Acute Abdominal Pain

What is acute abdominal pain?

Acute abdominal pain is discomfort in the stomach area that lasts for less than three days. The word acute is used to describe pain that starts suddenly, worsens quickly, and lasts for a short time. The abdomen is the area between the chest and the hips, and contains organs of the digestive system. These organs include the stomach, intestines (bowel), liver, gallbladder, pancreas, and spleen. The digestive system in your body breaks down and absorbs what you eat and drink. If your stomach discomfort is not treated, it may lead to chronic pain. Chronic abdominal pain is pain that worsens or keeps coming back over a period of at least six months.

What are the types of acute abdominal pain?

Visceral pain:

This is the pain you feel when your internal organs swell, or are damaged in your body. You may feel a dull, cramping, or burning pain that builds up slowly. You may feel pain down the middle of your stomach, or you may not be able to feel exactly where it is.

Parietal pain:

This type of pain is usually felt after a sudden injury. An injury can cause urine, pus, bile, or other contents to leak and hurt the lining of your abdomen. Parietal pain starts suddenly, feels sharp, and you can feel where it is in your abdomen.

Referred pain:

This pain is felt in a part of the body that is far from the actual cause of the pain. Referred pain may be felt when a nerve is hurt or pressed on.

What causes acute abdominal pain?

In some cases, the cause is acute abdominal pain is unknown. In other cases, the pain may be caused by one or more of the following:

Abscess (collection of pus) in the liver or other organs.

Bowel blockage, peptic ulcer, or rupture (tearing apart) of the esophagus or spleen.

Diseases of the blood or blood vessels.

Inflammation (swelling) in the esophagus, stomach, intestines, or other organs in the abdomen.

Injuries, treatments, surgery, or heat or radiation therapy.

Swelling or stones in the kidney or gallbladder.

If you are female, having your unborn baby grow outside of the uterus (womb), diseases of the fallopian tubes or ovaries, or menstrual (monthly period) pain.

How can I tell caregivers about my abdominal pain?

Tell caregivers when you last had abdominal pain, and how it started. Show them where you feel pain. Tell them how bad it is and how long it lasts. Tell caregivers about your diet, and if the pain happens before, during, or after meals. Tell caregivers about other signs and symptoms that you have. Tell them if you find it hard to eat, or have recently lost weight without trying. Tell them if you are throwing up blood, or if you are passing dark-colored stools. Tell your caregivers if you have had gallstones or other diseases or surgeries in the past. If you are female, tell caregivers about changes to your period, or if you know or think you might be pregnant.

What signs and symptoms may be related to my acute abdominal pain?

Your stomach muscles may be tight, or your stomach may feel tender and look swollen. Other common signs and symptoms include:

Blood in your stool, or blood coming from your rectum or vagina.

Changes in bowel movements, such as diarrhea (loose, watery stools). You may also have constipation, which is when you have hard, dry stools that are difficult to pass, less often than usual.

Fever (high body temperature).

Loss of appetite for food or weight loss.

Mass (lump) in the stomach or pelvic area.

Nausea (upset stomach), vomiting (throwing up), or restlessness.

Yellowing of the skin and whites of the eyes.

Other signs and symptoms may include:

Fast or pounding heartbeat.

Headache, dizziness, being unable to think clearly, or fainting.

Irregular or fast breathing.

Pain when you take deep breaths.

Sweating or having pale, cool, and clammy skin.

How may my acute abdominal pain be treated?

The aim of treatment is to make your pain go away. If caregivers find a condition causing your pain, that condition will be treated. Treatment is also aimed at stopping or preventing other signs and symptoms. You may need one or more of the following treatments:

Diet:

You may not be allowed to eat or drink for a period of time while you have stomach pain. You may need to wait to eat or drink until your caregiver says it is OK. You may need to follow a special diet. In some cases, your caregiver may start giving you total parenteral nutrition (TPN). TPN is used when you have problems with eating food through your mouth.

Medicines:

The following medicines may be given to treat either acute or chronic abdominal pain:

Analgesics:

This is a group of medicines that includes most painkillers and non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs are a group of medicines that include aspirin and ibuprofen. Analgesics may help decrease pain and swelling. Some analgesics may also be used to decrease fever (high body temperature).

Other medicines:

If caregivers know what is causing your abdominal pain, the condition will be treated. Pain caused by infections may be treated with antibiotic or anti-viral medicine to kill the germs. Pain from cancer may be treated with chemotherapy or radiation therapy. Your caregiver may suggest other medicines to help control your pain or other signs and symptoms.

