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Understanding Abdominal Pain: Types, symptoms, causes, and treatment

Team AckoJan 6, 2023

A stomach ache is something most people have experienced at some point. Because there are so many organs in the area, there are numerous reasons for Abdominal Pain ranging from acidity to appendicitis to cancer! 

Abdominal Pain simply refers to any pain felt in the area below the chest and above the genitals, referred to as the abdomen. The major structures in the abdomen include organs involved in digestion, organs involved in excretion, and reproductive organs in females.

Understanding Abdominal Pain: Types, symptoms, causes, and treatment

Contents

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Types of Abdominal Pain

To evaluate the cause of Abdominal Pain, doctors first evaluate the type of pain.

Localised Pain: Pain that is restricted to a single area. While pain can radiate or extend into a different area, localised pain essentially refers to pain that is focused on a specific area. This type of pain is commonly seen in the abdomen due to appendicitis, gallstones, kidney stones, gastric reflux disease, etc. 

Generalised Pain: In contrast to localised pain, Abdominal Pain is diffusely present throughout the abdomen, and the patient is unable to pinpoint a specific region from where the pain seems to arise. Some common examples of diffuse generalised Abdominal Pain include gastroenteritis due to infection, peritonitis, pancreatitis, severe constipation, etc.

Acute Pain: This is pain that starts suddenly and is of a short duration.

Chronic Pain: Pain that lasts from weeks to months to even years that can be continuous, or recurring. 

Colicky Pain: Colicky Abdominal Pain refers to pain that appears in waves, with a sudden start and sudden end. Colicky pain is usually severe. The common causes of colicky pain are gallstones, kidney stones, and intestinal spasms in case of any obstruction in the digestive tract. 

Crampy Pain: This type of pain is usually mild to moderate in severity. It can be due to a sudden involuntary contraction of the muscles or internal structures. It is non-specific and can have variable onset and duration. Examples include viral gastroenteritis, menstrual cramps, indigestion, etc. 

Causes of Abdominal Pain

The abdomen has many important structures. It is generally divided into 4 major quadrants, by two perpendicular lines through the midlines both horizontally and vertically. This results in the Right Upper Quadrant, Left Upper Quadrant, Right Lower Quadrant, and Left Lower Quadrant. Here is a basic list of the structures in each of the quadrants, the knowledge of which may help in understanding where your Abdominal Pain is arising from.

1. Right Upper Quadrant   

  • Liver

  • Gallbladder

  • The first part of the small intestine (called the duodenum)

  • The head of the pancreas

  • Right kidney

  • Right adrenal gland

  • Parts of the large intestine

Common causes of pain in this region include: 

  • Gallstones

  • Gallbladder infection (cholecystitis)

  • Liver infection (abscess, hepatitis)

  • Acid peptic disease (duodenal ulcer)

  • Growths/tumours of organs in this region

2. Left Upper Quadrant

  • Stomach

  • Spleen

  • The second part of the small intestine (called Jejunum)

  • Pancreas

  • Left kidney

  • Left adrenal gland

  • Parts of the large intestine

Common causes of pain in this region include:

  • Gastritis

  • Acid peptic disease (stomach ulcer)

  • Pancreatitis

  • Injury to the spleen

  • Growths/tumours of organs in this region

  • Pain referred from the chest can occur in this region in conditions like heart attack, pneumonia, rib pain, etc. 

3. Right Lower Quadrant

  • The third part of the small intestine (called the ileum)

  • Appendix

  • The beginning parts of the large intestine (caecum & ascending colon)

  • Right ureter

Causes of pain in this region include:

  • Appendicitis

  • Stones in the right kidney and ureter

  • Cancers of the structures in this region

4. Left Lower Quadrant

  • Left ureter

  • The end parts of the large intestine (sigmoid colon & rectum)

Causes of pain in this region include:

  • Stones in the left kidney and ureter

  • Diverticulitis

  • Cancers of the structures in this region

In females, there are also ovaries on both sides in the lower quadrants and the uterus & urinary bladder in the lower abdomen. In men, the reproductive organs are not present inside the abdomen, and only the urinary bladder is present in the lower abdomen. In addition to this, the abdomen is covered by layers of muscle, as well as a covering layer known as the peritoneum.

