Abdominal Pain - When To See A Doctor

Abdominal pain — pain or discomfort in the abdominal area — is something all of us experience sooner or later. Usually when we have belly pain the cause is benign and the problem is self-limited. But sometimes abdominal pain indicates a serious medical condition, or even a medical emergency. So it is important to know when to see a doctor if you have abdominal pain.

There is a lot going on in the abdomen. The abdominal cavity contains many important organs (including stomach, duodenum, small intestine and large intestine, pancreas, gall bladder, liver, kidneys, and reproductive organs), as well as muscles, blood vessels, bones and other structures. Problems with any of these organs or structures can cause pain (as well as other symptoms).

So the list of disorders that can produce abdominal pain is very large.

Here is a partial list of some of the more common causes of abdominal pain:

• Indigestion or gas
• Gastroesophageal reflux disease (GERD)
• Ulcers
• Gallstones
• Kidney stones
• Appendicitis
• Peritonitis (inflammation of the abdominal cavity)
• Hepatitis
• Endometriosis
• Irritable bowel syndrome (IBS)
• Abdominal aortic aneurysm (AAA)
• Food poisoning and food allergies
• Ulcerative Colitis
• Hernia
• Pancreatitis
• Bowel ischemia
• Bowel obstruction
• Pelvic inflammatory disease (PID)

Here are a few generalizations doctors often use in evaluating abdominal pain. Be aware, however, that these generalizations are not true in every case, and doctors treat them as clues, and not as rules: 

Pain that is widespread (involving more than half of your abdomen) tends to have a relatively benign cause such as indigestion or a stomach virus, while pain that is localized to a particular area is more likely to be from a particular organ, such as the appendix or gallbladder. 

Cramping pain is usually benign unless it is severe, lasts for more than 24 hours, or occurs with a fever.

Colicky pain (pain that occurs in waves) is likely to be caused by obstruction or partial obstruction, such as with kidney stones or gallstones. 

Keep in mind that it is often difficult enough for experienced physicians to make the right diagnosis of abdominal pain; it is usually foolish to try to figure this out for yourself. If your abdominal pain is concerning to you, or unusual in any way, you should consult your doctor.

There are certain signs that should always cause you to see a doctor or call for help whenever they occur with abdominal pain. These signs indicate a possible emergency: 

• You are vomiting blood
• You have bloody or tarry stools
• You are unable to pass stools, especially with vomiting
• The pain extends above the abdomen (to the chest, neck or shoulder areas)
• The pain is severe, sudden and sharp
• The pain is accompanied by dyspnea (shortness of breath)
• You have cancer, are pregnant, or have had recent trauma
• You have extreme tenderness in the region of the pain
• Significant abdominal distention

You should also see (or at least call) a doctor if you have any of these signs or symptoms:

• Pain that persists for more than a day or two, or becomes more severe over the first day, or is colicky
• Fever
• Nausea, vomiting or diarrhea that persists for more than a day or two
• Prolonged poor appetite or weight loss
• Persistent vaginal bleeding
• Burning with urination, or frequent urination
• Pain that, while mild and self-limiting, recurs frequently

While abdominal pain is common and is usually benign, it is important not to just brush it off. If you have any of the signs or symptoms that might suggest a serious problem, get medical advice.

If you decide to self-treat your abdominal pain, try to drink frequent sips of water or clear liquids, and skip food for at least several hours. Stay away from NSAIDS or other pain medicines unless your doctor says it’s OK.

And reassess your symptoms every few hours — or any time you notice new symptoms — to decide whether it’s time to see a doctor.