Abdominal Pain in Adults

 In some cases abdominal pain ranges from meek to very serious pain. Normally this pain can be caused by range of conditions and it’s not particular. There are numerous organs which are found within the abdominal cavity. In some cases pain is unswervingly associated to particular organ like bladder or ovary. Digestive system is the major area where the pain starts normally. The best instance which can be considered is the pain which is caused due to appendicitis, diarrheal cramping, or food poisoning.

When the type and the area from where the pain is originated is known then it will be easier for the physician to know the cause. At the time of the analysis it’s vital to consider the duration of and the intensity of the pain.

Following are the few features of abdominal pain:

 

•    A person who is suffering from abdominal pain may get the feel of symptoms something like very dreary, cramplike, twisty, very sharp i.e. knifelike and there chances for further more kinds of pains.

•    In some cases this pain may be constant while in some cases it just lasts for few minutes and in few more cases this pain comes in a sturdy manner for some time and later the pain gets reduced for sometime.

•    Abdominal pain hurts so much in some cases which makes you throw up yet remains intense. While in other cases the person suffering from abdominal pain will feel better after throwing up.

 •     This pain makes the person very restless unless they feel that they’ve got the right position and sometimes it makes them to be so constant that they don’t even feel like moving a muscle.

Abdominal pain is caused due to many acute i.e. short term and chronic i.e. long term diseases.

•     The diseases which make people worry are appendicitis, gallbladder disease, ulcers, infections, and pregnancy problems.
   
•    At times pain doesn’t come from the abdomen and In addition to ruptured blood vessels, heart attacks, liver and pancreas inflammations, kidney stones, problems with circulation to the intestine, diverticulitis, and more make the doctors anxious.
   
•    This pain is also caused by few heart attacks and pneumonias. And also diseases occurred in pelvis and groin can also be the reason behind the abdominal pain.
   
•   Though everything is all right in your body some rashes like shingles may also make the person feel like abdominal pain.
   
•    Very serious abdominal pain may also caused due to black widow spider.

Just about the half time the reason behind the abdominal pain is ascertained and The pain gets cured within hours or days and thus the rest of the time no particular reason is found out. In case the pain continues then the reason behind is ascertained.

 The symptom is abdominal pain which at times indicates some medical problem that requires medical treatment. And this sometimes goes with further symptoms. It’s better to keep a track of symptoms as this will precisely help the doctor in finding the cause behind the pain.

Consult your doctor if you are undergoing any of the following:

•     The pain getting to a worse condition or if it lasts for more than 6 hours
•     Pain which makes you to stop eating
•     Vomiting takes place more than 3-4 times
•     Unable to move as the pain gets worsen
•     The pain spreads all over the body yet settles in one particular area mainly the right lower right abdomen
•     As the pain worsens it doesn’t allow you to sleep and thus it makes you to getup at night
•     Pain with vaginal bleeding or pregnancy, even if you only think you might be pregnant
•     Along with the pain having fever above 101°F
•     Along with the pain facing the problem in urinating, making your bowels, or pass gas
•     Any pain other than a normal stomach pain
•     Any pain that drags your attention or takes your concern in any manner

Rush to Hospital Emergency Department incase you have any of the following or in position not to reach your health care:

•     Incase you feel that this is the worst pain you’ve ever suffered in your life or very bad and stern pain
•     Due to severe bad which leads you to pass out
•     Pain which makes you not to move all around
•     Along with pain your suffering from vomiting blood which lasts for more than 6 hours
•     Along with pain no bowel movement over 3days
•     Making you remember your previous pain which ended up with a surgery
•     When you feel that pain is in chest yet your not sure
•     Pain which makes you feel that its from the testicles

One of the intricate tasks for the health care is in analyzing the reason behind the abdominal pain.

•    In some cases the health care ought to be sure that no surgery is required for the pain or any kind of admission in the hospital.
•    When the health care comes to know through the analysis that its abdominal pain without peritonitis then there is no necessity of surgery.

