Ways Of Managing Abdominal Pain

By Stephen Bennett


There are many conditions that may manifest in gastrointestinal symptoms. The conditions may be inflammatory in nature, infections, traumatic events and cancers among others. There is no doubt that most Greenbelt, MD, residents if not all, have had to deal with some form of abdominal pain at one time or the other. Most of the time, the cause is an underlying structure. In this article, we explore the various types of pain that exist and how to manage them.

The first thing that one needs to do as they attempt to identify the origin is to establish where it is most intense. The source is likely to be the anatomic structures that are located beneath this area. For instance, if it is the epigastric region, the organs most likely to be affected are the stomach or the liver which means the most probable diagnoses are gastritis, peptic ulcer disease or hepatitis. If it is most severe around the belly button, on the other hand, the intestines are likely to be involved.

The pattern and character of this symptom is also a useful tool in determining its origin. Constricting pain is usually due to a tubular structure such as the intestine, the ureters or the gall bladder among others. Dull, diffuse pain, on the other hand, is likely to be traced to a solid organ. Associated symptoms may provide more clues. For example, if associated with failure to pass stool, its presence is highly suggestive of intestinal obstruction or constipation.

A number of investigations need to be carried out to differentiate the various possibilities that exist. The nature of these investigations is greatly depended on the problem that is suspected. A septic screen is conducted when an infection is suspected. The screen includes, among other things, a full blood count. This is a determination of levels of cellular components in blood. Of greatest concern is the level of white blood cells. Urine, cerebrospinal spinal fluid are subjected to culture studies as part of this screen.

Radiological studies are also useful in the identification of the source of pain. For instance, X-rays (also known as plain radiographs) are an important tool in the diagnosis of intestinal obstruction. Typical findings include the presence of gaseous distension. Tumors within the abdominal cavity are best assessed using ultrasound, CT scans and MRI. Specimens may also be collected under the guidance of some of these radiological modalities.

The treatment varies depending on the underlying condition. A majority of cases can be managed expectantly or may resolve with the administration of over the counter analgesic agents. Antibiotics and other antimicrobial agents are usually administered when an infection is present. If the cause of symptoms is an ulcer then the most appropriate medication will be an antacid or mucosal protective agent. Metastatic tumors such lymphomas may benefit from chemotherapeutic drugs.

Surgery is used both as a therapeutic and diagnostic option. Examples of conditions that may be diagnosed during surgery include appendicitis, abscesses, tumors and ectopic pregnancies among others. Once the problem has been identified through visualization, the intervention can be undertaken. The operation may be done through the open approach or laparoscopically.

Pain in the abdomen is a very common complaint. While many of the cases resolve spontaneously, there are others that are more serious and require further investigation and more aggressive interventional measures. Inflammatory conditions, infections, drugs, trauma and tumors are all possible causes.




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