Acute Abdominal Pain and Treatment
Abdominal discomfort is commonly a minor issue, yet sudden, severe abdominal pain can signal a serious condition, potentially necessitating urgent surgery. Specifically, older individuals, people with HIV, or those using immunosuppressants like corticosteroids might experience less intense pain, even in severe cases. Importantly, their pain often develops more gradually. Moreover, young children, especially infants, frequently struggle to communicate their abdominal pain.
Types of Abdominal Pain:
Abdominal pain varies based on affected body areas and includes several types:
- Firstly, Visceral Pain originates from internal organs within the abdomen, typically described as vague and nauseating. Notably, it can be hard to pinpoint and is sensitive to stretching or organ muscle contractions.
- Secondly, Somatic Pain arises from the peritoneum, the abdominal cavity lining, characterized by sharp, easily localized pain.
- Lastly, Referred Pain is felt in a location away from the pain source. For instance, gallbladder disease might cause shoulder blade pain.
- Peritoneal Cavity Inflammation:
Severe pain in the peritoneal cavity often indicates a serious condition, triggered by issues like appendicitis, diverticulitis, and pancreatitis. Consequently, leakage of blood or bodily fluids into this cavity, due to organ rupture or severe trauma, can cause irritation and inflammation.
Acute Abdominal Pain and Treatment:
Acute abdominal pain stems from various causes, including infections, inflammation, ulcers, ruptures, obstructed muscle contractions, and organ blood flow blockage. Critically, urgent conditions like ruptured abdominal aortic aneurysms, perforated stomach or intestine, mesenteric ischemia, and ruptured ectopic pregnancies necessitate swift diagnosis and often surgery.
Evaluation of Acute Abdominal Pain:
In cases of acute abdominal pain, symptoms like intense pain, shock signs, peritonitis indicators, and abdominal swelling require immediate medical attention.
During an evaluation, doctors actively focus on the patient’s symptoms and medical history, and perform a physical exam. They pay particular attention to the characteristics of the pain, any accompanying symptoms, the patient’s medication use, known medical conditions, and any previous surgeries. The physical exam involves actively checking the abdomen for tenderness, guarding, rigidity, rebound, and any masses.
The approach to diagnosing acute abdominal pain involves selecting diagnostic tests that align with the suspected condition. Typically, these tests may include:
- Urine Pregnancy Tests: For females of childbearing age, this is often a standard initial test.
- Imaging Tests: CT scans are commonly used to visualize the abdominal area for better understanding of the underlying issue.
- Urine Analysis: This helps in identifying any urinary tract infections or kidney problems.
- Blood Tests: These tests can provide a broad spectrum of information, including markers of infection, inflammation, and organ function.
- Endoscopic Examinations: In certain cases, doctors might use endoscopic procedures to get a closer look inside the gastrointestinal tract.
In terms of treating acute abdominal pain, the primary goal is to tackle the root cause of the pain.
Traditionally, doctors were reluctant to give pain medication before making a clear diagnosis, fearing it might mask symptoms. However, this perspective has shifted. Now, it’s more common for doctors to administer small doses of pain medication even during the diagnostic phase. This approach helps manage pain without significantly interfering with the diagnosis process.