Formula Medical Group
Apple Valley, CA

James Krider, MD

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Abdominal pain

Pain in the abdomen is usually related to the intestines and other organs in the abdominal cavity (viscera). The pain can be caused by a stomach upset that disappears on its own in a few hours, by more serious conditions that require treatment, or by life-threatening emergencies. Accompanying symptoms often help to identify the cause.

Causes of abdominal pain

Acute infectious hepatitis

In addition to stomach pain, a person with infectious hepatitis usually has jaundice, which yellows the skin and eye whites. Weakness, headache, nausea, and vomiting are also common. The urine may be dark and the stools yellowish. Sometimes red, itchy hives develop.

Acute pancreatitis
The pancreas is a long, narrow organ that lies just below the stomach and to the left of the liver and duodenum (the uppermost segment of the small intestine). In acute pancreatitis, the organ becomes inflamed, causing tenderness in the pit of the stomach, writhing pain high in the abdomen, severe vomiting, and a weak, rapid pulse.

Addison's disease
Addison's disease is a hormonal disorder, in which the adrenal cortex fails to produce adequate hormones. Symptoms include abdominal pain and vomiting, which may be accompanied by weakness, weight loss, craving for salt, intolerance to cold, dizziness and fainting, and bronzed skin.

Pain of appendicitis begins at the navel
The pain of appendicitis begins around the navel and extends to the lower right side.

Appendicitis typically begins as discomfort in the area of the navel. The area soon becomes tender, rigid, and then severely painful, especially in the lower right abdomen. There also may be nausea.

Many kinds of cancer can produce abdominal pain, usually along with other symptoms. For example, cancer of the colon or rectum produces lower

There are many causes of abdominal pain.

abdominal discomfort that is not relieved by a bowel movement. It may also cause painful defecation, alternating constipation and diarrhea, bloody stools, and weight loss.

Gallbladder cancer causes pain in the upper right abdomen, as well as jaundice, progressive weakness, and weight loss. There may also be vomiting. Cancer of the pancreas can cause boring pain in the upper abdomen, extending to the back. There may also be indigestion, jaundice, brown urine, clay-colored stools, and weight loss. Stomach cancer may occasionally have sudden stomach pain as its first sign. More often, it causes prolonged indigestion and upper abdominal distress. Cancer of the small intestine may also produce chronic pain.

Colon disorders
A number of colon disorders produce intestinal pain, usually accompanied by diarrhea and/or constipation. Crohn's disease, also called regional enteritis, is a serious intestinal disorder that is characterized by severe inflammation and ulceration of the colon and portions of the small intestine. Symptoms include intense abdominal pain, diarrhea, abdominal bleeding, and fever. In irritable bowel syndrome, pain is usually felt in the upper left side of the abdomen, and there is chronic constipation, occasionally alternating with diarrhea. In ulcerative colitis — a serious condition marked by inflammation and ulcers along the colon — diarrhea, which is sometimes bloody, is the major symptom.

Stomach pain is a major symptom of acute gastritis. In addition, there may be a fast pulse, difficulty swallowing,

excessive thirst, clammy skin that may turn blue, profuse sweating, and possibly vomiting of blood.

A gallbladder attack causes agonizing cramps that come in waves and radiate to the back and the right shoulder. There may also be mild jaundice, nausea and vomiting, flatulence, belching, and a rapid heartbeat.

Kidney Disorders
Kidney disorders typically produce flank pain that radiates to the lower abdomen and the back. The pain may be spasmodic, as in kidney stones, or dull and constant as in nephritis (infection of the kidney). The pain is on one side unless both kidneys are affected. The urine may be bloody or cloudy.

In ulcers, there is usually a burning or boring pain in the pit of the stomach, which is relieved by food and antacids. There may be frequent vomiting of blood, and the passing of black, tarry stools. A perforated peptic ulcer produces sudden, agonizing pain, a rise in pulse and temperature, and breathlessness.

Advice about abdominal pain

  • Most stomach pain is self- limiting and related to simple indigestion. Identify and avoid foods that produce these reactions.
  • Seek medical advice for abdominal pain that does not go away in a few hours, or if other symptoms develop, such as fever, weakness, sweating, pallor, bleeding from the mouth or the bowel, or bloating.
This article was last reviewed November 11, 2005 by Dr. James Krider.
Reproduced in part with permission of Home Health Handbook.
Addison's disease
Cancer, colon
Cancer, gallbladder/bile
Cancer, pancreatic
Cancer, small intestine
Cancer, stomach
Crohn's disease
Gastritis, acute
Hepatitis, infectious
Irritable bowel synd
Kidney stones
Pancreatitis, acute

Ulcer, peptic
Ulcer, stomach
Ulcerative colitis

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