abdominal pain

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Abdominal Pain

Abdominal Pain Names

Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps; Acute abdomen

Abdominal Pain Definition

Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.

Abdominal Pain Considerations

There are many organs in the abdomen. Pain in the abdomen can originate from any one of them, including:

abdominal pain Organs related to digestion -- the stomach, the end of the esophagus, the small and large intestines, the liver, the gallbladder, and the pancreas.
abdominal pain The aorta -- a large blood vessel that runs straight down the inside of the abdomen.
abdominal pain The appendix -- an organ in the lower right abdomen that no longer serves much function.
abdominal pain The kidneys -- two bean shaped organs that lie deep within the abdominal cavity.

However, the pain may originate from somewhere else -- like your chest or pelvic region. You may also have a generalized infection affecting many parts of your body, like the flu or strep throat.

The intensity of the pain does not always reflect the seriousness of the condition causing the pain. Severe abdominal pain can be from mild conditions, such as gas or the cramping of viral gastroenteritis. On the other hand, relatively mild pain or no pain may be present with life-threatening conditions, such as cancer of the colon or early appendicitis.

Abdominal Pain Causes

Many different conditions can cause abdominal pain. The key is to know when you must seek medical care right away. In many cases you can simply wait, use home care remedies, and call your doctor at a later time only if the symptoms persist.

Possible abdominal pain causes include:

cases of abdominal pain Excessive gas
cases of abdominal pain Chronic constipation
cases of abdominal pain Lactose intolerance (milk intolerance)
causes of abdominal pain Viral gastroenteritis (stomach flu)
causes of abdominal pain Irritable bowel syndrome (sensitive stomach with intermittent episodes of diarrhea and constipation)
causes of abdominal pain Heartburn or indigestion
causes of abdominal pain Gastroesophageal reflux
causes of abdominal pain Ulcers
causes of abdominal pain Cholecystitis (inflammation of the gallbladder) with or without gallstones
causes of abdominal pain Appendicitis (inflammation of the appendix)
causes of abdominal pain Diverticular disease, including inflammation of small pouches that form in the large intestines (diverticulitis)
causes of abdominal pain Bowel obstruction -- in addition to pain, this causes nausea, bloating, vomiting, and inability to pass gas or stool
causes of abdominal pain Food allergy
causes of abdominal pain Food poisoning (salmonella, shigella)
causes of abdominal pain Hernia
causes of abdominal pain Kidney stones
causes of abdominal pain Urinary tract infections
causes of abdominal pain Pancreatitis (inflammation of the pancreas)
causes of abdominal pain Intussusception (telescoping intestines) -- while uncommon, this is a serious possible cause of pain in an infant who may be drawing his or knees to the chest and crying to indicate the pain
causes of abdominal pain Dissecting abdominal aortic aneurysm -- bleeding into the wall of the aorta
causes of abdominal pain Parasite infections (Giardia)
causes of abdominal pain Sickle cell crisis
causes of abdominal pain Crohn's disease or ulcerative colitis (two different types of inflammatory bowel disease)

When an inflamed organ in the abdomen ruptures or leaks fluid, you not only have excruciating pain, your abdomen will be very stiff (board-like) and you will likely have a fever. This occurs when you have peritonitis due to an infection spreading in the abdominal cavity from the ruptured organ, like the appendix. This is a medical emergency.

In infants, prolonged unexplained crying (often called "colic") may be caused by abdominal pain that may end with the passage of gas or stool. Colic is often worse in the evening. Cuddling and rocking the child may bring some relief.

Abdominal pain that occurs during menstruation may be from menstrual cramps or it may indicate a problem in a reproductive organ. This includes conditions such as endometriosis (when tissue from the uterus is displaced to somewhere else like the pelvic wall or ovaries), uterine fibroids (thick bands of muscular and fibrous tissue in the uterus), ovarian cysts, ovarian cancer (rare), or pelvic inflammatory disease (PID) -- infection of the reproductive organs, usually from a sexually transmitted disease.

Abdominal pain may actually be caused by an organ in the chest, like the lungs (for example, pneumonia) or the heart (like a heart attack). Or, it may stem from a muscle strain in the abdominal muscles.

Cancer of the colon, stomach, or pancreas are serious but uncommon causes of abdominal pain.

Other more unusual causes of abdominal pain include a type of emotional upset called somatization disorder, reflected as physical discomfort (including recurrent abdominal pain). Strep throat in children can cause abdominal pain.

Abdominal Pain Home Care

For mild abdominal pains:

mild abdominal pain Sip water or other clear fluids.
mild abdominal painAvoid solid food for the first few hours. If there has been vomiting, wait 6 hours. Then, eat small amounts of mild foods.
mild abdominal pain If the pain is high up in your abdomen and occurs after meals, antacids may provide some relief, especially if you feel heartburn or indigestion. Avoid citrus, high-fat foods, fried or greasy foods, tomato products, caffeine, alcohol, and carbonated beverages. You may also try H2 blockers (Tagamet, Pepcid, or Zantac) available over the counter. If any of these medicines worsen your pain, CALL your doctor right away.
mild abdominal pain AVOID aspirin, ibuprofen, and narcotic pain medications unless your health care provider prescribes them. If you know that your pain is not related to your liver, you can try acetaminophen (Tylenol).