In order to know the cause the health care might ask you few questions in which few may be silly yet endeavor in answering them frankly and completely as much as you can. And these answers may help your doctor in finding the reason behind the pain quickly and without any trouble.
 

•     Whats the duration of your pain?
•     At the start of the pain what did you do?
•     What was your feeling at the start of your pain?
•     Were you OK during the previous days?
•     What was the remedy taken to reduce the pain and did it work better?
•     Are you able to move around or unable to move due to this pain?
•     How did you feel the ride to the hospital and was this ride in car hurting you?
•     Is it paining more when you cough?
•     Did this pain make you throw up?
•     And did this throwing up lead to bad condition or better condition?
•     Are your bowel movements normal?
•     Are you able to pass gas?
•     Are you feeling that you’ve got fever?
•     Did you have pain like this previously? If so when and what was the remedy you’ve taken for it?
•     Have you ever undergone any surgery? If so why and when?
•     Right now are you conceived and using birth control?
•     Were you with anyone facing these symptoms?
•     Recently did you travel to abroad?
•     Did you have any eatables which are odd?
•     Did the pain start around your stomach and settle in one place?
•     And did the pain start even in your chest/back?
•     Are you able to cover the pain with your palm or is the pain area is more than that?
•     Are you facing any problem in breathing because of this problem?
•     Are you suffering from any heart disease/diabetes/AIDS?
•     Are steroids taken by you and pain killers like aspirin/Motrin?
•     Have you taken any antibiotics/pills/herbs?
•     Do you intake alcohol/coffee/tea?
•     Do you have the habit of smoking?
•     Are you sing any cocaine/any other drugs?

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Physical examination is nothing but which comprises a careful analysis of your abdomen, heart, and lungs to endeavor to indicate the source of the pain.

•     In order to check for tenderness or other signs that point out the source of the pain the examiner will touch all the parts of the abdomen and he might also do a rectal exam in order to check for the hidden blood or further problems.
•     Incase your man your health care provider may check your testicles and penis.
•     Incase you’re women your health care provider, for the problems in womb, ovarian tubes, and ovaries might do a pelvic test.
•     The health care provider may also check your eyes for jaundice and also your mouth to ensure that your not dehydrated.
• Certain blood and urine tests may be taken as these tests help in determining the reason behind the pain your suffering.
•     Vital thing is to test whether women is pregnant.
•     Increase in white blood cell count may refer to too much of stress of pain and vomiting or some infection.
•     Most of the conditions that entail bleeding are not hurting yet low blood count can show that you might be bleeding internally.
•     While urinating if there is blood which might not be seen, it refers to that oyu have a kidney stone.
•     Further blood tests like liver enzymes and pancreas enzymes may also help you determine which organ is mainly entailed.
• Radiology of your abdomen is even less useful.
•     Periodically your bowel might show air outside of your bowel which means that there is something which has been ruptured or perforated.
•     At times X-ray can also be helpful in diagnosis of bowel obstruction.
•     X-ray may also show kidney stones at times.

In order to find the cause for the abdominal pain Ultra sound is also a procedure which is painless and useful.

•     If your doctor suspects problems with the gallbladder/gallstones, pancreas, liver, or reproductive organs of women this test will be done.
•     This procedure is also helpful in the analysis of problems with kidneys and the spleen or the large blood vessels which come from the heart and give the lower half of your body.

Good and better information is provided by CT scan which special type. It gives information about the liver, pancreas, kidneys and ureters, spleen, and small and large intestine, comprising diseases such as appendicitis and diverticulitis.

By this your doctor might not do any tests and this also helps in know the correct cause for the pain and is also known not to be serious. Incase these tests are undergone by you the doctor ought to explain the results to you.
 

Without any treatment most of the abdominal pains get cured.

|Self-Care at Home|

No special treatment is required when abdominal is there without fever vaginal bleeding, passing out, and other serious symptoms.

