Abdominal pain (or discomfort) varies according to many factors including the organ involved, the type and severity of damage to that organ, as well as an individual’s perception of pain.
Common patterns of abdominal pain include:
1. Location
(i) upper abdomen – usually related to the oeosphagus, stomach, gallbladder, liver or pancreas (ii) central abdomen – often the small or large intestine (iii) lower abdomen – the large intestine, bladder, uterus, ovaries, appendix (iv) the side of the abdomen (flank) – kidneys or large intestine
2. Pattern / Type
(i)’Post-prandial’ – means after meals and often related to gastric acid irritation of the stomach or oesophagus (reflux). The gallbladder (gallstones) and pancreas (pancreatitis) can also fit this picture. (ii)’Colicky’ – describes pain that comes in waves can be caused by obstruction of an organ (e.g.bowel obstruction). iii) ‘Musculoskeletal’ – often sharp or stabbing pain that is worse with movement. usually localizes to a specific area.
Abdominal pain is often associated with other symptoms. These may include: nausea and vomiting, a change in bowel habit, fevers or sweats, weight loss or bleeding. These symptoms can be helpful in pinning down the underlying cause.
A detailed history and examination is the starting point to diagnosing abdominal pain. The location, pattern, associated symptoms, frequency and duration, exacerbating and relieving factors are all important factors to determine the underlying cause. Additional information such as past medical conditions, medications and family history are also helpful.
Frequently, investigations are also needed to help reach a diagnosis. These can include blood tests, bacterial studies, a stool sample, imaging, motility studies, or possibly a gastroscopy or colonoscopy. The location, type and pattern of your abdominal pain will dictate which investigations are recommended.
The treatment for abdominal pain depends upon the underlying cause and needs to be tailored individually. Reaching a clear diagnosis is important to guide treatment that can include but is not limited to: dietary modification, medications, endoscopic treatment, surgery and gut-focused psychology.