Abdominal Pain: Causes, Symptoms, and Treatment Options

It is a very frequent symptom and it can have different causes. Depending on the type of pain, its onset, its duration and its location, the diagnosis may vary. Several different devices converge in the abdomen.

• We find the stomach in the upper left part, which continues with the digestive tract distributed throughout the abdomen until it reaches the rectum.
• In the upper right part of the abdomen is the liver, with the gallbladder, and in the upper central part, the pancreas.
• In the middle part of the abdomen is the small intestine, and in the lower right part, the ovary and the right tube and the appendix.
• In the central part of the lower abdomen are the bladder in the most anterior part, the uterus and vagina in the middle part and the rectum in the back part.
• In the lower left part of the abdomen is the end of the digestive tract and the ovary and the left tube.
• In the lumbar part are the kidneys and from there come the two ureters, the tubes that carry urine from the kidneys to the bladder crossing forwards through the lower lateral part of the abdomen.

To properly diagnose abdominal pain, a good medical history and a physical examination should be taken. Digestive problems, such as, gastroenteritis or, should be ruled out, and never forgotten.

In colicky pain, which comes and goes, with peaks of pain and of high intensity, they can be due both to biliary colic, due to stones in the gallbladder, as well as to renal colic, due to kidney stones. In lower abdominal pain there may be several origins, but gynecological pain is common in women. The menstrual cycle and whether it is related to the appearance of pain should be investigated.

Tests and diagnosis of abdominal pain

Besides the abdominal x-ray There are several complementary tests that can help in the diagnosis, such as blood and urine tests.

The imaging tests that can be performed are ultrasound, both abdominal and vaginal, abdominal X-ray, or the scanner or MRI.

Other types of abdominal pain:

1.Gynecological in origin

If the pain is gynecological in origin, it may have several possible causes. The most typical is dysmenorrhea or pain coinciding with the rule. Some women do not have any type of discomfort with menstruation, but others have severe pain that is sometimes accompanied by vomiting or that requires admission and analgesic treatment.

Women with endometriosis frequently have severe menstrual cramps that may require analgesia, sometimes intravenously in the hospital. Mid-cycle ovulation can also be very painful. Approximately two weeks after the start of your period you may experience pain in the lower third of the abdomen, stabbing and coinciding with a more mucous discharge, such as egg white. In cases where ovarian cysts appear, they can be totally asymptomatic, but on other occasions they are painful, due to their size or structure. If the cysts produce an ovarian torsion, the pain is very intense and does not improve with analgesia. The torsion of the ovary consists of this organ turning on itself, thus collapsing the blood supply and, therefore, causing the ovarian tissue to necrose, that is, its cells die. This accident requires urgent surgical treatment.

Right ovarian torsion is sometimes difficult to distinguish from appendicitis and may require exploratory surgery in order to make an accurate diagnosis and appropriate treatment. Sometimes, uterine fibroids can also cause abdominal pain, especially by compression of adjacent structures when they are large.

During pregnancy abdominal pain is usually more alarming and often does not have any significant repercussions.

2. Urine infections

Urine infections can give pain in the lower abdomen that is confused with gynecological pain, but in these cases a good medical history determining the type of pain and a urine test help a lot in the diagnosis. Kidney colic can also cause pain in the lower third of the abdomen so it should also be taken into account when making a diagnosis. Infections of the vaginal discharge can sometimes be associated with discomfort in the abdomen, although they are not usually as strong as those of urinary origin.

In any case, when in doubt about abdominal pain, and especially in pregnancy, a doctor should be consulted to rule out urgent or serious pathology that requires treatment.

• Endoscopies, on the other hand, are techniques in which a camera is introduced to be able to see inside the abdomen or organs and can be very useful, including gastroscopy, hysteroscopy, cystoscopy or laparoscopy, according to the suspected origin of the pain.
  • During the first weeks of pregnancy, it is common to have abdominal discomfort, such as when menstruation is about to begin. They are normal pains due to the growth of the womb, but if the pain is greater than that of a period or is accompanied by loss of blood from the vagina, an examination should always be done to rule out complications such as abortions or ectopic pregnancies. They are also common.
  • In the second trimester it is less frequent that pains appear, but if they do so rhythmically and coinciding with stiffening of the belly, a threat of premature birth should be ruled out and therefore a visit to the emergency room should be done.
  • During the third trimester, the threat of premature labor should also be ruled out when rhythmic pains appear that do not stop with rest and a visit to the emergency room or the referring doctor is necessary. On the other hand, in case of rapid onset pain, of moderate or strong intensity, with hardening of the womb, which may or may not be accompanied by dark bleeding from the vagina, the emergency visit should be immediate since it could be a detachment of placenta, which would require very urgent treatment.
  • In pregnancy, abdominal pain may appear due to pathologies not related to pregnancy, such as urinary tract infections or gastroenteritis, or even appendicitis. Appendicitis during pregnancy can be very difficult to diagnose since the appendix is ​​displaced from its usual place and therefore can be confused with abdominal pain from some other origin.