Abdominal Pain

Diagnosing the etiology of abdominal pain can be difficult and complicated, because of the proximity of different organs in a small cavity, and because there are several organs that overlap each other in this small space. When you see a doctor for abdominal pain, she will most likely spend time obtaining a thorough history and perform a detailed physical exam to narrow down the possibilities.

abdominal-pain2For example, as you can see in the diagram, the gallbladder, the stomach, and the pancreas are in close proximity, so often times your doctor will evaluate all different possibilities for upper stomach pain.

To simplify everything, think of the abdomen as several different quadrants, which is based on the location of different organs within the abdominal cavity. Depending on where your abdominal pain is located, your doctor may be able to narrow down the possibilities. Of course there are situations when the pain presents in an atypical pattern, and does not follow the “rules.”

As you can see above, there are many reasons why one could have pain, but I thought it would help you to visualize the differentials based on the location of your pain. You can help your doctor identify the cause if you could be descriptive as far as the following:

  • Location of the pain– for example: which quadrant
  • Duration of the pain– several years, months, or days
  • Intensity of the pain– mild, moderate, or severe
  • The pain character– sharp, cramping, dull etc…
  • The pain radiation– does it travel anywhere?
  • Pain pattern– comes and goes versus constant

abdominal-pain1Diagnosis and treatment will be based on the etiology of the pain. Your doctor will obtain a history and perform a physical exam. Sometimes it is necessary to perform additional studies such as blood work, ultrasound, CT scan etc…

As a GI physician, most of the time I see patients in my office who have had the appropriate work-up mentioned above, and they present to me for an additional evaluation and sometimes endoscopic evaluation as needed.
Of course treatment varies based on diagnosis.