ABDOMINAL PAIN:

when, how and why?

notes Dr. Claudio Italiano, gastroenterologist, internist hospital

Dear visitor, with great joy that I have created simple pages and useful for you all, I dedicate to you this article with the intent to explain the abdominal pain, depending on the type of places where onset and, especially, the seriousness of the case. Indeed abdominal pain is always a dangerous trap that may at any time become a surgical emergency, resulting in endangering the life of the patient. In the links below represented with arrows, carry other pages designed to explain why the pain, the pain of patients with diabetes, abdominal pain that has been directed by the surgeon and the dangerous chest pain that can conceal the trap cardiac infarction and how to approach the patient gastroenterology. this key moment for reading pathologies of the digestive tract. Good navigation.

Ele first rules to follow:

Never put down a treat abdominal pain or diarrhea with drugs advertised on TV, opioid derivatives!

Fasting should always keep the patient with abdominal pain.

That this sudden pain, excruciating, that blocks us, makes us bend in two, and leads us to the hospital! Compare underwent abdominal surgery on the page, then read on this page and go to investigate your type of pain, clicking the arrow-guide.

.... At the site of pain is usually the most important diagnostic aid, but do not always match the disease process. The patient may say he feels pain in this or that place, but the pain can also radiate, after questioning the patient, past examination. Palpation is begun in a painless and then proceed to explore this part of the whole abdomen, painful to the point. The areas of pain are located in (the arrows indicate an additional link for detail):

. Right upper abdominal pain

The upper right abdominal pain directing the diagnosis of liver diseases and biliary (calculations), then radiate back, under the right scapula. The pain is due to distension of the liver glissoniana, ie the lining of the liver where it is covered and that is innervated, is explained by the liver volume for hepatitis, cholangitis, abscesses, liver stasis. It is doubtful that there are other diseases that cause:

trial of duodenal and gastric pre-pyloric region (ulcer, gastritis, diverticulitis), as well as the pancreas (acute pancreatitis, chronic pancreatitis, inflammatory pseudocysts and tumors). Even the hepatic flexure of the colon can give pain: the right flexure syndrome (IBS).

Average abdominal pain ..

The average abdominal pain, including pain and epigastrium mesogastrial. A typical pain epigastrium is given by the condition of the stomach, eg. gastritis in pain is spontaneous and evoked by pressure, but is widespread; ulcer but is more circumscribed, exacerbated by meals. The esophageal hiatus hernia (reflux) it also causes pain in the epigastrium but may similarly angina pain! Eye diagnosis! In fact, it can also treat angina pectoris (coronary artery), myocardial infarction, pericarditis of a pulmonary embolism!

Never underestimate a pain to the sternum (chest pain)!

The pain caused by vascular mesogastrial, especially after a big meal, depend on a multitude dell'irrorazione based arteriosclerotic (clearly in the elderly, smoker, hyperlipidemic!), And give rise to so-called "intermittent claudication abdomen. If the pains are violent and sudden we think of portal vein thrombosis, accompanied by fever, enlarged spleen or the mesenteric artery embolism. Even an aneurysm of the aorta adominale can give intense pain (the aneurysm is a dilation of the vessel wall on a congenital or degenerative, bulging to the pot).



Abdominal pain upper left

The pain here appear in the case of diseases of the stomach and large intestine, for eye may be heart disease, the pleura of the left kidney and left (left hypochondria syndrome). Assume a special role in diseases of the pancreas, chronic pancreatitis alcoholism, cancer of the pancreas (!!). Pancreatic stones may also give similar symptoms to gallstones. Consistently located on the left splenic pain, therefore, for example. of an enlarged spleen, leukemia, Gaucher's disease (tesaurismosi cerebroside). Are sudden pain that hinder breathing, indicating splenic infarction, or endocarditis or atrial fibrillation!

Lower right abdominal pain

The pain of the lower right indicate appendicitis, colic from kidney stones or in women un'annessite, ie inflammation of the genital tract, or a tubal pregnancy, an ovarian cyst. Still a pain here you have terminal Ile (crohn), abdominal hernias, in typhoid and dysentery, in the trial of the bladder and male appendages.

Lower left abdominal pain

May be due to kidney disease, urinary tract, male and female adnexa. Or dependent ulcerative colitis involving the sigmoid colon and rectum, or simply depend on the irritable bowel syndrome. Do not forget that a colic pain (that comes and goes) is due to a hollow organ and may be affected simply by its gaseous distension. We can not exclude, however, that the cause lies in colon cancer or diverticulitis. Therefore, since we know that most cancers of the colon affects this region, even a trivial colic become instrumental findings follow: eg. colonoscopy, barium enema etc..

Types of pain.

Beyond the houses the doctor evaluate the type of pain that the patient presents, ie if it is colic (most serious spastic, which comes and goes) Gravatar (for gaseous distention huge) terebrante (in the serosa, perforation of ulcers) , burning (eg. retrosternal esophageal angina).

Relationships with time

The pain may be periodic, that is connected to the meal and dependent on them; duodenal ulcer pain is a hunger that calms down with the classic breadstick; in gastric ulcer is exacerbated with the meal (by the way, we are sure that it is not an ulcer-cancer? It is always done as soon as endoscopy in gastric ulcer disease and more biopsies!) Tenesmus is the pain of inflammatory diseases of the rectum of nature, as a sense of weight. Persistent pain suggests adhesions, scar retractions based, peritoneal inflammation, cholecystitis, annexes, releases tumor
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