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ABDOMINAL PAIN


Abdominal pain is one of the most frequent forms of pain among adults and children. Pain in the stomach area can be as simple as a belly ache or it can be life-threatening. How can you know for certain if your abdominal pain is a symptom of a serious condition? When you experience abdominal pain, you should call your doctor to make an appointment for an evaluation.

Answering two questions can be helpful when visiting your doctor:
  • When did the pain begin?
    Sudden, intense pain is a 911 from your body that something is wrong. Dull, gradual pain may be a symptom of a developing condition.

  • Where is the pain located?
    There are many areas within the abdominal region. Isolating the area that causes the most pain can help determine the cause of the pain. For example, acute pain on the right lower side could be caused by the appendix while pain on the left lower side could indicate diverticulitis, constipation, or other bowel problems.
Although this is not a comprehensive list, here are some common causes of abdominal pain:
In The Upper Abdomen:
Gastrointestinal Reflux Disease (GERD)

Chronic acid reflux , also known as GERD, causs a painful, burning sensation in the upper stomach and chest and often into the throat. Other symptoms include a dry cough and trouble swallowing. GERD is caused by a relaxation of the lower esophageal sphincter (LES), which is necessary to the passage between the esophagus and stomach.

Treatment for GERD includes over-the-counter antacids, proton pump inhibitors (PPIs), and H2 blockers. Lifestyle changes like eating smaller meals, avoiding fatty or spicy foods, avoiding smoking and maintaining a healthy weight are helpful in managing the symptoms of GERD.

Stomach Ulcers

Stomach ulcers, also known as gastric ulcers, are painful sores in the lining of the stomach. Ulcers can also form in the small intestine. Ulcers can be caused by:
  • Overuse of nonsteroidal anti-inflammatory drugs like asprin or ibuprofen
  • Excess stomach acid from tumors called gastrinomas
  • Infection by the bacteria H. pylori
Besides abdominal pain, ulcers may cause other problems such as heartburn, nausea, and bloating. The most severe ulcers may cause bleeding, perforation or obstruction from scar tissue accumulation. Doctors can diagnose ulcers by testing for the H. pylori bacteria and also by upper endoscopy. If ulcers are caused by H. pylori, an antibiotic can be administered for treatment. If bacteria are not the source of the ulcer, your doctor may prescribe acid-blocking medication.
Lower Abdominal Pain:
Diverticulitis

Diverticulitis is a common condition when pouches form in the wall of the colon and become inflamed. While it is unclear what causes diverticulitis, it seems that a low-fiber diet might contribute to the condition. Symptoms of diverticulitis are pain on the left side of the abdomen, fever, chills, gas, constipation or diarrhea, nausea, and loss of appetite.

Many people find relief with over-the-counter pain medication, antibiotics, and diet. For serious causes, surgery may be required.

Celiac Disease

Celiac disease is an autoimmune disorder that results in damage to the lining of the small intestine when foods containing gluten are consumed. Gluten is a form of protein that is found in many grains. When gluten damages the intestinal lining, it is difficult for the body to absorb nutrients. Besides abdominal pain and bloating, celiac disease sufferers may experience severe skin rash, iron deficiency, diarrhea, weight loss, seizures, muscle cramps, joint pain, and mouth ulcers.

Blood tests can detect the presence of certain antibodies in people with celiac disease as well as low iron levels. Stool samples may also be collected to look for fat in the stool, since celiac sufferers absorb fats from food less effectively. Doctors may also choose to take a biopsy of the intestine to check for tissue damage. The treatment for celiac disease is eliminating gluten from the diet. The intestinal lining begins to heal, and full restoration of the intestine is possible when adhering to a strict diet.

Inflamatory Bowel Disease (IBD)

Crohn's disease and ulcerative colitis are other conditions that may cause lower abdominal pain. These diseases are caused by inflammation in the intestinal tract. The body's immune system attacks the lining of the intestine. Besides abdominal pain, other symptoms include diarrhea, bloody stools, fatigue, fever, malnutrition, and weight loss.

Endoscopy (examination of the digestive tract with a thin tube containing a camera) and specialized X-rays can diagnose inflammatory bowel disease. Steroids and medicines, which suppress the immune response, are helpful in managing IBD.

Colon Cancer

Colon Cancer is the second leading cause of cancer death in the United States. About 150,000 people will be diagnosed with colon cancer each year, according to the American Cancer Society. Colon cancer begins with small clumps of cells called polyps which usually start out as benign. If those polyps are not removed in a colonoscopy, they could become cancerous.

Many people do not experience symptoms of colon cancer until the disease is in advanced stages. Some symptoms associated with colon cancer are:
  • Abdominal pain
  • Blood in the stool
  • Change in bowel habits
  • Cramping
  • Bloating
  • Vomiting
  • Unexplained weight loss
The best method of prevention and detection of colon cancer is colonoscopy. Using a lighted tube, a doctor can examine your entire colon for abnormalities and even remove polyps during the procedure. All adults who are at average risk for colon cancer should get a baseline colonoscopy at the age of 50. Ask your doctor when you should get your first colonoscopy.
Lower Right Abdominal Pain:
Appendicitis

Appendicitis is caused by inflammation of the appendix, a 3.5 inch tube of tissue that is attached to the large intestine. About one in 15 people get appendicitis, so it is very common, but it can be dangerous. If left untreated, an infected appendix will burst and release infectious materials into the abdomen. Appendicitis often begins with dull pain near the belly button that becomes sharper as it moves to the lower right abdomen. Other common symptoms are loss of appetite, nausea, vomiting, low-grade fever and muscle tension and resistance in the lower abdomen.

It is important to call your doctor immediately if you have these symptoms. An appendectomy is a simple procedure but extremely time-sensitive.

Nothing Replaces a Visit to Your Doctor

Abdominal pain is a common symptom that requires a physician exam for diagnosis. If you have abdominal pain, do not ignore the symptom. Call your doctor to make an appointment. Although a list of symptoms in a book or website may be helpful in suggesting certain conditions, a list is not sufficient to determine the cause. Visit your doctor for counseling, testing and diagnosis.
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Achalasia
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Anorectal Disease
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Barrett's Esophagus
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Celiac Disease
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Chronic Diarrhea
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Chronic Liver Disease
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Cirrhosis
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Colon & Colorectal Cancer
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Constipation
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Crohn's Disease
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Difficulty Swallowing (Dysphagia)
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Diverticulosis and Diverticulitis
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Esophageal Cancer
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Esophageal Varcies
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Esophagitis and Stricture
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Fecal Incontinence
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Gastrointestinal and Gastroenterologist
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Heartburn, Acid Reflux & GERD
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Helicobacter Pylori (Stomach Infection)
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Hemorrhoids
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Hepatitis B
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Hepatitis C
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Hernias
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Hiatal Hernia
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Inflammatory Bowel Disease
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Irritable Bowel Syndrome (IBS)
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Jaundice
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Liver Cancer
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Liver Disease
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Malabsorbtion
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Pancreatic Cancer
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Pancreatic Cysts
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Pancreatitis
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Peptic Ulcer Disease (PUD)
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Rectal Bleeding
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Reflux Esophagitis
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Silent Reflux (Laryngopharyngeal Reflux)
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Stomach Problems and Swallowing Problems
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Stomach Ulcers
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Strictures
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Ulcerative Colitis
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Waldorf, Maryland 20602

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Kensington Pathology
Consultants (Pathology Lab)

6736 Curran Street, Suite 1
McLean, Virginia 22101

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