Abdominal pain is something everyone has experienced at some point in their lives. It is a fairly common medical problem, and the severity of the issues range from a minor problem to a life-threatening situation. It could be as simple as a stomach upset due to what the individual ate or a complicated issue as a patient requiring emergency surgery to remove part of the intestines that have been deprived of oxygen. Whatever the reason or cause for abdominal pain is, each case is unique and must be treated as such. To properly diagnose the problem, information like the patient’s health history, age, gender, type of pain, area of pain and how long the pain has lasted will all be required.
Acute or chronic abdominal pain
An acute illness is one that has a sudden and often severe onset. Although an acute illness has a sudden onset, the pain or disease can last for an extended period, like weeks or even months. A good example of an acute illness is a broken leg. Acute abdominal pain can be a case where a patient experiences a severe case of appendicitis, and the infection causes the appendix to swell and become increasingly painful.
On the other hand, a chronic illness lasts for six months or longer. Chronic abdominal pain is one that has lasted for six months and is expected to last even longer, possibly a lifetime, if the situation is not treated or cured. Chronic abdominal pains are often caused by ongoing problems that cannot be cured, like cirrhosis of the liver.
Chronic abdominal pain usually has a known cause and a planned treatment; meanwhile, acute abdominal pain may need to be diagnosed first before it is treated.
Taking history
When you visit your doctor due to abdominal pain, do not be surprised if they ask you too many questions. Know that they are simply trying to find out the history of the illness and also the patient’s medical history. This will make it easier to narrow down the potential causes of the pain.
For example, a patient who complains of abdominal pain will be asked a lot of questions. Through the questions, if the patients indicate that they have been drinking heavily for decades, their problem can be attributed to liver issues. On the other hand, a woman of childbearing age who is sexually active without birth control may be experiencing abdominal pain owing to a complication of pregnancy.
Physical examinations
One of the best ways to properly diagnose abdominal pain is through physical examination of the abdomen by a knowledgeable and experienced clinician. The physical examination is carried out in the following order.
Inspection – The abdomen is exposed and examined for any external clues to the nature of the problem, like bruises, scars or other physical marks on the skin that can help suggest potential problems.
Auscultation – Here, a stethoscope is used to listen to different areas of the abdomen. The sounds that the intestines make or do not make will help rule different problems out.
Percussion – Here, the clinician methodically taps on different areas of the abdomen. This process can also help determine the organ size without an x-ray or imaging study.
Palpation – Here, different areas of the abdomen are gently pushed on to determine if they are tender or painful. It helps to narrow down the area of concern and make it easy for diagnosis.
Laboratory tests
Another way to diagnose serious abdominal problems is to examine body fluids, and this could mean taking a sample of blood, stool, urine, saliva or other options. Some examples of lab tests for abdominal pain include the following.
Complete blood count (CBC) – A CBC is a blood test that helps determine the presence of an infection in the body. Certain types of blood cells increase when there is an infection, which can help determine the nature of the problem. If there is an infection in the blood, a culture and sensitivity will be done to determine the type of infection and best treatment.
Urinalysis – This test looks at the urine to determine if there is an infection in the urinary tract or if blood is present in the urine. A urinary tract infection can cause pain in the kidney, bladder, urethra or ureter or all of them, leading to pain in the abdomen, back, or pelvis.
Liver enzymes or hepatic function tests – These are tests that, when elevated, indicate a problem with the function of the liver. When the liver is damaged due to too much medication, too much alcohol, or any other process, it can often cause painful conditions in the abdomen.
Occult stool or hemoccult Test – This is a test that looks for blood in the stool. If there is blood in the stool that cannot be seen with the naked eye, it can indicate a problem in the upper digestive tract.
Amylase and lipase – These are blood tests that look at enzyme levels produced by the pancreas. Elevated levels of this test indicate an infection or inflammation in the pancreas called pancreatitis, which can be extremely painful.
Pregnancy Test – Women who are of childbearing age who experience abdominal pain are usually advised to go for a pregnancy test. The positive test result can explain many symptoms, and the pain may indicate an ectopic pregnancy.
Another method for diagnosing abdominal pain include imaging studies and test such as:
- Computed tomography scan
- Magnetic resonance imaging (MRI)
- Pelvic examination
- Rectal examination
- Upper endoscopy
- Colonoscopy
- X-ray of the kidneys, ureter and bladder
- Ultrasound
You should see a doctor immediately you notice any kind of abdominal pain, whether mild or severe.
