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Abdominal pain diagnosis

Definition

There are clues to diagnosing the cause and severity of abdominal pain. See abdominal pain for a detailed discussion of the potential causes and what to do for your symptoms.

Alternative Names

Stomachache

Information

Abdominal pain can represent many different types of problems besides a simple stomachache. It can even be due to pain in the pelvis (such as menstrual cramps), back (such as kidney stones), or chest (such as a heart attack or heartburn).

Your doctor will ask you specific questions to help determine the cause of your abdominal pain:

  • What makes it feel worse?
  • What makes it feel better?
  • When did it begin?
  • How long does it last when you have it?
  • Is the pain constant or does it come and go?
  • What does the pain feel like? Is it sharp, dull, or crampy?
  • Do you also have nausea, vomiting, diarrhea, constipation, or blood in your stool?

Two common conditions that you may worry about if you have abdominal pain are appendicitis or an ulcer.

An inflamed appendix generally starts with pain in the center of the abdomen, around the belly button, followed by loss of appetite, nausea, and fever. As appendicitis worsens, the pain generally moves to the right lower abdomen. An inflamed appendix can rupture and should be treated as a medical emergency.

Ulcers often produce pain in the upper, central abdomen, a few hours after eating or during the night. Taking antacids may relieve the pain. The risks from an ulcer include bleeding or rupture.

Go to your the hospital emergency room or call your local emergency services number (such as 911) if:

  • Your pain is severe, sudden and sharp
  • You have a fever along with your pain
  • You are vomiting blood or have bloody diarrhea
  • You have a rigid, hard abdomen that is tender to touch
  • You are unable to pass stool, especially if you are also vomiting
  • You have chest, neck, or shoulder pain
  • You are dizzy or light-headed

Call your doctor if:

  • You have nausea and lack of appetite.
  • You have yellowing of your eyes or skin.
  • You have bloating for more than 2 days.
  • You have diarrhea for more than 5 days, or if an infant or child has had diarrhea for 2 days or vomiting for 12 hours. (Call right away if a baby under 3 months old has diarrhea or vomiting.)
  • You have had abdominal discomfort for more than one week.
  • You have burning with urination or you are urinating more often than usual.
  • You have painful menstrual periods.
  • You have abdominal pain and may be pregnant.
  • Your pain gets worse when you take antacids or eat something.
  • You are unintentionally losing weight.

References

Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtrans Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: WB Saunders; 2006.

Abdominal Pain. In: Marx J. Rosens Emergency Medicine: Concepts and Clinical Practice. 6th ed. St. Louis, Mo: Mosby; 2006: Chap 22.

Ebell MH. Diagnosis of appendicitis: part 1. History and physical examination. Am Fam Physician. 2008 Mar 15;77(6):828-30. Review. No abstract available.

Lyon C, Clark DC. Diagnosis of acute abdominal pain in older patients. Am Fam Physician. 2006 Nov 1;74(9):1537-44. Review.

Bundy DG, Byerley JS, Liles EA, Perrin EM, Katznelson J, Rice HE. Does this child have appendicitis? JAMA. 2007 Jul 25;298(4):438-51. Review.


Review Date: 4/25/2008
Reviewed By: Jacob L. Heller, M.D., M.H.A., F.A.C.E.P., Section of Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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