Sunday, February, 12, 2012

Abdominal pain

Table of Contents

  • Are currently being treated for cancer
  • Are unable to pass stool, especially if you are also vomiting
  • Are vomiting blood or have blood in your stool (especially if maroon or dark, tarry black)
  • Have chest, neck, or shoulder pain
  • Have sudden, sharp abdominal pain
  • Have pain in, or between, your shoulder blades with nausea
  • Your belly is rigid, hard, and tender to touch
  • You are pregnant or could be pregnant
  • You have had a recent injury to your abdomen
  • You are having difficulty breathing

Call your doctor if you have:

  • Abdominal discomfort that lasts 1 week or longer
  • Abdominal pain that does not improve in 24 - 48 hours, or is becoming more severe and frequent
  • Bloating that persists for more than 2 days
  • Burning sensation when you urinate or frequent urination
  • Diarrhea for more than 5 days, or if your infant or child has diarrhea for more than 2 days or vomiting for more than 12 hours -- call right away if a baby younger than 3 months has diarrhea or vomiting
  • Fever (over 100°F for adults or 100.4°F for children) with your pain
  • Prolonged poor appetite
  • Unexplained weight loss

What to expect at your health care provider's office

From your medical history and physical examination, your doctor will try to determine the cause of your abdominal pain. Knowing the location of pain and its time pattern will help, as will the presence of other symptoms like fever, fatigue, general ill feeling, nausea, vomiting, or changes in stool.

During the physical examination, the doctor will test to see if the pain is localized to a single area (point tenderness) or whether it is diffuse. He or she will be checking to see if the pain is related to inflammation of the peritoneum (called peritonitis). If the health care provider finds evidence of peritonitis, the abdominal pain may be classified as an "acute abdomen," which may require surgery right away.

Your doctor may ask the following questions about your abdominal pain:

  • Is the pain all over (diffuse or generalized) or in a specific location?
  • What part of the abdomen is affected? Lower or upper? Right, left, or middle? Around the navel?
  • Is the pain severe, sharp or cramping, persistent or constant, periodic and changing intensity over minutes?
  • Does the pain awaken you at night?
  • Have you had similar pain in the past? How long has each episode lasted?
  • How often do you have the pain? Is it constant or does it come and go?
  • Does it occur within minutes following meals? Within 2 to 3 hours after meals?
  • Is it getting increasingly more severe?
  • Does it occur during menstruation (dysmenorrhea)?
  • Does the pain go into your back, middle of the back, below the right shoulder blade, or your groin, buttocks, or legs?
  • Does the pain get worse after lying on the back?
  • Does the pain get worse after eating or drinking? After eating greasy foods, milk products, or alcohol?
  • Does the pain get worse after stress? After straining efforts?
  • Does the pain get better after eating or a bowel movement?
  • Does the pain get better after milk or antacids?
  • What medications are you taking?
  • Have you had a recent injury?
  • Are you pregnant?
  • What other symptoms are occurring at the same time?

Diagnostic tests that may be performed include:

  • Barium enema
  • CT scan
  • Colonoscopy or sigmoidoscopy (direct viewing of the lower bowel)
  • Blood, urine, and stool tests
  • Endoscopy of upper GI (gastrointestinal) tract ( EGD )
  • Ultrasound of the abdomen
  • Upper GI and small bowel series
  • X-rays of the abdomen

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Review Date: 10/07/2009
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)