Acute Abdominal Pain: Causes, Symptoms & Management
INTRODUCTION:
Acute abdominal pain is a common complaint, accounting for nearly 10% of all emergency department visits.
The causes are varied and include several potentially dangerous conditions. Early detection and treatment of acute abdominal pain save lives.
Acute abdominal pain is defined as a sudden onset of severe and usually constant pain in the abdomen. Pain can be located anywhere from the lower abdomen to the upper abdomen, but it’s usually centered around one area. The pain may radiate into other areas of your body.
This blog will discuss the causes of acute abdominal pain and ways to identify and treat this common complaint.
CAUSES:
APPENDICITIS: Appendicitis is a painful condition that occurs when your appendix becomes inflamed.
RENAL COLIC: Kidneys and the ureter (the tube that carries urine from the kidney to the bladder) can become blocked or injured, causing severe pain in your flank and abdomen.
GASTRIC ULCER: A gastric ulcer is a sore in your stomach lining caused by digestive juices irritating it.
CHOLECYSTITIS: Cholecystitis is an inflammation of your gallbladder. This is usually caused by gallstones. This can cause severe pain in your upper abdomen.
HEPATITIS: Hepatitis is a viral infection that inflames and damages your liver.
PANCREATITIS: Acute pancreatitis occurs when your pancreas becomes inflamed due to excessive alcohol consumption or gallstones blocking the flow of pancreatic juices into the intestines.
INTESTINAL OBSTRUCTION: An intestinal obstruction is when a section of your small intestine becomes blocked, preventing food from passing through. This can cause severe pain in your lower abdomen. An intestinal obstruction occurs when a portion of your small intestine becomes blocked by a tumor, adhesions, or scar tissue. This can cause severe abdominal pain and vomiting.
SIGMOID VOLVULUS: A sigmoid volvulus occurs when part of the large intestine twists around itself, causing pressure on nearby blood vessels and nerves.
DIVERTICULITIS: Diverticulitis occurs when small pouches in your bowel wall become inflamed.
COLON CANCER: Colon cancer usually causes symptoms such as rectal bleeding and abdominal pain, but sometimes, colon cancer may not cause any symptoms at all until later stages of development when symptoms include diarrhea, abdominal swelling, fatigue, and weight loss, among others; this is why regular screening tests are necessary for detecting early signs of colon cancer before it spreads through leading organs like lungs/liver.
OVARIAN TORSION: Ovarian torsion is a rare condition that occurs when the ovary twists on itself, which cuts off its blood supply. Symptoms include severe abdominal pain, nausea, and vomiting. It may also cause blood in the urine or stool. If not treated immediately, ovarian torsion can lead to infertility or even death.
PELVIC INFLAMMATORY DISEASE (PID): PID is an infection of a woman’s reproductive organs. It can cause pain, fever, and other symptoms like lower abdominal pain, bleeding from the vagina during sex or urination, painful intercourse, etc.
SYMPTOMS:
Pain in the abdomen: This is the most common symptom of acute abdominal pain. It may be a dull ache or a sharp, burning sensation. The area of the pain will depend on the cause of the pain. For example, pain in the right side of your abdomen may be due to appendicitis or a kidney stone, while pain in the lower abdomen could be caused by an ectopic pregnancy or ovarian torsion.
Nausea and Vomiting: Most people who have symptomatic gallstones, appendicitis, pancreatitis, and diverticulitis will present with nausea, vomiting, and severe abdominal discomfort (pain). The sickness is usually constant rather than intermittent and tends to worsen with eating or movement.
Patients with Intestinal Obstruction and Sigmoid Volvulus, too will present with nausea and vomiting. However, unlike the other conditions listed here, intestinal obstruction can be associated with severe pain that is intermittent and localized to the right lower quadrant of the abdomen (the area below your navel). The pain may come in waves or episodes that last 10 minutes or more. It’s often described as a feeling of pressure or fullness.
In addition, patients who have acute abdominal pain caused by an intestinal obstruction will often describe nausea and vomiting that is worse when they move around.
If the obstruction is in the small intestine, most patients will have nausea and vomiting but not pain. If it is in the colon (large intestine), patients may or may not have pain; however, they will have diarrhea (loose stools) and abdominal distention (enlargement). nausea and vomiting. However, they may also have diarrhea and constipation, which is not usually seen in patients with other causes of acute abdominal pain (such as appendicitis).
Loss of Appetite: Patients who have acute abdominal pain with nausea and vomiting are often too ill to eat or drink anything for a day or more until their symptoms subside. This loss of appetite can cause weight loss and dehydration.
Vomiting of Blood: In some cases, vomiting blood may occur because blood from an ulcerated stomach lining has been regurgitated into the stomach.
Blood in Stool or Urine: When you have an attack of acute pancreatitis, there may be blood in your stool or urine because pancreatic enzymes leak out of damaged cells into surrounding tissues, including those that line your intestine and urinary tract. Stones in the kidney and ureter can cause blood to appear during urination due to their abrasive effect on the bladder lining.
INVESTIGATIONS:
ULTRASOUND: Ultrasound may be used to look for gallstones or other abnormalities in the gallbladder. An ultrasound may also be used to examine the pancreas, liver and kidneys.
Ultrasound is used in the diagnosis of a number of conditions, including suspected biliary tract disease and ectopic pregnancy (transvaginal probe), suspected appendicitis in children, abdominal aortic aneurysm—and whether or not it has ruptured.
ABDOMINAL X-RAY may be used to look for signs of obstruction like dilated bowel loops and signs of intestinal perforation like free gas below the diaphragm.
CT SCAN of the ABDOMEN & PELVIS may be used to look for signs of cancer or other abnormalities in the pancreas and liver. A CT scan may also be used to look for any complications of acute pancreatitis, such as abscesses or free fluid around organs.
Non-Contrast Computed Tomography (CT) is the modality of choice for diagnosing renal stones. CT with oral and IV contrast can provide a definitive diagnosis in about 95% of patients who present with significant abdominal pain.
Blood tests may include complete blood count (CBC), and liver function tests, including enzymes like alkaline phosphatase and bilirubin levels.
Urine analysis examines the level of protein and glucose in your urine to assess kidney function or diabetes. It also checks for signs of infection, such as white blood cells and red blood cells in your urine.
TREATMENT:
Painkillers are the first line of treatment for acute abdominal pain. They can be taken to relieve pain and prevent infection. If you are experiencing severe pain, your doctor may give you an injection of morphine or another strong painkiller that will take effect more quickly than oral medication.
Antibiotics can be used to treat the underlying infection if one is present.
IV fluids to treat dehydration due to vomiting or diarrhea.
A blood transfusion may also be necessary in cases of severe bleeding like ruptured ectopic pregnancy.
Surgery may be needed for cholecystitis, appendicitis, if peritonitis is present, bowel obstruction or ovarian torsion, or ectopic pregnancy is suspected.
Early detection and treatment of acute abdominal pain save lives:
The sooner the cause of your acute abdominal pain is diagnosed and treated, the better your outcome.
Acute abdominal pain is a medical emergency and should be treated as such. If you are experiencing acute abdominal pain, go to the closest hospital as soon as possible.
All patients with acute abdominal pain should be treated as emergencies by doctors who know what they're doing when diagnosing and treating this condition effectively.
CONCLUSION:
Acute abdominal pain is a common and potentially serious condition. It can be dangerous, so it’s essential to seek medical attention as soon as possible if you have symptoms of this condition. Early detection and treatment of acute abdominal pain save lives.