Common causes of lower Abdominal Pain include:

  • Gastroenteritis

  • Inflammatory bowel disease (Crohn’s disease and ulcerative colitis)

  • Irritable Bowel Syndrome (IBS)

  • Urinary tract infection (UTI)

  • Cancers of the structures in this region (uterine, endometrial, colon)

  • Hernias can occur in the lower abdomen which can cause pain with swelling

  • Disorders of intestinal motility can cause pain

  • Abdominal muscle injuries and defects

  • Peritonitis

  • Menstrual cramps

  • Uterine fibroids

  • Endometriosis

  • Ectopic pregnancy (a pregnancy that is implanted outside the uterus)

  • Pelvic Inflammatory Disease

  • Infection of the kidneys (pyelonephritis)

  • Bladder infection (cystitis)

Knowing the location of the structures in different regions of the abdomen will give you an idea about what could be the underlying issue behind your pain. 

Symptoms of Abdominal Pain

Usually, Abdominal Pain is accompanied by a wide variety of symptoms depending on the cause. Some of these symptoms are minor, and expected, while some of them are an indication of a more serious issue. Here are some of the symptoms associated with Abdominal Pain.

  • Nausea

  • Vomiting

  • Abdominal bloating

  • Loose stools/diarrhoea

  • Constipation

  • Recurrent burping

  • Hiccups

  • Acid reflux

  • Regurgitation

  • Swelling in the abdomen

  • Fever

The following are some of the more serious symptoms that are associated with Abdominal Pain which require a more detailed evaluation.

  • Severe pain

  • Blood in vomit

  • Blood in motion

  • Dark, tarry stools

  • Mucoid discharge in motion

  • Loss of weight

  • Yellowish discolouration of the skin and eyes (jaundice)

  • Sudden distension of the abdomen

  • Persistent symptoms lasting for more than a week, with progressive worsening of intensity

  • Persistent fever

Evaluation of Abdominal Pain

The diagnosis of Abdominal Pain is done after a detailed history and physical examination. Important details you can share with your doctor that can help them in arriving at a diagnosis include:

  • How the pain started, if it radiates anywhere

  • Relationship of pain with the intake of food

  • Your dietary history before the onset of the pain

  • Associated symptoms

  • Bowel and bladder patterns

  • Frequency of alcohol and tobacco consumption

  • History of similar pain in the past

  • Any medications you may consume

  • History of any surgeries to the abdomen

  • Pattern of the menstrual cycle

  • Family history of cancers

Your doctor will examine your abdomen by palpating it. If required they may also perform a rectal/vaginal examination. 

Treatment of Abdominal Pain

The treatment of Abdominal Pain is mainly treating the underlying cause. Several causes of Abdominal Pain are due to causes that are self-limiting. The use of over-the-counter painkillers is not recommended in managing Abdominal Pain, as they can aggravate it. In general, Abdominal Pain lasting more than 3 days should be evaluated by a doctor, as the resolution of the pain depends on treating the cause. 

Mild Abdominal Pain can be aided by some of these changes.

  • Drinking plenty of water/Oral rehydration solution when pain is associated with vomiting & loose stools

  • Eating a bland, simple, fat-free diet

  • Eating a diet rich in fibre

  • Avoiding spicy, oily, acidic food items

  • Avoid eating food from restaurants/outside sources

  • A heating pad can be comforting for mild pain

  • Muscle pulls and pain can be treated with over-the-counter pain medication like muscle relaxant gels/sprays

Frequently Asked Questions (FAQs)

Here’s a list of common questions and their answers related to Abdominal Pain.

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Is home treatment good or consulting a medical professional better when it comes to Abdominal Pain?

When it comes to Abdominal Pain, it’s better to get it evaluated by a medical professional. The earlier the diagnosis is made, the better the treatment outcome. The next time you get Abdominal Pain that is severe or lasts for over a few days, make sure to consult a doctor to start appropriate treatment soon.

Should I use over-the-counter medication for treating Abdominal Pain?

It’s best to speak to your doctor before taking any medication for Abdominal Pain. 

Is weight loss a normal symptom or a serious symptom of Abdominal Pain?

Considerable weight loss is a serious symptom and you should contact your doctor at the earliest. 

How can Abdominal Pain be diagnosed?

There are several investigations available to aid a diagnosis. This includes ultrasonography, CT scan, various blood tests, endoscopy, etc.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.

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