•     You ought to immediately consult your doctor when you feel that pain continues or even when you think that it result to some serious problem.
•     You can get relieved from your pain by heating pad or soaking in warm water.
•     Certain kinds of abdominal pain can be reduced by antacids viz Tums, Maalox, or Pepto-Bismol.
•     Acetaminophen can also be helpful in reducing. Its always better to shun aspirin or ibuprofen as these pills make few of the stomach pains worse

|Medical Treatment|

Treatment is given in accordance to the reason behind the abdominal pain. You’ll be given IV fluids and doctor might ask you to stop having any liquids or solid eatables.Medication will be done for your pain.

•     You will be given a shot in the hip, arm, or leg for the pain caused by the bowel spasm.
•     You might be provided drink that contains antacid in it or any pain medication in case you aren’t throwing up.
•     Till you feel comfortable you ought to ask for some pain medicine though the pain may not go away completely.
   

Gynecologist, gastroenterologist, surgeon, or urologist may also check your health if required.

|Surgery|

Certain abdominal pains must be treated by surgery.

•    You ought to be taken to hospital in case your pain starts from an infected internal organ like appendix/gallbladder. And you’ll also require a surgery.
•     Based on the cause of the obstruction in some cases bowel obstructions may require surgery.
•     You ought to be operated in case pain is from the ruptured/perforated organ like bowel/stomach.

|Follow-up|

After examination incase your discharged you’ll be given directives regarding the diet and the medications to be taken and you’ll also be told to come to hospital emergency care in case of any severe conditions.

Below are the directives to be followed in case you don’t get any instructions from the doctor:

•     When you feel like having anything its better to start with clear liquids.
•     In case clear liquids doesn’t cause any problems like vomiting or pain then carry on with solid stuffs like rice, bananas toast or crackers.
•     In case you don’t get back the symptoms then you can stick to your regular diet.

Consult the Emergency Department in any of the following situations:

•     Go in case there is increase in your pain/fever/vomiting/cannot urinate/move your bowels.
•     Any symptoms which drags your attention or which appears to be worse
•     In case abdominal symptoms don’t get cured within 24hours

|Prevention|

In case the analysis is found then you ought to follow the directives which are specific for that particular analysis.

•     You got to shun nicotine, caffeine, and alcohol in case there is ulcer pain.
•     You also got to shun greasy, fatty, and fried foods incase it’s caused due to gallbladder disease.

|Outlook|

On the whole most of the people require relief from their symptoms and no surgery is required for the most of the pains.

Though there are exceptions, the medical reasons usually have better results.

Based on the seriousness of the situation and the person’s medical condition, the surgical causes of abdominal pain have different outcomes.

•     You’ll recover from the surgery without any long-term problems in case you have simple appendicitis/simple gallstones.
•     You may take long period to recover in case you have got ruptured appendix/infected gallbladder.
•     You also need long duration to recover in case the abdominal pain is from a perforated ulcer/blocked bowel as it refers to major surgery.

The diagnosis is worse for the problems with major blood vessels like rupture/clot.

For information about disorders of the digestive system that might cause abdominal pain, see the following Web sites. After you have seen your health care provider, you should have a better idea of what is causing your pain. Many diseases have their own Web sites.

|Web Links|

American Academy of Family Physicians Family Health and Medical Guide, Abdominal Pain, Short-Term 

American College of Gastroenterology, Patient Information

American Gastroenterological Association

National Digestive Diseases Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health

abdomen, acute abdomen, adhesions, belly pain, diverticulitis, gripes, stomach ache, tummy ache, appendicitis, gallbladder disease, ulcer, infection, ruptured blood vessel, heart attack, liver inflammation, pancreas inflammation, kidney stone, kidney stones, circulation to the intestine, abdominal pain, abdominal pain in adults, diarrhea, food poisoning, acute stomach pain, stomach pain, diarrheal cramping

Author: Joseph R Lex, Jr, MD, Assistant Professor, Department of Emergency Medicine, Temple University Hospital.

Editors: Scott H Plantz, MD, FAAEM, Research Director, Assistant Professor, Department of Emergency Medicine, Mount Sinai School of Medicine; Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, ; Anthony Anker, MD, FAAEM, Attending Physician, Emergency Department, Mary Washington Hospital, Fredericksburg, VA.