Types of Abdominal Pain and Appropriate Treatments
When abdominal pain follows typical patterns, physicians can narrow down the likely sources. Persistence of pain or worsening of pain is a trigger for many (other than those regarded as stoic) that indicates a need for medical attention.
Abdominal pain is the most common complaint for people seeking help in an Emergency Room. Everybody experiences abdominal pain at times, and in many cases, it is something minor that will resolve itself in a short time. In other circumstances, abdominal pain might be related to something more serious. How does a person know what to do? This brief article should help give you some good pointers.
As a surgeon, many of the patients referred to me are sent because of stomach or abdominal pain. In most cases, the patients have already been to the ER or to their primary care doctor for this issue before seeing me. It is helpful to look at the process of what happens typically before I’m ever made aware of a patient.
Since we are all different, we react to things based on our experience, our education, and our personal thresholds. Before somebody makes the decision to go seek medical care, usually the problem has been dealt with through self-care for some time.
Many people with minor abdominal pain will assume it was from something they ate. In these cases, one expects the pain to pass within a short time. If it does, it is typical that nothing further is done, and the person goes on with life as if nothing of significance happened. Persistence of pain or worsening of pain is a trigger for many (other than those regarded as stoic) that indicates a need for medical attention.
Do you frequently experience abdominal pain?
DECISION TO SEEK HELP
Let’s assume that the pain is enough that you have now decided you need to seek help. What should you expect when you first meet a healthcare provider? Expect to be asked about your medical history and be sure to bring along any information about your personal medical issues, prior surgeries, medicines, and allergies that will help speed you through this process.
You should be asked questions to help determine the cause of your abdominal pain: location (right upper, right lower, left upper, left lower, central, or all over), character (sharp, dull, pressure, transient, constant, etc), associations (nausea, vomiting, diarrhea, constipation, fever, chills, etc), and timing (before meals, after meals, while sleeping, etc). When pain follows typical patterns, we as physicians can narrow down the likely sources. Often, we need an imaging study or blood tests to clarify the diagnosis before offering treatment(s).
ABDOMINAL PAIN EVALUATION
Most doctors focus on what is common and what is most serious first, as we don’t want to miss something bad or delay treatment. The process of evaluation often follows algorithms to reach a diagnosis. Think of your abdomen divided into four quadrants by lines drawn vertically and horizontally with the intersection at your umbilicus (belly button).
If you have right upper quadrant pain especially after meals and with nausea and vomiting, there is a good chance you have gallstones. An ultrasound exam will usually clarify this, and if you are found to have gallstones, most likely a surgery will be recommended to remove your gallbladder.
If your pain is right lower quadrant and it started within the last few days and has progressed over time, you might have appendicitis. Usually you will also have a fever and no desire to eat with this diagnosis. It can be confirmed with a CT scan in most cases, and if this is your diagnosis, surgery to remove your appendix will most likely follow.
Left lower quadrant pain that is cramping might be from diverticulitis. This could be evaluated with a CT scan too. Sometimes this can be treated with just antibiotics and other times surgery is needed. Central abdominal or left upper quadrant pain can be from many things related to your stomach, your pancreas, intestines, major arteries, etc. This will probably require blood tests and CT scan to figure out, and depending on the findings, there could be need for surgery.
Keep a doctor with you all the time
It is important to understand that doctors go to school for many years and they receive ongoing education because there is much to know and it is constantly changing. Ideally, the relationship between you and your doctor should be viewed as a partnership. You will likely have a better experience and outcome when you do your part to be healthy.
It is very important to be truthful and forthcoming to your doctor as things that may not seem important to you or that might be embarrassing may bear greatly on your treatment and outcome. It is best to err on the side of caution. Even bad things such as cancer often give notable clues at different times. Catching things early can make a huge difference in outcome.