Abdominal Pain- Gastroenterology, Pain Management, Pediatrics

There are numerous reasons for abdominal pain, some more significant than others. What you perceive as a stomach ache could be originating from another organ in your abdomen. Abdominal pain is not always caused by a medical issue. Furthermore, the degree of discomfort does not always indicate the seriousness of the root cause. However, always contact a doctor if your stomach ache is severe, undiagnosed, or chronic.

What Are The Types and Causes Of Abdominal Pain?

Your abdomen comprises many organs, including:

• Stomach
• Gallbladder
• Liver
• Small intestine
• Large intestine
• Pancreas

By focusing on a specific area of your body, your doctor may be able to determine the kind of pain you are experiencing. The abdomen is frequently divided into four quadrants by medical professionals. These are:

• Upper right quadrant
• Upper left quadrant
• Lower right quadrant
• Lower left quadrant

The location of your pain is an essential clue to the organs affected, such as:

Right Upper Quadrant Pain

Your liver, gallbladder, and bile ducts are situated in the upper right abdomen. The right kidney is located in your back. Additionally, the beginnings of your small and large intestines pass through the right upper quadrant.

The most frequent cause of upper right abdominal pain is liver or gallbladder disease, such as:

• Gallbladder stones
• Inflammation of the liver (Hepatitis)
• Gallbladder inflammation (cholecystitis)
• Stones, malignancy, and strictures of the bile duct
• Bile duct cancer
• Cancer of the liver

The pain might also be due to a specific issue with your right kidney, ascending colon, or duodenum, such as:

• A duodenal ulcer
• Kidney infection or stones
• Blockage of the large bowel

Left Upper Quadrant Pain

The stomach, pancreas, and spleen are located in the upper left abdomen. The heart and left lung lie directly above the left kidney, located at the back of the abdominal cavity.

Upper left abdominal pain may indicate:

• Gastritis
• Stomach ulcer
• Stomach cancer
• Inflamed pancreas (pancreatitis)
• Cancer of the pancreas
• Enlarged spleen (splenomegaly)
• Biliary reflux
• Renal stone or infection

If the pain originates from the chest, it may be due to the following:

• Heart attack
• Angina
• Heartburn
• Non-cardiac chest pain
• Pericarditis
• Pleurisy
• Pneumonia
• Pulmonary embolism

Lower Abdominal Pain

Most of the small and large intestines are located in the lower abdomen. GIT disorders are most likely to be the cause of lower abdominal pain. It could also be related to the uterus, ovaries, or ureters.

Following are a few causes of lower abdominal pain:

• Functional dyspepsia
• Irritable bowel syndrome
• Inflammatory bowel disease (Crohn’s Disease, ulcerative colitis)
• Small intestine cancer
• Colon cancer
• Large or small bowel obstruction
• Abdominal aortic aneurysm
• Peritonitis
• Intestinal (mesenteric) ischemic syndrome
• Mesenteric lymphadenitis
• Renal stones
• Hernia

Your appendix may be the cause of right lower abdominal pain. Appendiceal inflammation, or, more rarely, appendiceal malignancy, could be the cause.

Diverticulosis and diverticulitis of the colon are the most frequent causes of pain in the lower left abdomen. Diverticula are microscopic holes in the gut wall that can develop anywhere in the colon, however, they usually start in the lower left corner.

Apart from the location, the description of abdominal pain can also differ and be indicative of the underlying condition. Pain might be described as:

• Generalized, i.e., felt predominantly across or all over. Such pain is typical of a viral infection or due to gas or digestive difficulty.
• Localized pain affecting a particular area typically signifies an abdominal organ-related problem. A stomach ulcer is an example of this type of pain.
• Cramping is another sensation that describes abdominal pain. Common causes include bloating, menstruation, or diarrhea. Cramping pain is usually not serious unless it occurs frequently, lasts more than a day, or is accompanied by fever.
• Colicky pain refers to sudden-onset and often sharp yet short-lived pain. Colicky pain usually occurs in spasms. Gallstones and kidney stones are common examples of conditions that can cause such type of pain.

