Abdominal Pain

Causes of Abdominal pain:

Abdominal pain can have various causes, ranging from mild and self-limiting conditions to serious medical emergencies. Some common causes of abdominal pain include:

  1. Gastrointestinal issues:
    • Gastritis: Inflammation of the stomach lining.
    • Gastroenteritis: Infection or inflammation of the stomach and intestines.
    • Peptic ulcer: Sores that develop in the lining of the stomach or upper portion of the small intestine.
    • Gallstones: Hardened deposits in the gallbladder that can cause pain if they block the bile ducts.
    • Pancreatitis: Inflammation of the pancreas.
    • Irritable bowel syndrome (IBS): A chronic disorder affecting the large intestine, characterized by abdominal pain, bloating, and changes in bowel habits.
  2. Gastroesophageal reflux disease (GERD): Chronic acid reflux that irritates the esophagus.
  3. Appendicitis: Inflammation of the appendix, typically causing pain in the lower right abdomen.
  4. Kidney stones: Hard mineral and salt deposits that form in the kidneys and can cause severe abdominal or flank pain.
  5. Urinary tract infections (UTIs): Infections in the urinary system, which can cause lower abdominal pain, frequent urination, and a burning sensation.
  6. Hernias: Protrusion of an organ or tissue through a weak spot in the abdominal wall, often causing pain and a visible bulge.
  7. Ovarian cysts: Fluid-filled sacs that develop on the ovaries and can cause abdominal pain, especially if they rupture or twist.
  8. Endometriosis: A condition where the tissue that lines the uterus grows outside of it, leading to pain, especially during menstruation.
  9. Diverticulitis: Inflammation or infection of small pouches (diverticula) that form in the lining of the intestine.
  10. Bowel obstruction: Blockage of the intestines, which can be caused by various factors, including tumors, adhesions, or impacted stool.
  11. Inflammatory bowel diseases (IBD): Conditions such as Crohn’s disease and ulcerative colitis that cause chronic inflammation of the digestive tract, leading to abdominal pain, diarrhea, and other symptoms.
  12. Food intolerances or allergies: Some individuals may experience abdominal pain due to lactose intolerance, gluten sensitivity, or other food allergies or sensitivities.
  13. Abdominal muscle strain: Overuse or injury to the muscles of the abdominal wall can cause localized pain.
  14. Psychological factors: Stress, anxiety, or emotional distress can sometimes manifest as abdominal pain.

It’s important to note that this is not an exhaustive list, and the cause of abdominal pain can vary depending on individual circumstances. If you experience persistent or severe abdominal pain, it’s recommended to seek medical attention for a proper evaluation and diagnosis.

Evaluation of Abdominal pain:

When evaluating a patient with abdominal pain, a physician typically follows a systematic approach to identify the underlying cause. The evaluation process may involve the following steps:

1. Medical history: The physician will begin by taking a detailed medical history, asking questions about the onset, duration, and nature of the pain. They will inquire about the location, intensity, and character of the pain, as well as any factors that exacerbate or alleviate it. They will also ask about associated symptoms, such as nausea, vomiting, changes in bowel movements, urinary symptoms, or fever. Additionally, the physician will inquire about the patient’s medical history, including any relevant pre-existing conditions, surgeries, medications, allergies, and family history of similar conditions.

2. Physical examination: The physician will conduct a thorough physical examination, which may include palpation of the abdomen to assess tenderness, masses, or organ enlargement. They will also check vital signs, listen to bowel sounds, and perform other specific examinations based on the suspected cause of the pain. For example, they may evaluate the chest and cardiovascular system, examine the pelvis, or check for signs of inflammation.

3. Diagnostic tests: Depending on the history and physical examination findings, the physician may order specific diagnostic tests to further evaluate the cause of abdominal pain. These tests can include:

– Laboratory tests: Blood tests may be performed to assess organ function, detect signs of inflammation or infection, or check for markers of specific conditions. These tests may include complete blood count (CBC), liver and kidney function tests, amylase and lipase levels, or specific tumor markers.

– Imaging studies: Various imaging techniques can be utilized to visualize the abdominal organs and identify abnormalities. Commonly used imaging tests include abdominal ultrasound, computed tomography (CT) scan, magnetic resonance imaging (MRI), or X-rays.

– Endoscopic procedures: In certain cases, the physician may recommend endoscopic examinations to directly visualize the gastrointestinal tract and obtain tissue samples for analysis. Examples include upper gastrointestinal endoscopy (esophagogastroduodenoscopy) or colonoscopy.

– Other specialized tests: Depending on the suspected cause, additional tests such as urinary tract imaging, pelvic examinations, or specific functional tests may be necessary.

4. Consultations or referrals: If the cause of abdominal pain remains unclear or requires specialized expertise, the physician may refer the patient to other specialists, such as gastroenterologists, surgeons, gynecologists, or urologists for further evaluation and management.

The evaluation of abdominal pain is a complex process, and the approach may vary depending on the individual patient and their unique circumstances. It’s important to consult with a healthcare professional for a comprehensive evaluation and accurate diagnosis of abdominal pain.


Other Sources:

The Cleveland Clinic

The Merck Manuals

Treatment Options for Acute Abdominal Pain

Chronic Abdominal Pain Diagnosis

Abdominal Emergency 

Emergency: Urgent Signs in Abdominal Pain

  • Nausea, fever, or the inability to keep food down for several days
  • Bloody stools
  • Difficulty breathing
  • Jaundice coupled with abdominal pain
  • Vomiting blood
  • The pain occurs during pregnancy.
  • The abdomen is tender to the touch.
  • The pain is the result an injury to the abdomen in the previous days.
  • The pain lasts for several days.