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Abdominal Pain

Overview

Abdominal Pain is a common condition that can occur due to various causes. Your abdomen contains certain major organs of your system, including the stomach, intestines, gall bladder, pancreas, kidneys, urinary bladder, etc. Any abnormality in one or more organs can lead to abdominal pain. It is important to identify the origin of abdominal pain before beginning treatment. Many cases of abdominal pain can be managed well, but certain cases require emergency medical attention before any severe complication develops.

Causes

Abdominal pain can occur due to various underlying causes. The causes can be divided based on duration, severity, location, or other factors. A less complex way to understand these causes is to divide them on the basis of onset and duration.
Acute abdominal pain can occur due to blunt or perforating trauma, inflammatory diseases (appendicitis, hepatitis, diverticulitis, pancreatitis, peritonitis, cholecystitis, pyelonephritis, etc.), structural abnormalities, mechanical obstruction, hernia, obstruction of the vascular supply, or ectopic pregnancy. Acute abdominal pain can become a life-threatening condition and requires immediate medical attention to identify the underlying cause.
Chronic abdominal pain can be caused by gastroesophageal reflux disease, celiac disease, dyspepsia, irritable bowel syndrome, hernia, gall stones, kidney stones, peptic ulcer, menstruation, constipation, and other several cases. Chronic abdominal pain is comparatively less severe but can cause recurrent discomfort if not identified and managed well.
Abdominal pain can also occur due to external factors such as food poisoning, alcohol poisoning, drug intoxication, etc. Another major cause of abdominal pain is cancer of one of the abdominal organs, such as pancreatic cancer, stomach cancer, liver cancer, kidney cancer, etc. As the tumor grows, the pain progresses from mild to severe and needs appropriate treatment measures.

Risk Factors And Epidemiology

Risk factors of abdominal pain are linked with its causes. Age is a significant risk factor because most organs get affected as you age. This may not be directly connected with aging but other causes such as systemic diseases (diabetes, constipation, etc.) or medications. Dietary habits can also contribute to the development of abdominal pain. Intake of food lacking essential nutrients, vitamins, minerals, or fibers can lead to multiple gastrointestinal tract diseases. Genetic or family history of abdominal conditions can also be a risk factor. Smoking, alcohol consumption, and the use of illegal drugs can also increase the risk of developing abdominal pain. Less physical activity, lack of exercise, and a sedentary lifestyle are other risk factors.

 

Abdominal pain can develop at any age due to different causes, but as mentioned above, the risk increases with increasing age. It occurs in both males and females. Females have a higher tendency to develop abdominal pain related to menses, pregnancy, ovarian cysts, etc. 

Signs And Symptoms

Abdominal pain itself is a symptom of some underlying condition. It can be accompanied by other symptoms depending on the causative agent. Infection or inflammation of any abdominal organ may present with severe pain along with fever, chills, nausea, vomiting, difficulty in urination or defecation, etc. You may also experience tenderness or rigidity at a certain point of the abdomen or the entire abdominal area. In multiple cases, the pain worsens as the affected area is palpated. In the presence of acute signs and symptoms, emergency medical attention is required. 

Diagnosis

Diagnosis of abdominal pain begins with obtaining a detailed history of your symptoms, dietary habits, use of medicines, past surgeries, etc., to determine a list of possible causes. This is followed by a physical examination of the abdomen, which involves inspection, percussion, palpation, and auscultation of the abdomen. Clinical signs for the suspected disease are noticed. Your doctor may require particular lab tests such as CBC Blood test, ESR, CRP levels, Liver Function Test, RFTs, etc., to diagnose an underlying infection, inflammation, tumor, or another disease. Radiographic techniques such as x-rays, ultrasound, CT scan, and MRI Scan are suggested in particular cases such as intestinal obstruction, pancreatic tumor, etc. Other procedures such as endoscopy, colonoscopy, etc., may also be utilized to visualize the underlying cause more precisely. 

Differential Diagnosis

Since abdominal pain is a symptom of multiple diseases, it is important to identify possible causes and differentiate them from other systemic diseases. This may be done based on onset, duration, severity, and location of pain, medical history, clinical examination, diagnostic tests, and suitable radiographic imaging techniques. 

Treatment

Treatment of abdominal pain depends on its causative factor. Acute abdominal pain is a medical emergency and requires immediate care in a hospital. Clear fluids and intravenous analgesics may be given to reduce the symptoms and improve the vital signs. Bacterial infections require the administration of antibiotics as well. Stomach pumping may be done in cases of food poisoning, alcohol poisoning, or drug overdose. Mild abdominal pain can be managed at home by improving diet, drinking plenty of water, and taking oral medications if necessary. Severe abdominal pain cases associated with factors such as intestinal obstruction, hernia, tumor, etc., will need surgical intervention followed by suitable medical therapy. 

Medication

Analgesics such as acetaminophen, ketorolac, aspirin, morphine, etc., are prescribed for abdominal pain in doses that depend on the severity of pain. NSAIDs are avoided in particular conditions such as peptic ulcer, appendicitis, etc., because they may worsen the condition. 

Prognosis

Prognosis depends on the cause and severity of abdominal pain. Mild to moderate cases can be managed well with medications and supportive care. Chronic cases of abdominal pain may persist for a long time and can only be managed with a few medications and lifestyle modifications. 

Prevention

All causes of abdominal pain cannot be prevented. Some of the reasons can be prevented by eating fresh, homemade food, drinking plenty of water, maintaining sanitary conditions while cooking food, eating a balanced diet, and avoiding high cholesterol foods. It is also necessary to make sure that you include a diet that contains the essential vitamins, minerals, and fibers for your body. Exercising and maintaining a healthy routine can reduce the risk of multiple causes of abdominal pain. 

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