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Abdominal Pain

It is common to hear of people suffering from “stomach aches”, this is something fairly innocuous and no alarm bells go off. The pain is experienced between the chest and pelvic area; the abdomen and is therefore called abdominal pain. 

The causes are fairly treatable and common over the counter medicine, self-medication and at times a day to two: are all that is required to make the pain go away. The abdomen consists of both small and large intestines, kidneys, liver, spleen, pancreas, Uterus and ovaries (female), and of course the stomach. Abdominal pain can be pain of any nature be it cramps or sharp stinging pain. 

Causes of Abdominal Pain

Infections (bacterial, parasitic or viral) are the most common cause of abdominal pain along with inflammation, abnormalities within the either/both intestines, blockages or abnormalities in organs.

Infections that arise in the throat, intestines or blood; travel through the digestive tract, causing abdominal pain. Menstrual cramps are associated with abdominal cramps but in fact these cause pain in the pelvic area rather than the central abdominal area. Diarrhoea, constipation, stomach flu(gastroenteritis), acidity or acid reflux, stress and vomiting feature among the most common causes of abdominal pain. Diseases that causes abdominal pain are usually those which affect the digestive tract. These include gastroesophageal reflux disease (or GERD), irritable bowel syndrome, lactose intolerance and Crohn’s disease. Diseases that causes severe abdominal pain include gall bladder stones, appendicitis or kidney stones. 

There are three kinds of abdominal pain, namely localised, cramp and colicky. Localised pain means pain in one particular area and generally in one affected organ; stomach ulcers usually cause this pain. Cramp is attributable to constipation, diarrhoea, bloating, infection, menstruation etc; cramps come and go without treatment. Colicky pain points towards more severe syndromes like gallbladder or kidney stones. 

The specific location of the pain in the abdomen can point towards specific causes. 

  • 1. When the pain is generally felt across the abdomen, it may be caused due to Crohn’s disease, appendicitis, urinary tract infections, irritable bowel syndrome or a flu.
  • 2. Lower abdominal pain can be caused due to obstructions/blockages in the intestines or appendicitis. With respect to women’s lower abdominal areas, the pain can be caused due to ovarian cysts, menstrual pains, fibroids, miscarriages, endometriosis, pelvic inflammatory disease or an ectopic pregnancy (which occurs outside the womb).
  • 3. Upper abdominal pain can be attributed to gall stones, pancreatitis, gastroenteritis, injury in the area, a heart attack or due to excess waste in the blood.
  • 4. Lower left side abdominal pain can be attributed to colitis, cancer, Crohn’s disease, kidney infections, ovarian cysts and appendicitis. 
  • 5. Upper left side abdominal pain may arise due to an enlarged spleen, kidney infections, hardened stool, pancreatitis, cancer or a heart attack. 
  • 6. Lower right-side abdominal pain may be experienced due to hernia, appendicitis, cancer, flu or a kidney infection. 
  • 7. Upper right-side abdominal pain can be due to hepatitis, pneumonia, an injury in the area or appendicitis.

The causes or reasons stated above should help readers better discern the kind of abdominal pain, the location and the related causes albeit all abdominal pain is not cause for concern. In innocuous circumstances the pain disappears just as quickly as it begins. The severity of pain is usually a good indicator of whether or not a visit to a doctor is required. In case the pain is mild, it will most likely treat itself but in case it is extremely high or unbearable: visit a doctor. When a person cannot even sit still in one position or needs to curl up in a foetal position to alleviate the pain, if there is blood passed along with stool, very high fever , vomiting blood (hematemesis), continuously feeling nauseated or vomiting, yellowish tinge to eyes or skin, difficulty in breathing or heavy swelling around the abdomen : all these mandate an immediate visit to a doctor. One must also visit a doctor in case there is prolonged pain (lasting more than a day) or constipation, fever, a burning sensation upon urination, inexplicable weight loss and sudden loss of appetite. Women must keep in mind to consult their doctors if they experience abdominal pains during breastfeeding or when pregnant.

Diagnosis can be done through a string of tests that will be performed in a hospital or clinic. Prior to any specific tests a general physical examination will be conducted wherein the doctor will press against different areas of the abdomen to determine the areas that are affected. The severity of pain coupled with the location will dictate further diagnostic options. Usually imaging tests such as X Rays and ultrasounds, CT Scans, MRI scans are deployed to further detect and examine the affected abdominal organs and help reveal tumours, fractures or ruptures. A colonoscopy (for looking within the colon and intestines), an endoscopy (for oesophageal and stomach inflammation) or an upper GI (for the stomach) can also be used.

Dr. Inder Kasturia
Consultant Physician & Wellness Expert
Family-medicine

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