How Is Abdominal Pain Diagnosed?

Doctors determine the cause of your abdominal discomfort with the help of a series of tests and an in-depth discussion about your symptoms. Before recommending tests, your doctor will perform a physical examination. Checking for tenderness and edema involves gently pushing on several parts of your abdomen.

Be ready to respond to the following questions from your doctor:

• Which part of your body is hurting specifically?
• How bad is the discomfort?
• Has the discomfort always been located in one area, or has it changed places?
• Is the pain severe enough to interfere with your everyday activities?
• Does the pain consistently linger, or does it come in waves?
• Does the pain get worse at certain times of the day?
• When did the discomfort first start, and what were you doing?
• When did you last urinate and pass stool?
• Do you go to the bathroom regularly?
• Have you recently made any significant dietary changes?
• Have your urine characteristics changed at all?

Imaging procedures, including ultrasounds, MRI scans, and X-rays, are used to view the abdominal organs, tissues, and other structures in detail. Tumors, ruptures, fractures, and inflammation can all be diagnosed with these tests.

An endoscopy (to detect esophageal and abdominal inflammation and abnormalities),

a colonoscopy (to see inside the colon and intestines), and an upper GI series (an X-ray test to check for growths, ulcers, inflammation, blockages, and other abnormalities in the stomach using a contrast dye) may also be requested, depending on the symptoms.

To check for signs of bacterial, viral, and parasitic illnesses, taking samples of your blood, urine, and feces may also be necessary.

How Is Abdominal Pain Treated?

The diagnosis has a significant impact on the treatment of stomach discomfort.

Mild abdominal pain may go away spontaneously within hours or a few days. Medications or over-the-counter pills often successfully treat mild stomach pains and symptoms.

Stomach aches should not be treated with aspirin or an anti-inflammatory drug like ibuprofen unless prescribed. These drugs may worsen any existing gastrointestinal or intestinal disorders.

Follow these steps if you are managing minor stomach pain at home:

• Consume clean fluids to stay hydrated; avoid alcohol, tea, and coffee
• Rest well and apply a warm wheat or hot water pack on your stomach
• Stick to bland meals or follow your doctor's instructions
• Eat several smaller meals in a day rather than three full meals
• Chew your food slowly before swallowing
• Stay away from fried or spicy food that is difficult to digest
• Regular exercise helps boost digestion and gives relief from stomach pain

Depending on the cause of your abdominal discomfort, you may benefit from the following particular treatments:

Gas - Over-the-counter drugs are available to minimize gas bubbles, such as antacids containing simethicone. Medications that lower gas, such as charcoal products, may be useful for persistent wind problems. A dietary modification could also be advantageous. Dietary advice can be provided by your doctor or dietitian.

Constipation - A stool softener or laxative can help get rid of constipation, easing the pain and discomfort.

GERD - GERD or gastroesophageal reflux disease may cause heartburn and upper abdominal pain, which can be treated with an antacid or acid reducer.

Diarrhea - Diarrhea can cause stomach cramps. These cramps can be treated with medicines that have bismuth subsalicylate (Kaopectate or Pepto-Bismol) or loperamide (Imodium).

Pain brought on by muscle spasms - Bowel spasms may be lessened with the aid of antispasmodic drugs.

After the cause for abdominal discomfort has been determined, your doctor will guide you on what needs to be done. Certain conditions, such as appendicitis or bowel obstruction, may require immediate surgery.

When To See A Doctor Immediately?

Seek immediate medical help, if you are experiencing pain along with any other unsettling symptoms or signs, such as:

• Fever
• Severe pain
• Bloody stool
• Persistent dizziness and nausea
• A yellowish tinge in the eyes and skin
• Weight Loss
• Extreme sensitivity to touch in the abdomen
• Abdominal swelling
• Inability to pass stools followed by persistent vomiting
• Persistent heartburn that does not go away with over-the-counter drugs

To learn more about Abdominal Pain, please check our blog on ACUTE GASTROENTERITIS IN CHILDREN.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7121692/

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