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Abdominal pain

Abdominal pain, also known as stomach pain or tummy ache, is a common symptom associated with non-serious and serious causes. Common causes of pain in the abdomen include gastroenteritis and irritable bowel syndrome. In a third of cases the exact cause is unclear. About 10% of people have a more serious underlying condition such as appendicitis, leaking or ruptured abdominal aortic aneurysm, diverticulitis, or ectopic pregnancy. Determining the cause can be difficult, because many diseases can cause this symptom.

Differential diagnosis

The most frequent reason for abdominal pain are gastroenteritis (13%), irritable bowel syndrome (8%), urinary tract problems (5%), inflammation of the stomach (5%) and constipation (5%). In about 30% of cases, the cause is not determined. About 10% of cases have a more serious cause including gallbladder ( gallstones or biliary dyskinesia) or pancreas problems (4%), diverticulitis (3%), appendicitis (2%) and cancer (1%). More common in those who are older, mesenteric ischemia and abdominal aortic aneurysms are other serious causes. A more extensive list includes the following:

Acute abdominal pain

Acute abdomen can be defined as severe, persistent abdominal pain of sudden onset that is likely to require surgical intervention to treat its cause. The pain may frequently be associated with nausea and vomiting, abdominal distention, fever and signs of shock. One of the most common conditions associated with acute abdominal pain is acute appendicitis.

Selected causes of acute abdomen

By location

Location
  • Upper middle abdominal pain
  • * Stomach ( gastritis, stomach ulcer, stomach cancer)
  • * Pancreas pain ( pancreatitis or pancreatic cancer, can radiate to the left side of the waist, back, and even shoulder)
  • * Duodenal ulcer, diverticulitis
  • * Appendicitis (starts here, after some time moves to lower right abdomen)
  • Upper right abdominal pain
  • * Liver (caused by hepatomegaly due to fatty liver, hepatitis, or caused by liver cancer, abscess)
  • * Gallbladder and biliary tract ( gallstones, inflammation, roundworms)
  • * Colon pain (below the area of liver – bowel obstruction, functional disorders, gas accumulation, spasm, inflammation, colon cancer)
  • Upper left abdominal pain
  • * Spleen pain ( splenomegaly)
  • * Pancreas
  • * Colon pain (below the area of spleen – bowel obstruction, functional disorders, gas accumulation, spasm, inflammation, colon cancer)
  • Middle abdominal pain (pain in the area around belly button)
  • * Appendicitis (starts here)
  • * Small intestine pain (inflammation, intestinal spasm, functional disorders)
  • Lower abdominal pain ( diarrhea, colitis and dysentery)
  • Lower right abdominal pain
  • * Cecum ( intussusception, bowel obstruction)
  • * Appendix point ( Appendicitis location)
  • Lower left abdominal pain
  • *diverticulitis, sigmoid volvulus, obstruction or gas accumulation
  • Pelvic pain
  • * bladder ( cystitis, may be secondary to diverticulum and bladder stone, bladder cancer)
  • * pain in women (uterus, ovaries, fallopian tubes)
  • Right lumbago and back pain
  • * liver pain ( hepatomegaly)
  • * right kidney pain (its location below the area of liver pain)
  • Left lumbago and back pain
  • * less in spleen pain
  • * left kidney pain
  • Low back pain
  • * kidney pain ( kidney stone, kidney cancer, hydronephrosis)
  • * Ureteral stone pain

Diagnostic approach

When a health care practitioner assesses a patient to determine the etiology and subsequent treatment for abdominal pain the history of the presenting complaint and physical examination should derive a diagnosis in over 90% of cases. Investigations that aid diagnosis include If diagnosis remains unclear after history, examination and basic investigations as above then more advanced investigations may reveal a diagnosis. These as such would include

Management

Butylscopolamine (Buscopan) is used to treat cramping abdominal pain with some success.

Epidemiology

Abdominal pain is the reason about 3% of adults see their family physician. Rates of emergency department visits in the United States for abdominal pain increased 18% from 2006 through 2011. This was the largest increase out of 20 common conditions seen in the ED. The rate of ED use for nausea and vomiting also increased 18%.

References

External links

"green air" © 2007 - Ingo Malchow, Webdesign Neustrelitz
This article based upon the http://en.wikipedia.org/wiki/Abdominal_pain, the free encyclopaedia Wikipedia and is licensed under the GNU Free Documentation License.
Further informations available on the list of authors and history: http://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=history
presented by: Ingo Malchow, Mirower Bogen 22, 17235 Neustrelitz, Germany