Abdominal Pains

The abdominal cavity contains many organs. Various diseases of each of these organs can cause pain.

When assessing the diseases of these organs, pain is usually stimulating, unlike headache and low back pain. Abdominal pain is a symptom that should be evaluated without delay. While painkillers are given in other chronic pains, it is extremely inconvenient to give painkillers without determining the cause in abdominal pain. Because in this case, since the underlying disease will be hidden by the cessation of pain, greater damage may be caused by delaying the treatment.

 

In the abdominal cavity, there are stomach, intestines, liver, pancreas, gall bladder, biliary tract, spleen, appendix, kidney and urinary tract, bladder, uterus and ovaries in women, prostate in men. There are many acute and chronic pains originating from all these organs and the abdominal wall. All these pains are very difficult to evaluate. Good examination of the patient is required.

 

The most common abdominal pains are abdominal pain due to appendicitis, pain caused by inflammation and stones of the gallbladder, pain caused by stomach and duodenal ulcers, pain caused by inflammation of the pancreatic gland. In addition, severe pain occurs in cancers of the abdominal organs.

 

Abdominal pains are generally classified according to the region where the pain is located in order to reach the diagnosis more easily. For this purpose, the abdominal region is divided into various parts.

 

Belly circumference

Pain around the navel may be associated with small bowel diseases and appendicitis (appendicitis).

 

Upper middle region

This region is also called the epigastric region. It is located in the midline above the navel. Pain in this area is usually related to stomach diseases. These can be heartburn, gastritis or ulcers. In addition, continuous and severe pain may occur in the upper part of the small intestine (duodenum), pancreas and gallbladder diseases. Another condition that causes pain in this area is diaphragmatic hernia. Apart from all these, severe pain occurs in the upper middle region of the abdomen in cancers of organs located in the region (stomach, pancreas).

 

Upper left region

Pain in this area is not very common. Sometimes it can be seen in diseases related to stomach, spleen, pancreas and large intestine.

 

Upper right region

The most important cause of severe pain in the upper right region is inflammation of the gallbladder. In this case, the resulting pain can spread to the navel and lower back. Sometimes diseases originating from the pancreas or duodenum can also cause pain in the upper right region of the abdomen.

 

Lower middle region

Pain in this area may be due to inflammation of the large intestine, urinary tract infections in women, or diseases related to the reproductive organs. A common painful disease of the region is spastic colon.

 

Lower left area

Often, problems arising from the hindgut cause pain in this area. A specific type of colon inflammation called diverticulitis and Crohn's disease can be counted as examples.

 

Lower right region

In large intestine diseases, pain is also seen in this region. Appendicitis pain also spreads to the lower right part of the abdomen after the initial period.

 

Reflected pain

Pain originating from organs located outside the abdomen, such as the lower parts of the lungs, kidneys, uterus, and ovaries, sometimes radiates to the abdomen. This type of pain is called referred pain. In addition, it is common for pain originating from the abdominal organs to spread to other regions. For example, gallbladder pain spreads to the chest and right shoulder, pancreatic pain spreads to the lower back and between the shoulder blades. These are examples of referred pain.

 

Diagnosis in Abdominal Pain

In patients who apply to the physician due to abdominal pain, first of all, the patient's complaint and the nature of the pain are questioned in detail, followed by physical examination, various laboratory tests, imaging methods and, if necessary, endoscopic examinations.

The way the pain starts is important. For example, a sudden onset of pain is a sign of a sudden onset disease such as malnutrition in the intestines, obstruction in the gallbladder ducts or intestines.

The shape of the pain also provides valuable information for diagnosis. For example, in intestinal obstructions, cramp-like pain occurs due to contractions of the intestines. Obstruction of the bile ducts causes severe and constant pain in the upper abdomen. Acute pancreatitis typically has very severe, excruciating, constant pain in the upper abdomen and back. In acute appendicitis, the pain starts around the navel and shifts to the lower right region of the abdomen as the picture progresses.

Another important diagnostic criterion is the duration of pain. For example, spastic colitis pain persists, increasing and decreasing over months or even years. Gallbladder pain does not last longer than a few hours. Pain due to pancreatic inflammation continues for a few days.

Imaging methods have a very important place in the diagnosis of abdominal pain. Intestinal obstructions or perforations can be detected by direct X-ray.