Abdominal Pain

ABDOMINAL PAIN

Almost everyone has pain in their belly at one time or another. Most of the time, a serious medical problem would not be the cause, and how bad the pain is does not always reflect the seriousness of the problem that may be causing the pain. A person may feel very bad pain if they  have gas or stomach cramps due to viral gastroenteritis, better known as a stomach virus.

Some life-threatening conditions, such as colon cancer or a very early case of appendicitis, may cause only some mild pain, or perhaps no pain at all. The important thing to know about abdominal pain is when to seek immediate medical care.

Less serious causes of abdominal pain include

• Food allergies
• A stomach virus
• Irritable bowel syndrome
• Lactose intolerance
• Food poisoning, and
• Constipation

Other, more serious, causes include

• Gastro esophageal reflux
• Appendicitis
• An abdominal aortic aneurysm
• A bowel blockage
• cancer

It is possible sometimes to have abdominal pain that could be from a problem that is not in the belly (e.g.  A heart attack, menstrual cramps, or pneumonia).  

Here are some helpful tips on what to do if one has abdominal pain;

• Try sipping water or drink clear fluids.
• Avoid solid food for the first few hours of onset of pains.
• If vomiting occurs, wait 6 hours and then eat small amounts of mild foods like rice or crackers.
• If the pain is high in the abdomen and occurs after meals, antacids may help, especially with heartburn or indigestion.

People must seek medical attention if they have abdominal pain and:

• Have chest, neck, or shoulder pain.
• Cannot pass any stool,
• Are vomiting blood, or
• Are being treated for cancer,

People must call their doctor if:

• Pain does not improve in 24 to 48 hours,
• Abdominal pain lasts 1 week or longer,
• Bloating lasts for more than 2 days, or diarrhea lasts for more than 5 days.

Considerations

Almost everyone experiences pain in the abdomen at some point. A lot of the time, it is not serious. How bad the pain is does not always reflect the seriousness of the condition that may be causing the pain (e.g. one might have very bad abdominal pain if they have gas or stomach cramps due to viral gastroenteritis).

Instead however, fatal conditions, such as colon cancer or early appendicitis, may only cause very mild pain or no pain at all.

Ways to describe pain in the abdomen include:

Colicky pain -- Kidney stones and gallstones are common causes of this type of belly pain. This pain comes in waves and very often it begins and ends suddenly. It is often severe.

Cramp-like pain -- Most of the time this type of pain is not serious. It is likely to be due to gas and bloating, it is often followed by diarrhea. More worrisome signs include pain that occurs more often and lasts more than 24 hours, sometime it occurs with a fever.

Generalized pain -- This means the pain is felt in more than half of the belly. This type of pain is more typical for a stomach virus, indigestion, or gas. If the pain becomes more severe, a blockage of the intestines may be the cause.

Localized pain -- This pain is found in only a particular area of the belly. It is more likely to be a sign of a problem in an organ, such as the appendix, gallbladder, or stomach.

TYPES OF ABDOMINAL PAIN

Constipation - Constipation is prevalent among a lot of people. It occurs when pressure builds up in the colon and small intestine. Bowel movements are lumpy, hard to pass, and one defecates less than three times a week.  

The best treatment for constipation is to add more fiber to the diet, drink more water, and exercise. As and when needed, one can also try stool softeners or laxatives. If the constipation is accompanied by rectal bleeding or blood in the stool, constant pain, inability to pass gas, vomiting, fever, lower back pain, and losing weight without trying, there might be need to make an appointment with a doctor.

Appendicitis - This is a pain that hits one out of nowhere. The appendix is attached to the large intestine and helps the body fight off infections. But the appendix itself can also be infected. Appendicitis occurs when there is a blockage inside the appendix, which becomes sore, swollen, and can even burst. People with it experience a very uncomfortable sensation around their belly buttons. The pain continues to get worse over time, making it hard to walk.

So, if one experiences severe stomach pain, fever, and vomiting, they should get to the hospital right away. One will need surgery to remove the appendix.

Irritable Bowel Syndrome (IBS) -   IBS is defined as 'a collection of symptoms such as cramping, abdominal pain, bloating, diarrhea, and constipation.' There are two subtypes of IBS. IBS-C is constipation-predominant irritable bowel syndrome. It is characterized by chronic constipation and abdominal pain. IBS-D is diarrhea-predominant irritable bowel syndrome.  

People must schedule an appointment with their doctors immediately they suspect IBS or experience excessive weight loss or rectal bleeding. IBS is not life-threatening, yet one must not live in discomfort. The doctor can discuss the medical history and symptoms, as well as perform a rectal exam to help make a proper diagnosis.

