Common GI Symptoms
Common GI Symptoms > Abdominal pain
Introduction
What is an abdominal pain?
Abdominal pain is a common problem. Most patients have a benign and/or self-limited aetiology, and the initial goal of evaluation is to identify those patients with a serious cause for their symptoms that may require urgent intervention.
The history of a patient with abdominal pain includes determining whether the pain is acute or chronic and a detailed description of the pain and associated symptoms. All patients should have vital signs and an abdominal examination. Other physical examination will depend on the history.
What is an acute abdomen?
An episode of abdominal pain that starts suddenly and lasts for a few hours or longer. An acute abdomen may potentially be life-threatening. Worrisome features include vomiting, the inability to pass flatus (or pass wind), bleeding from the anus or vomiting blood.
The pain symptoms are different for different people. The pain can feel sharp or crampy. People can feel the pain all over their belly, or only in one part. Some people feel better if they curl into a ball, while others need to lie flat and completely still. People often feel sick to their stomach and retch or vomit.
What causes an acute abdomen?
An acute abdomen can have different causes. Most of the time, an acute abdomen happens when there is a serious problem with one or more organs in the abdomen. Organs in the abdomen can be part of the digestive, urinary, or female reproductive systems. Conditions that affect organs in the chest or genital area can also cause pain in the abdomen, for example, a heart attack may sometimes present with pain in the upper part of the abdomen.
Signs that abdominal pain may be serious?
Patients with unstable vital signs, worrying signs of an abdominal exam, or in whom there are concerns for life-threatening causes of abdominal pain should be referred to the emergency department. Patients with concern for infection on initial evaluation (eg, fever, jaundice, and right upper quadrant pain) should also be evaluated promptly, often requiring referral to the emergency department for expedited evaluation.
Signs that abdominal pain may be serious?
Common causes of an acute abdomen in adults include Appendicitis, diverticulitis, gallstones, abscess, bowel perforation, perforated ulcer, pancreatitis, a ruptured cyst in the ovary and ectopic pregnancy.
Should I see a doctor or nurse?
Yes. If you have symptoms of acute abdomen, see your doctor or nurse or go to the hospital right away.
Will I need tests?
Your doctor will decide which tests you should have based on your symptoms and individual situation. The tests might include:
- Blood tests
- Urine tests
- X-rays
- An ultrasound, CT scan, or other imaging test – Imaging tests create pictures of the inside of the body.
How is an acute abdomen treated?
Treatment depends on what is the cause of the pain. It might include one or more of the following:
- Fluids are given by IV
- Pain medicines
- Antibiotic medicines to treat an infection
- Other medicines to treat other medical conditions
- Surgery
Chronic Abdominal Pain
Most patients with chronic abdominal pain have a benign functional disorder such as irritable bowel syndrome (IBS) or functional dyspepsia. Initial work-up is focused on differentiating benign functional illness from organic pathology. (At the conclusion of the initial work-up, young patients with no evidence of organic disease can be treated symptomatically.
However, in patients above 50 years of age and have risk factors for colorectal cancer, should have a thorough evaluation to exclude colorectal cancer before a diagnosis of a functional disorder is made.