Abdominal Pain (Causes, Remedies, Treatment) (cont.)
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)
Dr. Anand received MBBS degree from Medical College Amritsar, University of Punjab. He completed his Internal Medicine residency at the Postgraduate Institute of medical Education and Research, Chandigarh, India. He was trained in the field of Gastroenterology and obtained the DPhil degree. Dr. Anand is board-certified in Internal Medicine and Gastroenterology.
In this Article
- Abdominal pain facts
- What is abdominal pain?
- What causes abdominal pain?
- When should I call my doctor about abdominal pain?
- How is the cause of abdominal pain diagnosed?
- Signs and symptoms associated with abdominal pain
- Physical examination to diagnose abdominal pain
- Exams and tests to diagnose abdominal pain
- IBS (irritable bowel syndrome) and diagnosing abdominal pain
- Why can diagnosis of the cause of abdominal pain be difficult?
- What are home remedies for certain causes of abdominal pain?
- What medications can be used to treat certain causes of abdominal pain?
- What lifestyle choices can I make to prevent abdominal pain?
- Pictures of Abdominal Pain - Slideshow
- Pictures of What's Causing Your Pelvic Pain - Slideshow
- Pictures of Appendicitis & Appendectomy - Slideshow
- Find a local Doctor in your town
IBS (irritable bowel syndrome) and diagnosing 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.
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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