Abdominal pain (or stomach ache) is a common symptom associated with transient disorders or serious disease. Diagnosing the cause of abdominal pain can be difficult, because many diseases can cause this symptom. Most frequently the cause is benign and/or self-limiting, but more serious causes may require urgent intervention. Differential diagnosis [edit ] Gastrointestinal GI tract Inflammatory: gastroenteritis, appendicitis, gastritis, esophagitis, diverticulitis, Crohn's disease, ulcerative colitis, microscopic colitis Obstruction: hernia, intussusception, volvulus, post-surgical adhesions, tumours, superior mesenteric artery syndrome, severe constipation, hemorrhoids Vascular: embolism, thrombosis, hemorrhage, sickle cell disease, abdominal angina, blood vessel compression (such as celiac artery compression syndrome), Postural orthostatic tachycardia syndrome digestive: peptic ulcer, lactose intolerance, coeliac disease, food allergies Glands Bile system Liver Pancreatic Renal and urological Gynaecological or obstetric Abdominal wall Referred pain Metabolic disturbance Blood vessels Immune system Idiopathic irritable bowel syndrome (affecting up to 20% of the population, IBS is the most common cause of recurrent, intermittent abdominal pain) Acute abdominal pain [edit ] Acute abdomen can be defined as severe, persistent abdominal pain of sudden onset that is likely to require surgical intervention to treat its cause. The pain may frequently be associated with nausea and vomiting, abdominal distention, fever and signs of shock. One of the most common conditions associated with acute abdominal pain is acute appendicitis. Selected causes of acute abdomen By location [edit ]
[1 ] Upper middle abdominal pain Upper right abdominal pain Liver (caused by hepatomegaly due to fatty liver, hepatitis, or caused by liver cancer, abscess) Gallbladder and biliary tract ( gallstones, inflammation, roundworms) Colon pain (below the area of liver - bowel obstruction, functional disorders, gas accumulation, spasm, inflammation, colon cancer) Upper left abdominal pain Spleen pain ( splenomegaly) Pancreas Colon pain (below the area of spleen - bowel obstruction, functional disorders, gas accumulation, spasm, inflammation, colon cancer) Middle abdominal pain (pain in the area around belly button) Appendicitis (starts here) Small intestine pain (inflammation, intestinal spasm, functional disorders) Lower abdominal pain ( diarrhea and dysentery) Lower right abdominal pain Lower left abdominal pain Sigmoid colon ( polyp), sigmoid volvulus, obstruction or gas accumulation) Pelvic pain Right lumbago and back pain liver pain ( hepatomegaly) right kidney pain (its location below the area of liver pain) Left lumbago and back pain less in spleen pain left kidney pain Low back pain Diagnostic approach [edit ]
When a physician assesses a patient to determine the etiology and subsequent treatment for abdominal pain the patient's history of the presenting complaint and physical examination should derive a diagnosis in over 90% of cases.
It is important also for a physician to remember that abdominal pain can be caused by problems outside the abdomen, especially
heart attacks and pneumonias which can occasionally present as abdominal pain.
Investigations that would aid diagnosis include
If diagnosis remains unclear after history, examination and basic investigations as above then more advanced investigations may reveal a diagnosis. These as such would include
Management [edit ] Butylscopolamine (Buscopan) is used to treat cramping abdominal pain with some success. [2 ] References [edit ] Further reading [edit ] Boyle, J. T.; Hamel-Lambert, J. (2001). "Biopsychosocial issues in functional abdominal pain". Pediatr Ann 30 (1): 32–40. PMID 11195732. Abdominal pain