it stabbing, cramping or dull?
Whether there were similar episodes of pain in the past?
How severe is the pain? (this is usually estimated on a scale of 1 to 10)
Does the pain come and go, or is it constant? Is it brought on by food or is it experienced during certain times of the day or month, e.g. when you are having menstruation?
Is the pain felt somewhere else in addition to the predominant region, e.g. the back or shoulder tip?

Red flags

What are the danger symptoms?

Persistent or severe pain
Persistent vomiting
Inability to pass gas and open bowels
Increase in abdominal girth
Fever

Chills
Severe shivering
Passage of blood or black stools
Vomiting of blood
Yellowing of the skin, dark coloured urine or pale stools

Investigations

Depending on the doctor’s suspicion after he has performed a detailed history taking and a physical examination, he may order certain tests. Such tests include blood tests, stool and urine tests, X-rays, endoscopy, and scans such as an ultrasound or CT scans.

Treatment

Treatment depends on the cause of the pain once it is determined. It can be lifestyle modification such as with gastric reflux disease. Or medications may be necessary for both symptom control and specific treatment of the problem. For conditions like acute pancreatitis, a person can become very sick and may even need to be admitted into ICU in some situations. In other situations, surgical operation may be required, such as for conditions like acute appendicitis, gallbladder stones and cancer.