Abdominal pain

Abdominal pain

Abdominal pain

Other names: Tummy ache, Stomach ache, Tummy ache

The abdomen extends from under the chest to the groin. Some call it a stomach, but the abdomen contains many other important organs. Abdominal pain can come from any of them. The pain can start somewhere else, such as the chest. Severe pain does not always indicate a serious problem, and mild pain does not mean that the problem is not serious.

If mild pain persists for a week or more, or if it is accompanied by other symptoms, call a healthcare professional. Get immediate medical help if

You have a sudden and intense abdominal pain.

You also have pain in your chest, shoulder or neck.

Vomit blood or observe blood in bowel movements

It has a stiff, hard and touch sensitive abdomen

You cannot evacuate (move the bowel), especially if you also have vomiting.

What is abdominal pain?

Normally, we do not notice any of the actions of the internal organs of the abdomen, or the discomfort caused by activities such as food intake, the transit of these through the intestines and bowel movements. The nerves constantly control the activities of the body; so that when these messages are transmitted to the brain and reach the person's consciousness as unpleasant sensations, it is possible to feel pain or discomfort.

What causes abdominal pain?

Pain can arise from any interior structure of the abdomen or abdominal wall. In addition, pain messages that originate in the chest, back or pelvis can sometimes be perceived as coming from the abdomen. For example, patients with heart attacks or pneumonia occasionally complain of pain in the upper abdomen instead of chest pain. There are many causes for pain, and the list below shows some of the most common:

Non-abdominal causes:

Pneumonia (lung infection)
Myocardial infarction (heart attack)
Pleurisy (irritation of the lining of the lungs)
Pulmonary embolism (clots in the lungs)

Abdominal or chest wall pain:

Herpes (herpes zoster infection)
Costochondritis (inflammation of the cartilage in the ribs)
Injury (trauma, muscle strain)
Irritation of the nerves (neuropathy)
Hernias (protrusion of the organs through the abdominal wall)
Scars

Inflammatory conditions of the upper abdomen:

Ulcerative diseases (duodenal ulcer, gastric ulcer)
Esophagitis (gastroesophageal reflux disease)
Gastritis (irritation of the stomach lining)
Pancreatitis (inflammation of the pancreas)
Cholecystitis (inflammation of the gallbladder)
Choledocolithiasis (passage of gallstones through the bile duct)
Hepatitis (infection or inflammation of the liver)
Colitis (infection or inflammation of the colon)

Functional problems of the abdomen:

Non-ulcer dyspepsia (discomfort after eating not due to ulcers)
Oddi sphincter dysfunction (problem with bile duct valve)
Functional pain of the abdomen (pain without apparent cause)
Irritable bowel syndrome (pain associated with bowel movements)

Cancers of the upper abdomen:

Hepatoma (liver cancer)
Cholangiocarcinoma (cancer of the bile duct or gallbladder)
Pancreatic cancer
Stomach cancer
Lymphoma (cancer of immune system cells)

When should a person worry about abdominal pain?

It is never normal to feel pain, but it is not always a medical emergency. You should talk with your doctor about mild or chronic pain, not related to danger signs (“red flags”), when it is convenient for you. However, do not wait to talk with your doctor about severe pain or raise red flags, as he or she may recommend that you go to see him or go to the emergency room, depending on the specific complaint that you Present. Among the red flags that should lead to a conversation with your doctor are: fever, diarrhea, persistent constipation, blood in the stool, persistent nausea or vomiting, vomiting with blood, very painful belly, jaundice (yellow skin) or swelling of the abdomen .

How is the cause of abdominal pain determined?

The patient's medical history is the most useful information available to the doctor to determine the cause of abdominal pain. The characteristics of pain (if it is acute or dull, type colic, to squirm, burning, heartbreaking, penetrating), as well as the location and relationship with food or bowel movements are important clues. Other factors that are equally useful include pain pattern, duration, irradiation (spread) to other areas of the body and its relationship to other symptoms such as jaundice (yellow skin), nausea, vomiting, bleeding, diarrhea and constipation.

The findings during the physical exam are also useful. Among the main findings are: sore areas, the presence or absence of bowel sounds or bloating, masses, enlarged organs and evidence of blood in the stool.

According to the medical history and physical examination, the doctor may (or may not) have a clear idea about the cause of the pain. On certain occasions, a diagnosis is established and treatment is initiated. In other circumstances, diagnostic tests are applied to confirm or exclude a specific diagnosis; For this purpose, several tests may be requested, among which the most frequent are: blood tests, urine and stool samples, abdominal x-rays and endoscopy.

Blood tests include complete blood counts (analysis of the number of white blood cells that fight infection, of red blood cells that carry oxygen and that are reduced when there is anemia, as well as platelets that help in blood clotting), chemical tests (liver and kidney tests, levels of minerals in the blood and enzymes that are released from liver or pancreas injury), and serology tests that measure the levels of antibodies to various infections. Urine tests include analysis of the urine (measurement of the characteristics and chemicals present in the urine along with the microscopic inspection of a drop of urine), and urine cultures for bacterial infections. Stool can be analyzed to determine the presence of blood or pus (markers of inflammation, infection or tumors), fat (evidence of digestive disturbance or malabsorption), and germs.

Many different kinds of x-rays and imaging tests are used to take pictures of the inside of the body. These include barium studies (barium taking radiography, upper gastrointestinal series, small bowel transit test), in which the patient swallows barium sulfate (a substance that appears on the x-rays) or it is injected through a tube to the small intestine (electrolysis) or to the colon (barium enema). The CT scan (CT scan or CT scan) consists of a sophisticated technique that reconstructs cross-sectional radio-graphic images of the body with the help of a computer. Magnetic resonance imaging (MRI) is a similar technique that uses radio waves and magnets to obtain images of internal organs. Ultrasound uses high frequency sound waves to inspect inside the human body and visualize the internal anatomy. Nuclear medicine scans use isotopes to identify parts of the body and examine their function.