Call your health care provider if

Call 911 if you:

mild abdominal pain Have sudden, sharp abdominal pain
abdominal pain Have chest, neck, or shoulder pain
abdominal pain Are vomiting blood or have blood in your stool (especially if maroon or dark, tarry black)
abdominal pain Have a rigid, hard abdomen that is tender to touch
abdominal pain Are unable to pass stool, especially if you are also vomiting

Call your doctor if you have:

abdominal painBloating that persists for more than 2 days
abdominal pain Diarrhea for more than 5 days
abdominal pain Abdominal discomfort that lasts one week or longer
abdominal pain Fever (over 100°F for adults or 100.4°F for children) with your pain
abdominal pain A burning sensation when you urinate or frequent urination
abdominal pain Pain in your shoulder blades and nausea
abdominal pain Pain that develops during pregnancy (or possible pregnancy)
abdominal pain Prolonged poor appetite
abdominal pain Unexplained weight loss

What to expect at your health care provider's office

From your medical history and physical examination, your doctor will try to determine the cause of your abdominal pain. Knowing the location of pain and its time patten will help, as will the presence of other symptoms like fever, fatigue, general ill feeling, nausea, vomiting, or changes in stool.

During the physical examination, the doctor will test to see if the pain is localized to a single area (point tenderness) or whether it is diffuse. He or she will be checking to see if the pain is related to inflammation of the peritoneum (called peritonitis). If the health care provider finds evidence of peritonitis, the abdominal pain may be classified as an "acute abdomen", which may require surgery right away.

Your doctor may ask the following questions about your abdominal pain:

abdominal pain Is the pain all over (diffuse or generalized) or in a specific location?
abdominal pain What part of the abdomen is affected? Lower or upper? Right, left or middle? Around the navel?
abdominal pain Is the pain severe, sharp or cramping, persistent or constant, periodic and changing intensity over minutes?
abdominal pain Does the pain awaken you at night?
abdominal pain Have you had similar pain in past? How long has each episode lasted?
abdominal pain How often do you have the pain?
abdominal pain Does it occur within minutes following meals? Within 2 to 3 hours after meals?
abdominal pain Is it getting increasingly more severe?
abdominal pain Does it occur during menstruation? dysmenorrhea)
abdominal pain Does the pain go into your back, middle of the back, below the right shoulder blade, or your groin, buttocks, or legs?
abdominal pain Does the pain get worse after lying on the back?
abdominal pain Does the pain get worse after eating or drinking? After greasy foods, milk products, or alcohol?
abdominal pain Does the pain get worse after stress? After straining efforts?
abdominal pain Does the pain get better after eating or a bowel movement?
abdominal pain Does the pain get better after milk or antacids?
abdominal pain What medications are you taking?
abdominal pain Have you had a recent injury?
abdominal pain Are you pregnant?
abdominal pain What other symptoms are occurring at the same time?

Diagnostic tests that may be performed include:

abdominal pain Barium enema
abdominal pain Upper GI and small bowel series
abdominal pain Blood, urine, and stool tests
abdominal pain Endoscopy of upper GI (gastrointestinal) tract (EGD)
abdominal pain Ultrasound of the abdomen
abdominal pain X-rays of the abdomen

Abdominal Pain Prevention

For prevention of many types of abdominal pain:

abdominal pain Eat small meals more frequently.
abdominal pain Make sure that your meals are well-balanced and high in fiber. Eat plenty of fruits and vegetables.
abdominal pain Limit foods that produce gas.
abdominal pain Drink plenty of water each day.
abdominal pain Exercise regularly.

For prevention of symptoms from heartburn or gastroesophageal reflux disease:

abdominal pain Quit smoking.
abdominal pain Lose weight if you need to.
abdominal pain Finish eating at least 2 hours before you go to bed.
abdominal pain After eating, stay upright for at least 30 minutes.
 abdominal pain Elevate the head of your bed.
 

abdominal pain

Anatomical Landmarks, Front View

There are three body views (front, back and side) that may be helpful if you are uncertain of a body area. Many areas are referred to by both descriptive and technical names. For example, the back of the knee is called the popliteal fossa. However, areas like the "flank" may not have both names, so the location may be unclear.

 

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Digestive System

The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

 

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Abdominal Organs

The process of digesting food is accomplished by many organs in the body. Food is pushed by the esophagus into the stomach. The stomach mixes the food and begins the breakdown of proteins. The stomach propels the food then into the small intestine. The small intestine further digests food and begins the absorption of nutrients. Secretions from the pancreas in the small intestine help neutralize the acid in the intestine to provide a proper environment for the enzymes to function. Bile from the gallbladder and liver emulsify fat and enhance the absorption of fatty acids. The large intestine temporarily stores and concentrates the remainder until it is passed out as waste from the body.

 

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Abdominal Quadrants

Since the abdominal area contains many different organs it is divided in smaller areas. One division method, uses one median sagittal plane and one transverse plane that passes through the umbilicus at right angles. This method divides the abdomen into four quadrants. Medical personnel can easily refer to these quadrants when describing pain or injury regarding a victim.

 

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Appendicitis

The appendix is a small finger-shaped tube that branches off the first part of the large intestine. The appendix can become inflamed or infected causing pain in the lower right part of the abdomen.

 

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Kidney Function

Blood from the aorta reaches the kidneys so it can be filtered and cleaned. Among other functions, the kidneys remove toxins, metabolic waste, and excess ions from the blood which leaves the body in the form of urine.

Abdominal Pain References

American Academy of Pediatrics Subcommittee on Chronic Abdominal Pain. Chronic Abdominal Pain in Children. Pediatrics. 2005; 115(3): 812-815.

D'Agostino J. Common abdominal emergencies in children. Emerg Med Clin North Am. 2002; 20(1): 139-153.

Update Date: 4/12/2007

Updated by: Christian Stone, M.D., Division of Gastroenterology, Washington University in St. Louis School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network.

[Articles from the MedLine Plus Medical Encyclopedia of the US National Library of Medicine and the National Institutes of Health.]

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