By Todd Sandstrom, MD
Ministry Medical Group
There are many reasons for a pain in the abdomen. It could be a simple stomach ache caused by something you ate. Or it could be a life threatening problem such as a ruptured appendix.
Pain is a sign that something is not quite right, but it doesn’t necessarily require urgent or emergency medical attention. When it’s severe when it’s accompanied by other symptoms such as fever, vomiting, diarrhea, persistent constipation or swelling of the abdomen, it’s important to get medical help right away.
Inside the abdomen are numerous major organs–the intestines, stomach, kidneys, gallbladder, liver, spleen, pancreas and appendix. An infection, inflammation or irritation of any of these organs can cause pain. The problem could also be a growth or cancer on one of these organs. Pain that is localized usually gives some clue as to which organ or organs might be involved.
In making a diagnosis, many clinicians will also want to know what the pain feels like (sharp, dull, stabbing, cramp-like, knife-life, twisting, piercing); how long it lasts and what seems to trigger it. Is it worse after a heavy meal? Better after a bowel movement? Worse when lying down?
Some of the common causes of abdominal pain
KIDNEY STONES: Pain–coming on strongly and then getting less intense after a while can be a clue that a kidney stone may be present. A urine test can also rule out another strong possibility: a bladder or urinary tract infection.
MENSTRUAL CRAMPS: Women are familiar with menstrual cramps–one of the most common reasons for abdominal pain. If the pain is severe enough to cause you to miss work or school, though, you should see your primary care clinician.
Sudden cramping or pelvic pain could be a sign of an infection. Left untreated, it could cause scarring and damage to reproductive organs, resulting in infertility.
Other reasons for pain related to female reproductive organs include fibroids, endometriosis, pelvic inflammatory disease and sexually transmitted infections.
FOOD POISONING: The most common cause of abdominal pain is food poisoning. In addition to stomach pain and cramps, symptoms usually include diarrhea, vomiting, mild fever, nausea and headaches. Most cases can be treated at home and will pass in three to five days. Get medical attention if the diarrhea lasts more than three days, you have a fever over 101.5 or show symptoms of severe dehydration.
GASTROENTERITIS: What is commonly called the stomach flu is really viral gastroenteritis–an inflammation of the stomach and intestines caused by a virus such as rotavirus or norovirus. These viruses can spread through food or drink but also by close personal contact. Students in dormitories and children in day care centers are particularly vulnerable.
GALL STONES: The gallbladder is a little sac that stores bile from the liver and is also a common source of abdominal pain. As with kidney stones, the pain can be spasmodic but when a stone is blocking a cystic duct the gallbladder contracts vigorously. The pain may extend to the back or beneath the right shoulder blade, and it usually worsens after eating a meal, particularly fatty or greasy foods.
IRRITABLE BOWELS: Irritable bowel syndrome (IBS) is less serious than inflammatory bowel disorders such as Crohn’s disease and ulcerative colitis. But many of the symptoms are similar: diarrhea, constipation (or a combination of the two); bloating, cramping and gas that may lead to bathroom emergencies.
While the pain and cramping of IBS can be distressing, the disorder does not damage the bowels, as Crohn’s disease and ulcerative colitis do. The latter, however, usually have additional symptoms such as weight loss and intestinal bleeding.
APPENDICITIS: An inflammation of the appendix, usually caused by a partial or complete obstruction in the appendix, a small protrusion of the colon, is appendicitis. If the inflamed appendix ruptures, fecal matter can fill the abdominal cavity–a medical emergency. What starts as mild cramping on the lower right side may gradually become more steady and severe.
There are many reasons you could be feeling a pain in your abdomen. In the vast majority of cases, it will pass quickly and there is no cause for concern. When the pain is severe, persistent, and recurrent or is accompanied by other troubling symptoms, there is good reason to act quickly.
Dr. Todd Sandstrom is a General Surgeon with Ministry Medical Group in Rhinelander