Procedures:

Blood transfusion:

You may need a blood transfusion for certain medical conditions, or if there is bleeding inside your abdomen. During a blood transfusion, you will get whole blood, or parts of blood through a small tube in your vein (IV). The risk of getting AIDS, hepatitis, or West Nile Virus from a blood transfusion is rare. Blood banks test all donated blood for AIDS, hepatitis, and West Nile Virus.

Endoscopy:

This procedure uses a scope to see the inside of your digestive tract. A scope is made of a long, bendable tube with a light on the end of it. A camera may be hooked to the scope to take pictures. Bleeding in your abdomen may be found and treated using endoscopy.

Intravenous fluids:

This is when fluids are given to you through a tube placed in your vein. It is done to prevent you from losing too much body fluid, or replace fluids and electrolytes if you are dehydrated.

Nasogastric (NG) tube:

A nasogastric tube is put into your nose and down into your stomach. The tube may be attached to suction (vacuum) to keep your stomach empty. You may need a NG tube if your stomach gets too full or if you throw up a lot after surgery. You may also need it if you cannot use your mouth to eat. An NG tube may also be used to help get your bowels working. Food or medicine may be given through your NG tube.

Surgery:

Your caregiver may do surgery to help relieve your pain.

Other treatments for acute or chronic abdominal pain may include:

Electrical stimulation:

A special device is used to send mild electrical signals from the nerves going to your brain. These signals may decrease your pain when used on your stomach or another body part.

Hypnosis:

This is done by putting you in a sleep-like state. Hypnosis causes you to be open to the advice of your caregiver, and may decrease your abdominal pain.

Psychotherapy:

This is also called talk therapy. Meetings or talks may be held for you, your family, and people close to you. These meetings can help everyone better understand your health condition and how to manage it.

Relaxation therapy:

Relaxation therapy teaches you how to calm your body and mind. The goal is to feel less physical (body) stress and have less emotional (mind) stress.

What can I do to prevent or treat my acute abdominal pain?

Change your diet.

If you are constipated, eat foods that are high in fiber, such as fresh fruits and vegetables and whole grains. These foods help stools pass more easily through your bowel. If caregivers have told you that you have irritable bowel disease, avoid food or drinks that contain caffeine. Caffeine may be found in coffee, tea, soda, and chocolate. You may need to stop drinking milk or eating milk products for a period of time. You may also need to avoid foods that increase gas in your stomach, such as cabbage or grapes. Ask your caregiver if you need to follow a special diet, and for more information about it.

Talk to your caregiver about over-the-counter medicines.

Over-the-counter (OTC) medicines can be bought without a prescription (order) from a caregiver. These medicines are safe for most people to use and can help you feel better when used correctly. However, they can cause serious problems when they are not used correctly. People using certain other medicines or that have certain medical conditions are at a higher risk for problems. Using too much or using these medicines for longer than the label says can also cause problems. Follow directions on the label carefully. If you have questions, talk to your caregiver.

Will I need appointments with other caregivers?

Certain people will need to see a gastroenterologist. Make an appointment if you are 50 or older, the cause of your stomach pain is unknown, and you have other symptoms. These symptoms include losing weight without trying, blood in your vomit or stool, and not wanting to eat. Females with abdominal pain who are pregnant should see a gynecologist. A surgeon may need to check on you if your stomach feels tender, your stomach muscles are tight, and you feel pain when taking deep breaths or coughing. If you have chronic abdominal pain you may need an appointment with a pain management specialist.

What should I expect with time or treatment?

Relief from acute abdominal pain depends on its cause, other signs and symptoms, your treatment, and other factors. You may be given treatments to use at home if you do not also have a fever. You may be treated at home if you do not have other signs or symptoms, and your blood pressure and pulse are normal.

You may need to stay in the hospital if your abdominal pain keeps changing or its cause is unknown. Children with abdominal pain may need to stay in the hospital. You may need to stay in the hospital if you are elderly, pregnant, or have a weak immune system. In elderly people, abdominal pain may be a symptom of serious medical conditions which must be treated as soon as possible. The risk of your condition worsening increases if you are 50 years of age or older, and this may even cause death.

Call your caregiver if you have any of the following:

Temperature over _________________________ or under _________________________

New symptoms or your symptoms are worse than before.

Questions or concerns about your pain, medicine, or care.

Seek immediate help by calling 911 if you have any of the following:

Cool, clammy, pale skin, dizziness or fainting.

Dry eyes and mouth, feeling thirsty and cold, and you have little or no urine coming out.

Passing dark-colored stool or throwing up bright red blood.

Rigid (hard or board-like) abdomen, not able to pass gas, or problems having a bowel movement.

Severe (very bad) pain in different parts of your abdomen that does not go away after taking medicine.

Very fast heartbeat, shortness of breath, and fast, shallow breathing.