Introduction
Abdominal pain is always serious as life threatening situations can arise out of it. Different organs within the abdominal cavity can be the cause of pain. On the other hand often severe pain that appears organic in nature, can turn out to be psychosomatic. When the physician does a thorough work-up with no resulting diagnosis, the physician often concludes that there is nothing organically wrong. The physician implies that the pain is due to psychological reasons (this is also termed “psychogenic abdominal pain”).
The physician needs to think: what diagnoses could be behind this type of abdominal pain? We call this “differential diagnosis”. In other words the physician makes a mental list of all the possible diagnoses. Then one by one he/she excludes other diagnoses that do not apply. This way the care giver does not overlook anything. Abdominal pain divides into various locations of the abdomen and then one can list the differential diagnoses. I attempted to do this here by listing the 6 subcategories (links above on the left). They contain most of the important causes of abdominal pain. But the list is incomplete as there are many less common causes that are missing. I am also using text links to pages where you can find more details.
Signs and symptoms
All of the conditions above associate with some abdominal pain. However, depending on the location of the organ the pain maybe local or may radiate into a different area. Also the quality of pain varies and different symptoms associate with other findings. The underlying pathophysiology determines the symptoms. I do not repeat the conditions that I described earlier in the following chapter. I will briefly explain the other conditions of the differential diagnosis table of abdominal pain.
Abdominal Pain
Treatment
As all of the diseases, which I mentioned before in the links all have a different pathophysiology. Therefore the physician must individualize treatment. I have described specific treatments below for those conditions not already mentioned above in the chapter. However, there are some common themes. If there is an infectious process such as with PID (=pelvic inflammatory disease) or diverticulitis, then intravenous antibiotics are given.
If there is an abscess such as a liver abscess or a perforated appendicitis, then this has to be surgically drained and also be treated with antibiotics. A cancerous growth requires surgical removal. An incarcerated inguinal hernia or a volvulus needs to be surgically reduced before it leads to gangrene of a segment of the bowel. Acute pancreatitis needs to be supportively treated and the pain needs to be suppressed with narcotics, the same is true for kidney stones.
Treatment for quite a number of diseases is to not give anything by mouth. This rests the gut through the use of intravenous fluids for a period of time. This approach helps for pancreatitis, for acute cholecystitis, ileus and ulcerative colitis just to mention a few.