Lactose intolerance - People who are lactose are unable to digest the sugar in dairy products and may experience abdominal cramping, bloating, gas, nausea, vomiting, and diarrhea 30 minutes to two hours after consuming dairy. Some studies suggests that lactose intolerance is most prevalent among people of African or Asian descent. It is not a significant concern and can therefore be quickly relieved by consuming less dairy or trying dairy-alternatives. Whenever a person experiences stomach pain, watery stools, and cramps their doctors must be informed so they can perform tests to confirm the diagnosis. One way to combat lactose intolerance is to do a trial period within which no dairy is consumed to see if symptoms will improve.

Ulcerative colitis - Ulcerative colitis is defined as a chronic disease that causes inflammation, irritation, or swelling, and ulcers on the inner lining of the large intestine. Symptoms include abdominal cramps, bloody stools, nausea, and weight loss. It affects mostly young people between ages 15 and 30. It has the tendency to run in families.

There are other forms of colitis including Crohn's colitis and infectious colitis. There is no cure yet. However, mild cases can be maintained with medications bought over-the-counter, more severe cases might require stronger medicines with steroids.  

People who have been struggling with stomach pain, and are unsure of what the cause might be, should consult with their doctors.

WHAT CAUSES ABDOMINAL PAIN?

Abdominal pain can be caused by a lot of conditions. However, the main causes are infection, abnormal growths, inflammation, obstruction and intestinal disorders.

Infections in the throat, intestines, and blood can cause bacteria to enter the digestive tract, this will most likely result in abdominal pain. These infections may also cause diarrhea or constipation.

Other common causes of abdominal pain include:

• constipation
• vomiting
• acid reflux
• diarrhea
• gastroenteritis (stomach flu)
• stress

The diseases that affect the digestive system can also cause chronic abdominal pain. The most common are:

• Crohn's disease (an inflammatory bowel disease)
• Gastro Esophageal Reflux Disease (GERD)
• Irritable bowel syndrome or spastic colon (a disorder that causes abdominal pain, cramping, and changes in bowel movements)
• Intolerance for lactose (the inability to digest lactose, the sugar found in milk and milk products)

Causes of severe abdominal pain include:

• Kidney stones
• Organ rupture or near-rupture (e.g. a burst appendix, or appendicitis)
• Kidney infection
• Gallbladder stones (known as gallstones)

SYMPTOMS OF ABDOMINAL PAIN

Symptoms of abdominal pain include:

• Gas - Gas forms in the large intestine (colon) when bacteria ferment carbohydrates
• Bloating - When the gastrointestinal (GI) tract is filled with air or gas
• Indigestion - A general term that describes discomfort in the upper abdomen.
• Diarrhea - Loose, watery and possibly more-frequent bowel movements
• Constipation - When bowel movements become less frequent and stools become difficult to pass.
• Heartburn - A common problem created by acid reflux, a condition where some of the stomach contents are forced back up into the esophagus.
• Chest discomfort - Chest pain or discomfort occurs when the heart muscle does not get enough oxygen-rich blood

Location of pain within the abdomen

The location of the pain within the abdomen could be a clue to its cause.

Pain that is generalized throughout the abdomen (not in any specific area) may indicate any of the following:

• Flu - Flu is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and sometimes the lungs
• Irritable bowel syndrome - A common disorder that affects the large intestine.
• Appendicitis - An inflammation of the appendix
• Crohn's disease - Inflammation of the digestive tract
• Traumatic injury - Refers to physical injuries of sudden onset and severity
• Urinary tract infection - An infection in any part of the urinary system (i.e. the kidneys, ureters, bladder and urethra.

Pain that is focused in the lower abdomen may indicate:

• Appendicitis - An inflammation of the appendix
• Intestinal obstruction - When the small or large intestine is blocked
• Ectopic pregnancy - A pregnancy that occurs outside the womb

Pain in the reproductive organs of the lower abdomen of women can be caused by:

• Pelvic inflammatory disease - An infection of one or more of the upper reproductive organs, including the uterus, fallopian tubes and ovaries.
• Ectopic pregnancy - When a fertilized egg implants and grows outside the main cavity of the uterus.

Upper abdominal pain may be caused by:

• Pneumonia - An infection in one or both lungs caused by bacteria, viruses, and fungi
• Hepatitis – Inflammation of the liver
• Gallstones - Hardened deposits of bile that can form in the gallbladder
• Heart attack - The death of a segment of heart muscle caused by a loss of blood supply

Pain in the center of the abdomen might be from:

• Appendicitis - An inflammation of the appendix
• Gastroenteritis - An inflammation of the lining of the intestines caused by a virus
• Injury - Damage to the body caused by external force
• Uremia - A build-up of waste products in the blood

Lower left abdominal pain may be caused by:

• Crohn's disease - Inflammation of the digestive tract
• Appendicitis - An inflammation of the appendix
• Cancer - Cancer is the uncontrolled growth of abnormal cells anywhere in a body.
• Kidney infection - A kidney infection usually happens when bacteria, gets into the tube that carries urine out of the body.
• Ovarian cysts - Ovarian cysts are fluid-filled sacs or pockets in an ovary or on its surface.

