What you need to know about abdominal pain

KOCHI: Pain in the abdomen is a commonly heard condition. It could be just from ordinary dyspepsia (discomfort in the stomach) to life-threatening sepsis and malignancies. There will not be a single individual who has not experienced abdominal pain at least once in his or her life. It is very important to differentiate it from ordinary dyspepsia so that one should not continue with household remedies where proper treatment is delayed. 

When someone experiences acute abdominal pain, people usually enquire whether he or she is suffering from appendicitis. This is because it is the only condition people know of. 

The abdomen is divided into upper, middle and lower segments. Each segment is again divided into three from left to right amounting to a total of nine quadrants. Pain occurring in a particular quadrant may arise from the organ lying in that quadrant. 

Sometimes pain may not be from an organ but due to lead poisoning, porphyria, tabes dorsalis of syphilis or intestinal epilepsy. Right hypochondriac structures are liver, gallbladder, biliary passages, head of the pancreas, right kidney, hepatic flexure large intestine and duodenum. The causes of pain in this segment are the pain of cholecystitis, gallstones, biliary passage calculus, liver abscess and right kidney stones.
 
Gastric ulcer
Pain in the central upper abdomen is normally a food aggravate pain. Though empty stomach is comfortable to the patient, most chronic ulcer patients are afraid to eat. So, they lose weight and get emaciated gradually.

Upper Abdominal Pain associated with acid eructation, belching and will gain temporary relief with food and drinks. Once the stomach is empty pain recur. As the patient goes on taking food supplements afterwards, they put on weight.
 
Pancreatitis with stones

Chronic pancreatitis with pancreatic stones causes agonising pain. Usually, the patient rolls up in bed and vomits along with a severe upper abdominal pain. 
Pain in right and left lumbar region are witnessed due to the stone in the ureter. It radiates downwards to testicles in males. 

Right lower quadrant structures consist of appendix,  terminal ileum and lymph nodes. Acute appendicitis inflammation is the main cause of pain in the region. Other causes are typhlitis, regional ileitis and Iliac lymphadenitis. Hernias are protrusions of external intra-abdominal organs through weak points on the abdominal wall. At times, the intestinal loops might get entangled and resulting in the drain of blood supply.

Midventricular vascular thrombosis

In this condition the patient present with acute central abdominal pain vomiting and collapse. The blood supply to the intestine stops and a vascular gangrene sets in. Emergency vascular surgery to re-establish circulation should be done on an emergency measure. Dr C K Pareed Pillai is a laparoscopic surgeon and a retired Captain of Armed Forces Medical Service. (The views expressed by the author are his own).