February 19, 2017

Abdominal Pain (Causes, Remedies, Treatment)

How does IBS (irritable bowel syndrome) cause abdominal pain?

As previously discussed, the pain of irritable bowel syndrome is due either to abnormal intestinal muscle contractions or visceral hypersensitivity. Generally, abnormal muscle contractions and visceral hypersensitivity are much more difficult to diagnose than other diseases causing abdominal pain, particularly since there are no typical abnormalities on physical examination or the usual diagnostic tests. The diagnosis is based on the history (typical symptoms) and the absence of other causes of abdominal pain.

What are home remedies for certain causes of abdominal pain?

If you are unsure that your abdominal pain requires medical evaluation, contact your doctor before using any home remedies.

  • Common home remedies for abdominal pain are:
    • eating less food,
    • taking small amounts of baking soda,
    • using lemon and/or lime juice, and
    • starting a BRAT diet (banana, rice, applesauce and toast) for a day or so.
  • Stop smoking and drinking alcohol.

Some health care professionals recommend:

  • Taking ginger
  • Peppermint
  • Licorice
  • Chamomile tea
  • Medications such as bismuth subsalicylate (Pepto-Bismol), loperamide (Imodium), ranitidine (Zantac) and other over-the-counter substances

Some of these listed above may help reduce symptoms, but if symptoms persist, seek medical help. Beware of "cures" advertised for abdominal pains as a single treatment that can cure all types of this problem does not exist.

Taking aspirin or NSAIDs should be avoided until the cause of the pain is diagnosed because the medications could make some causes worse (for example, peptic ulcers, intestinal bleeding).

Why can diagnosis of the cause of abdominal pain be difficult?

Modern advances in technology have greatly improved the accuracy, speed, and ease of establishing the cause of abdominal pain, but significant challenges remain. There are many reasons why diagnosing the cause of abdominal pain can be difficult. They are:

  • Symptoms may be atypical. For example, the pain of appendicitis sometimes is located in the right upper abdomen, and the pain of diverticulitis is on the right side. Elderly patients and patients taking corticosteroids may have little or no pain and tenderness when there is inflammation, for example, with cholecystitis or diverticulitis. This occurs because corticosteroids reduce the inflammation.
  • Tests are not always abnormal.
    • Ultrasound examinations can miss gallstones, particularly small ones.
    • CT scans may fail to show pancreatic cancer, particularly small ones.
    • The KUB can miss the signs of intestinal obstruction or stomach perforation.
    • Ultrasounds and CT scans may fail to demonstrate appendicitis or even abscesses, particularly if the abscesses are small.
    • The CBC and other blood tests may be normal despite severe infection or inflammation, particularly in patients receiving corticosteroids or other drugs that suppress the immune system.
  • Diseases can mimic one another.
    • IBS symptoms can mimic bowel obstruction, cancer, ulcer, gallbladder attacks, or even appendicitis.
    • Crohn's disease can mimic appendicitis.
    • Infection of the right kidney can mimic acute cholecystitis.
    • A ruptured right ovarian cyst can mimic appendicitis; while a ruptured left ovarian cyst can mimic diverticulitis.
    • Kidney stones can mimic appendicitis or diverticulitis.
  • The characteristics of the pain may change. Examples discussed previously include the extension of the inflammation of pancreatitis to involve the entire abdomen and the progression of biliary colic to cholecystitis.
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Reviewed on 5/1/2015