Definition of abdominal pain
Discomfort in the abdominal cavity. Symptoms accompanying abdominal pain may include belching, nausea, vomiting, rumbling and gurgling noises, and flatulence (wind).
Causes of abdominal pain
Mild abdominal pain is common and is often due to excessive alcohol intake, eating unwisely, or an attack of diarrhoea. Pain in the lower abdomen is common during menstruation but may occasionally be due to a gynaecological disorder such as endometriosis (in which fragments of uterine lining are present in abnormal sites within the abdomen). Cystitis (inflammation of the bladder) is another common cause of pain or discomfort in the lower abdomen. Bladder distension due to urinary obstruction may also cause abdominal pain.
Abdominal colic is the term used for pain that occurs every few minutes as one of the internal organs goes into muscular spasm. Colic is an attempt by the body to overcome an obstruction such as a stone or an area of inflammation. The attacks of colic may become more severe and may be associated with vomiting (see actue abdomen).
A peptic ulcer, which is associated with an increase in the amount of acid formed in the stomach, often produces recurrent gnawing pain. Other possible causes of abdominal pain are infection, such as pyelonephritis (infection of the kidneys) and pelvic inflammatory disease (infection of the internal female reproductive organs), and ischaemia (a lack of blood supply), as occurs when a volvulus (twisting of the intestine) obstructs blood vessels. Tumours affecting an abdominal organ can cause pain. Abdominal pain may also have a psychological cause, such as anxiety.
Abdominal pain treatment
For mild abdominal pain, self-treatment measures, such as a wrapped hot-water bottle or a milky drink, are often effective. Pain due to peptic ulcer can be temporarily relieved by consuming food or by taking antacid drugs.
Abdominal pain that is not relieved by vomiting, persists for more than six hours, or is associated with sweating or fainting requires urgent medical attention. Urgent attention is also necessary if pain is accompanied by persistent vomiting, vomiting of blood, or passing of bloodstained or black faeces. Abdominal pain that is accompanied by unexplained weight loss or changes in bowel habits should always be investigated by a doctor.
Investigation and diagnosis
The doctor makes a diagnosis of abdominal pain based on a physical examination and a detailed description of the patient’s symptoms. Investigation of severe abdominal pain may also include blood tests, imaging tests such as ultrasound scanning, and endoscopy (examination of a body cavity using a flexible viewing tube) in the form of laparoscopy (viewing the abdominal cavity), gastroscopy (viewing the stomach and duodenum), or colonoscopy (viewing the large intestine).
Diagnosing abdominal pain
The doctor conducts a physical examination and listens to the patient’s description of the pain. More investigations, such as blood tests, X-rays, or imaging tests (including ultrasound scanning), may be carried out. If the diagnosis is still in doubt, endoscopic inspection of the stomach and duodenum (gastroscopy), large intestine (colonoscopy), or abdominal cavity (laparoscopy) may be performed.
A burning pain in the chest that is accompanied by regurgitation of stomach acid and is often worse after meals or when lying down at night.
A cramplike or steady pain under the right ribs that is often accompanied by vomiting and fever.
Duodenal ulcer pain
This pain often occurs in the same small area and may be temporarily relieved by eating or taking antacids.
This pain starts around the navel before finally settling in the lower right side of the abdomen.
Excess wind in the digestive system affects a large area of the abdomen and can cause an uncomfortable, distended feeling.
Pelvic organ inflammation
A constant diffuse pain, usually accompanied by vaginal discharge or fever, that extends over the lower abdomen.