Abdominal Pain

Abdominal pain is pain that is felt on the torso specifically within the area below the ribs and above the pubis. Abdominal pain is not a disease per se, but is a symptom that can be an indication of an underlying disease process.  Abdominal pain is a very common symptom that has been experienced by almost every individual.

The abdomen contains various organs. It contains hollow organs like the stomach, small intestines, large intestines, gallbladder, urinary bladder, ureters, and uterus. It also contains solid organs like the liver, spleen, pancreas, kidneys, adrenal glands, ovaries, and prostate. It also has various soft tissues like nerves, blood vessels, and muscles. Any abnormality in any of these structures can result in abdominal pain. Hence, the exact cause of abdominal pain can sometimes be difficult to identify.

Causes of abdominal pain

There are many different causes of abdominal pain.  It can originate from:

• Distention of hollow organs as in cases of intestinal gas, indigestion, constipation, or even pregnancy
• Obstruction of hollow organs as in cases of gastric tumors, intestinal tumors, gallbladder stones, kidney stones, and ureteral stones
• Inflammation of hollow organs as in cases of gastritis, gastroenteritis, appendicitis, diverticulitis, cholecystitis, cystitis, and endometritis
• Inflammation of solid organs as in cases of hepatitis, pancreatitis, nephritis, and prostatitis
• Abnormalities of other soft tissues as in cases of abdominal aortic aneurysm, mesenteric aneurysm, costochondritis, dysmenorrhea, and others

When to seek consult

Abdominal pain is often times benign and would usually resolve spontaneously. However, it is something that should not be dismissed easily because it can indicate a more serious underlying problem.

The term “acute abdomen” is used to describe severe and sudden abdominal pain of unidentified etiology that warrants investigation and probable surgical management. Acute abdomen is an emergency that requires immediate consult and evaluation. It is characterized by the following:

• Severe and sudden abdominal pain
• Lasting for several hours
• Felt in more than one quadrant of the abdomen
• Associated with guarding or tensing of the abdominal wall

Aside from the signs of acute abdomen, other accompanying signs and symptoms of abdominal pain might also suggest a serious underlying problem. The presence of the following signs and symptoms with abdominal pain warrants immediate consult:

• Fever
• Excessive diarrhea and vomiting
• Blood in the stools or in the vomitus
• Black tarry stools
• Abdominal distention
• History of trauma to the abdomen
• Pregnancy
• Long-standing abdominal pain
• Weight loss
• Loss of appetite

Diagnosis

The diagnosis of the cause of abdominal pain can be challenging because of the various organs that are located in the abdomen. To aid in the diagnosis, doctors (usually gastroenterologists for more challenging cases) are often guided by the location, duration, severity, and accompanying symptoms of the abdominal pain. Doctors perform a thorough history and a comprehensive physical examination to narrow down their differential diagnoses. In addition, they may request for additional tests to confirm their diagnosis. These tests can include:

• Blood tests such as complete blood count and blood chemistries, kidney function, liver function and pancreatic function tests
• Imaging tests such as ultrasound, CT scan or MRI of the abdomen
• Microscopic analysis such as urinalysis and Fecalysis
• Diagnostic laparoscopy (endoscopy or colonoscopy)

Treatment

The treatment of abdominal pain depends on the underlying cause. Some causes of abdominal pain can be managed conservatively with just watchful waiting; other causes can be managed medically with painkillers; others might require antibiotics and anti-inflammatory medications; and some severe cases might require surgical intervention.

Home Remedies

Although the causes of abdominal pain can be varied, some helpful tips can decrease the occurrences of abdominal pain.

• Drink plenty of water and eat high fiber foods to avoid constipation.
• Eat small frequent meals.
• Avoid foods that are known to cause your abdominal pain. For example, avoid dairy products if you are lactose intolerant.
• Avoid too much alcohol.
• Avoid foods that are rich in fat.
• Avoid aspirin or NSAIDs for abdominal pain because these can aggravate your pain by increasing the acidity in your stomach.