Upper left abdominal pain is sometimes caused by:

• Cancer - The uncontrolled growth of abnormal cells anywhere in a body.
• Injury - Damage to the body caused by external force
• Enlarged spleen - An enlarged spleen is not normal and occurs because of another underlying disease.
• Fecal impaction - Hardened stool that cannot be eliminated
• Kidney infection - Usually happens when bacteria, gets into the tube that carries urine out of the body.
• Heart attack - The death of a segment of heart muscle caused by a loss of blood supply

Causes of lower right abdominal pain include:

• Flu
• Appendicitis
• Hernia - When an organ protrudes through a weak spot in the abdominal muscles
• Kidney infection
• cancer

Upper right abdominal pain may be from:

• pneumonia
• hepatitis
• appendicitis
• injury

Progressive Pain:

Abdominal pain that steadily worsens over time, often accompanied by the development of other symptoms, is usually serious. Causes of progressive abdominal pain include:

• Non-Hodgkin's lymphoma - A type of cancer that develops in the lymphatic system, a network of vessels and glands spread throughout the body. The lymphatic system is part of the immune system
• Tubo-ovarian abscess - An inflammatory mass found in the fallopian tube, ovary and adjacent pelvic organs.
• Liver cancer - Cancer that begins in the cells of the liver
• Cancer
• Crohn's disease
• Lead poisoning - A type of metal poisoning caused by lead in the body. The brain is the most sensitive.
• Enlarged spleen
• Gallbladder cancer
• Hepatitis
• Kidney cancer
• Pancreatic cancer - When cells in the pancreas, a glandular organ behind the stomach, begin to multiply out of control and form a mass
• Stomach cancer - Stomach cancer is characterized by a growth of cancerous cells within the lining of the stomach.
• Uremia

WHEN TO SEE A DOCTOR

People should seek help if they have:

• Swelling of the abdomen
• Weight loss
• Severe abdominal pain
• Fever
• Bloody stools
• Persistent nausea and vomiting
• Skin that appears yellow
• Severe tenderness when abdomen is touched

RISK FACTORS

Risk factors for abdominal pain are factors that are associated with the conditions that weaken the immune system such as diabetes, organ transplant, chemotherapy, AIDS, or sickle cell anemia increase the likelihood of suffering from abdominal pains.

Other potential risk factors of abdominal pain include:

• Old age
• Prior abdominal surgery
• History of bowel disorders
• Exposure to stomach virus

DIAGNOSIS

The cause of abdominal pain can be diagnosed through a series of tests. Before ordering any tests, the doctor will do a physical examination, and this will include gently pressing down on various areas of the abdomen to check for tenderness and swelling.

This information, in combined consideration with the severity of the pain and the location within the abdomen, will inform the doctor to determine which tests to order.

Imaging tests, (e.g.  MRI scans, ultrasounds, and X-rays), are used to view organs, tissues, and other structures in the abdomen in detail. These tests can help diagnose tumors, fractures, ruptures, and inflammations.

Other tests will include:

• Endoscopy - Used to detect inflammation and abnormalities in the esophagus and stomach
• Colonoscopy - Used to look inside the colon and intestines
• Upper GI – A special X-ray test that uses contrast dye to check for the presence of growths, ulcers, inflammation, blockages, and other abnormalities in the stomach

As part of the tests, blood, urine, and stool samples may also be collected to look for evidence of bacterial, viral, and parasitic infections.

TREATMENT

Treating abdominal pain depends on its cause. Options include:

• Antibiotics against infection.
• Changes in personal behavior against abdominal pain caused by certain foods or beverages.
• Medications against inflammation, gastro esophageal reflux disease or ulcers.

In more severe cases like appendicitis and hernia, surgery may be necessary.

PREVENTING ABDOMINAL PAIN

Eat plenty of fruits and green leafy vegetables

If one eats a lot of fruit and vegetables then one's chances of developing heart disease, a stroke or bowel cancer is reduced. The recommendation is that a person eats at least five portions of a variety of fruit or vegetables each day.

Fruits and vegetables:

• Contain plenty of fiber, which helps to keep bowels healthy. Problems such as constipation and diverticular disease are less likely to develop.
• Contain plenty of vitamins and minerals, which are needed to keep one healthy.
• Are naturally low in fat.
• Are filling but are low in calories.

Fiber is filling but has few calories, it is the part of food that is not digested. It helps the bowels to move regularly, which reduces constipation and other bowel problems. Fiber may also help to lower cholesterol levels.

Have plenty fluids to drink especially after a high-fiber meal.