Abdominal Pain

What is abdominal pain?

Abdominal pain (or “stomach pain”) is a common symptom but one that can cause significant distress and disruption to everyday life activities such as eating, working and sleeping. Because the nerve supply (autonomic nervous system) to the internal organs is not well developed, the pain felt from different organs can overlap and feel very similar. This creates challenges with identifying the underlying problem and is the reason you may need to undergo further tests.

What causes abdominal pain?

There are two main reasons people feel abdominal pain. Firstly, damage to, or dysfunction of, an internal organ such as the stomach (e.g. due to an ulcer). This can happen when an organ’s blood supply is affected, or becomes inflamed due to an infection or autoimmune disease. The second cause of abdominal pain is related to dysfunction of the nervous supply itself rather than underlying tissue damage. This is called ‘visceral hypersensitivity’ which can develop after an initial ‘insult’ or damage to an organ.

The major abdominal organs can all be responsible for causing abdominal pain. These include the oesophagus, stomach, small and large intestine, pancreas, gallbladder, liver, kidneys, bladder and ovaries/uterus. While its can be difficult to distinguish the different causes, pain arising from each organ often has a certain pattern and characteristics.

Abdominal Pain

What are the types of abdominal pain?

Abdominal pain (or discomfort) varies according to many factors including the organ involved, the type and severity of damage to that organ, as well as an individual’s perception of pain.

Common patterns of abdominal pain include:

1. Location

(i) upper abdomen – usually related to the oeosphagus, stomach, gallbladder, liver or pancreas
(ii) central abdomen – often the small or large intestine
(iii) lower abdomen – the large intestine, bladder, uterus, ovaries, appendix
(iv) the side of the abdomen (flank) – kidneys or large intestine

2. Pattern / Type

(i)’Post-prandial’ – means after meals and often related to gastric acid irritation of the stomach or oesophagus (reflux). The gallbladder (gallstones) and pancreas (pancreatitis) can also fit this picture.
(ii)’Colicky’ – describes pain that comes in waves and is usually caused by obstruction of an organ (e.g. bowel obstruction).
iii) ‘Musculoskeletal’ – often sharp or stabbing pain that is worse with movement. usually localizes to a specific area.

Abdominal pain is often associated with other symptoms. These may include: nausea and vomiting, a change in bowel habit, fevers or sweats, weight loss or bleeding. These symptoms can be helpful in pinning down the underlying cause.

How do you diagnose abdominal pain?

A detailed history and examination is the starting point to diagnosing abdominal pain. The location, pattern, associated symptoms, frequency and duration, exacerbating and relieving factors are all important factors to determine the underlying cause. Additional information such as past medical conditions, medications and family history are also helpful.

Frequently, investigations are also needed to help reach a diagnosis. These can include blood tests, bacterial studies, a stool sample, an ultrasound/x-ray/CT/MRI, motility studies, or possibly a gastroscopy or colonoscopy. The location, type and pattern of your abdominal pain will dictate which investigations are recommended.

How do you treat abdominal pain?

The treatment for abdominal pain depends upon the underlying cause and needs to be tailored individually. Reaching a clear diagnosis is important to guide treatment that can include: dietary modification, medications, endoscopic treatment, gut-focused psychology, medicinal cannabis or even a faecal microbiota transplant (FMT). At Gastro IQ, we follow an evidence-based medicine approach using data from the latest studies to provide up to date treatments for our patients.