Symptoms related to the gastrointestinal system are the result of varied medical conditions. Examples include, among others, inflammatory diseases, infections, cancerous processes and ulcers among others. Most of us (if not all)in Greenbelt, MD, have had to deal with abdominal pain at one time or the other. The majority of these cases are due to disorders affecting the underlying structures. We will explore the various types of this pain and how to manage them.
The first thing that one needs to do as they attempt to identify the origin is to establish where it is most intense. The source is likely to be the anatomic structures that are located beneath this area. For instance, if it is the epigastric region, the organs most likely to be affected are the stomach or the liver which means the most probable diagnoses are gastritis, peptic ulcer disease or hepatitis. If it is most severe around the belly button, on the other hand, the intestines are likely to be involved.
The character and pattern of the symptom also helps determine the source in a big way. For instance, pain that is predominantly constricting is most likely related to a hollow organ such as the intestines, the gall bladder or the ureters. On the other hand, dull and diffuse pain is often due to conditions affecting solid internal organs. Associated symptoms may also help shape the pattern. If pain is associated with diarrhea, for instance, an infection is most likely present.
After the history and the physical exam, the next thing that needs to be done is to have some investigations. These will mostly be guided by the suspected diagnosis. In case an infection is suspected, a septic screen is conducted. This involves, among others, a full blood count. The focus here is to establish whether there is an increase in the number of white cells and the subtypes affected. Other components of the screen include cerebrospinal fluid analysis, urine culture and blood culture.
Radiological studies are also useful in the identification of the source of pain. For instance, X-rays (also known as plain radiographs) are an important tool in the diagnosis of intestinal obstruction. Typical findings include the presence of gaseous distension. Tumors within the abdominal cavity are best assessed using ultrasound, CT scans and MRI. Specimens may also be collected under the guidance of some of these radiological modalities.
Treatment is varied and greatly depends on the diagnosis. The good news is that most cases can be managed through a conservative approach. This means that many of them resolve spontaneously without any treatment or may just need a few over the counter analgesic drugs. Antimicrobial agents are needed when an infection is identified and chemotherapeutic drugs used in presence of treatable cancers.
Surgical intervention has two main benefits. It may be used in making the diagnosis such as in the case of acute appendicitis, ectopic pregnancies, tumors and abscesses and may be a therapeutic intervention. Surgery not only allows the surgeon to see where the problem is through direct visualization but also ensures that the area is accessible for any interventions to be undertaken. Both open and laparoscopic approaches can be used.
Pain in the abdomen is a very common complaint. While many of the cases resolve spontaneously, there are others that are more serious and require further investigation and more aggressive interventional measures. Inflammatory conditions, infections, drugs, trauma and tumors are all possible causes.
The first thing that one needs to do as they attempt to identify the origin is to establish where it is most intense. The source is likely to be the anatomic structures that are located beneath this area. For instance, if it is the epigastric region, the organs most likely to be affected are the stomach or the liver which means the most probable diagnoses are gastritis, peptic ulcer disease or hepatitis. If it is most severe around the belly button, on the other hand, the intestines are likely to be involved.
The character and pattern of the symptom also helps determine the source in a big way. For instance, pain that is predominantly constricting is most likely related to a hollow organ such as the intestines, the gall bladder or the ureters. On the other hand, dull and diffuse pain is often due to conditions affecting solid internal organs. Associated symptoms may also help shape the pattern. If pain is associated with diarrhea, for instance, an infection is most likely present.
After the history and the physical exam, the next thing that needs to be done is to have some investigations. These will mostly be guided by the suspected diagnosis. In case an infection is suspected, a septic screen is conducted. This involves, among others, a full blood count. The focus here is to establish whether there is an increase in the number of white cells and the subtypes affected. Other components of the screen include cerebrospinal fluid analysis, urine culture and blood culture.
Radiological studies are also useful in the identification of the source of pain. For instance, X-rays (also known as plain radiographs) are an important tool in the diagnosis of intestinal obstruction. Typical findings include the presence of gaseous distension. Tumors within the abdominal cavity are best assessed using ultrasound, CT scans and MRI. Specimens may also be collected under the guidance of some of these radiological modalities.
Treatment is varied and greatly depends on the diagnosis. The good news is that most cases can be managed through a conservative approach. This means that many of them resolve spontaneously without any treatment or may just need a few over the counter analgesic drugs. Antimicrobial agents are needed when an infection is identified and chemotherapeutic drugs used in presence of treatable cancers.
Surgical intervention has two main benefits. It may be used in making the diagnosis such as in the case of acute appendicitis, ectopic pregnancies, tumors and abscesses and may be a therapeutic intervention. Surgery not only allows the surgeon to see where the problem is through direct visualization but also ensures that the area is accessible for any interventions to be undertaken. Both open and laparoscopic approaches can be used.
Pain in the abdomen is a very common complaint. While many of the cases resolve spontaneously, there are others that are more serious and require further investigation and more aggressive interventional measures. Inflammatory conditions, infections, drugs, trauma and tumors are all possible causes.
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