Abdominal pain is one of the most common complaints among digestive system disorders. Abdominal pain can be in the form of acute abdominal pain that starts suddenly and chronic pain that continues for a while.
Abdominal pain can sometimes be in the form of blunt pain at the level of any organ, but sometimes it can be in the form of pain that is reflected in different regions but cannot be understood which organ has pain. Sometimes there may be pain in the mesentery or peritoneal tissue outside the organs in the abdomen.
Let’s briefly examine the aching areas according to the organs in abdominal pain:
- Esophageal pain is usually seen as pain behind the breastbone, neck, jaw, arm, or back.
- Stomach pain is in the epigastrium region between the navel and breastbone. Sometimes it can be reflected to the left of this region and to the back.
- Duodenal pain can cause pain in the epigastrium region, in the lower level of the right lung ribs and in the back.
- Small bowel pain is usually around the navel. Sometimes it is above the place that causes the pain.
- Colon pain is usually located under the navel and towards the area causing the problem.
- Rectal pain can occur in the form of pain in the back, around the rectum, and in the buttocks.
- Pancreatic pain may spread to the entire abdomen, may be in the epigastrium region or in the form of pain in the back.
- Liver and gallbladder pain is usually seen as pain radiating from the right upper region to the right shoulder or back.
Acute abdominal pains
Acute abdominal pain can usually occur due to digestive system infections, inflammatory diseases of the digestive system, kidney and biliary tract diseases, intestinal obstructions or ruptures in organs. Since acute abdominal pain mostly indicates a serious condition, you should definitely consult your doctor, seek help from the 112 emergency service or the nearest health facility.
Acute abdominal pain can be caused by many reasons. Let’s talk about some of the most common.
Rupture of aneurysms in the abdominal aorta, one of the main vessels of the heart, is a life-threatening condition with severe abdominal pain. It requires urgent intervention.
In acute gastroenteritis, loss of appetite, nausea and frequent vomiting may accompany. Abdominal pain is in the form of cramps and the patient may not be able to express exactly where it hurts. Diarrhea and fever are also frequently seen in these patients.
In acute appendicitis, there is nausea and sudden loss of appetite. Vomiting is rare in these patients. In these patients, abdominal pain may be seen first in the epigastrium and, while widespread, around the navel. There is abdominal pain that collects in the lower right corner of the abdomen over time. In case of rupture of appendicitis, it can be seen that the pain in the lower right abdomen decreases or goes away. There is not much fever in the first 12 hours when the complaints start in the patient. Up to the first 24 hours, the patient may not experience abdominal tenderness, spasm or hardening of the abdomen. Abdominal pain is also collected in the lower right region after the first 24 hours.
Acute cholecystitis is inflammation of the gallbladder. The presence of cholecystitis is suspected in patients whose discomfort increases after fatty foods, who experience bloating and fullness in the stomach, and who express tenderness in the right upper abdomen. They describe severe and persistent pain in the right upper abdomen and epigastrium region. Anorexia, nausea and occasional vomiting may also be seen in these patients. Fever often accompanies these symptoms. Vomiting is an important surgical symptom in patients with cholecystitis.
Acute diverticulitis occurs in inflammatory conditions of diverticula formations in the intestines, which should not normally be present. In these patients, pain usually occurs in the lower abdomen and often in the lower left region. Tenderness and stiffness may occur along with abdominal pain. Fever, constipation, nausea and vomiting are also common in these patients.
Acute pancreatitis is inflammatory conditions of the pancreas. It is more common in people who drink heavily. Pancreatitis can also be seen frequently in patients with gallstones due to its close position. Patients with acute pancreatitis may develop different forms of abdominal pain, ranging from mild abdominal pain to very severe and even pain shock. Nausea, vomiting, sweating, weakness and fever are other symptoms accompanying abdominal pain in patients with acute pancreatitis.
In cases of acute intestinal obstruction, abdominal pain in the form of cramps may occur. At the same time, vomiting, constipation, abdominal tenderness and tension may occur in the patient.
Tearing or perforation of the intra-abdominal organs is expressed as perforation. Ulcer perforation is the most common organ perforation. In these patients, sudden onset of severe abdominal pain occurs. The patient tries to stay still because of the abdominal pain that increases with movement. Abdominal tenderness, stiffness, hypotension and shock in the advanced period are common conditions. It is one of the health problems that require urgent intervention.
Another cause of abdominal pain is blood supply disorder and tissue loss, which occurs as a result of slowing blood flow in the vessels of the mesentery tissue surrounding the abdominal organs. This condition is called mesenteric vascular infarction. It is usually seen in diseases that slow blood flow, such as heart failure. It causes moderate to severe abdominal pain. Sometimes patients may also experience vomiting or bloody diarrhea. Tenderness, tension and stiffness can be seen in the abdomen of the patients. In advanced cases, hypotension and shock may also develop.
One of the causes of acute abdominal pain in women is pain originating from the female reproductive organs. Pain during menstruation can also cause severe abdominal pain. Abdominal pains that start suddenly during menstruation can be caused by an infection or a rupture in the reproductive organs.
In addition, severe pain may occur as a result of inflammation of the tubes connecting the ovaries to the uterus in the female reproductive organs. This condition is called acute salpingitis. Cysts or masses in the region may also cause abdominal pain, which is generally seen in the lower region of the abdomen, accompanied by chills and fever. Sometimes sexually transmitted diseases can also cause acute salpingitis.
During the use of anticoagulant drugs, sudden onset abdominal pain may occur due to bleeding in the abdominal organs.
In addition, pelvic inflammatory diseases, ovarian cysts, ectopic pregnancies can also cause acute abdominal pain.
Testicular problems in men can also cause acute pain in the abdomen.
Since acute abdominal pains can be caused by life-threatening conditions, early recognition and early treatment is very important. For this reason, patients with such complaints should urgently seek help from healthcare teams.
As a general rule, patients with sudden onset severe abdominal pain and abdominal pain lasting longer than 6 hours while previously healthy are often considered to be a surgically important condition.
Chronic abdominal pains
This type of abdominal pain is pain that continues for weeks or months. Mild occurrence or non-progression of diseases that cause acute pain can cause abdominal pain to be experienced for a long time. Almost all of the causes of acute abdominal pain can also be experienced as chronic pain in a similar form of pain.
In addition to acute pain causes, some diseases can also cause chronic pain. For example, irritable bowel syndrome can cause abdominal pain further down the stomach and in the lower left region. The patient can bear this pain. The pain may increase with food and is usually relieved by defecation. Cycles of constipation and diarrhea can occur from time to time.
Colon cancers that occur in areas before the left descending colon (sigmoid colon) usually present with abdominal pain, while pain may not occur in cancers located towards the sigmoid colon and rectum. Rectal bleeding and anemia often accompany the symptoms in these patients.
In addition, chronic diverticulitis, chronic intestinal obstruction, peritonitis due to tuberculosis, and pancreatic cancer may also cause chronic abdominal pain.
Some systemic diseases can also cause chronic abdominal pain. For example, connective tissue diseases, lead poisoning, diabetes, porphyria, tabes dorsalis etc.