• Wed. Sep 28th, 2022

Evaluation of Abdominal Pain | How to approach patients ? | QuadBloggers

evaluation of abdominal pain

Evaluation of abdominal pain, a topic that needs clear understanding about the entire abdomen and how you can keep yourself healthy.

Abdominal pain, a condition that ranges from acute to chronic life threatening emergencies due to a functional disease and disorders of various organs that generates pain in the abdomen.

evaluation of abdominal pain

How do you approach a patient with abdominal pain ?

1) History :

  • The most important part of getting to know a patient is by detailed history.
  • Additionally, Critical history is adequate
  • Duration and pattern:
    • Duration and pattern describes the severity and hence, nature of the pain
  • Type and location:
    • This usually provides the nature of the pain all in all
  • Pain associated with internal organs:
    • Usually occurs in the midline
    • Meanwhile, Localization is poor
    • Abdominal pain may be crampy
    • Colon pain ( longest part of large intestine )hence is usually felt in the lowest and median part of abdomen.
    • Biliary pain ( pain in the abdomen, usually due to cyst or stone obstruction ) results in discomfort pain
    • Somatic pain ( pain from muscles, tendons and simultaneously skeletal structure ) is sharper and is associated with disease and increases with movement.

2) Factors that relieve pain:

Ask about its relationship to:

  • Eating habits
  • Defecation
  • Urination
  • Position
  • Medication
  • Menstrual cycle
  • Stress

3) Symptoms:

Look for the following associated symptoms

  • Weight loss: In cases of tumors, malabsorption and blood flow issues all in all.
  • Fever and chills: Indicating an infection, heart related issues or swelling accordingly
  • Nausea, vomiting
  • Gastritis
  • Additionally, Difficulty in swallowing
  • Constipation or inability to poop
  • Diarrhea
  • Jaundice
  • Painful urination
  • Disorders of skin, joints

4) Physical examination( Evaluation of abdominal pain ):

  • Evaluate the abdomen as to the reason behind the pain accordingly
  • Furthermore, Look for any abdominal distention, fluid or air accumulation
  • Pain felt other the site of location
  • Altered bowel sounds
  • Presence of hernias
  • Meanwhile, Check if the liver or spleen size has changed
  • Additionally, Rectal examination done to check for location, site of pain and if any mass is present
  • Examination of pelvis in women is vital all in all.

5) General examination:

  • Look for any nutritional deficiency accordingly
  • Electrolyte imbalance
  • Liver disease
  • Arterial disease
  • Lesions of skin
  • Cardiac issues

6) Investigations in evaluation of abdominal pain:

  • Complete blood count
  • Serum electrolytes
  • Serum glucose
  • Liver function test
  • Renal or kidney function test
  • Chest x ray simultaneously to determine diseases involving the lungs, heart, pleura and mediastinum
  • Furthermore, ECG to rule out cardiac pain
  • Abdominal radiographs, meanwhile to evaluate gas pattern, liver size, bowel displacement and abdominal distention.
  • Ultrasonography abdomen simultaneously for complete visualization of the abdomen
  • CT scan hence to look for masses, abscess and aneurysm ( enlargement of arteries ).
  • Gastrointestinal endoscopy
  • Colonoscopy
  • Biopsy
  • Laparoscopy

7) General treatment:

  • Proton pump inhibitors, all in all
  • Pan D containing pantoprazole and domperidone, before food for gastritis, burning sensation
  • Mucaine gel syrup simultaneously for chest burn and gastritis related issues

8) Causes of abdominal pain:

A) Pain that starts from the abdomen:

  • Stomach lining inflammation
  • Bacterial contamination
  • Ulcer
  • Inflammation of pancreas
  • Trauma
  • Typhoid fever
  • Appendicitis

B) Metabolic causes:

  • Diabetes
  • Increased fat
  • Fever

C) Pain originating away from abdomen:

  • Pneumonia
  • Heart attack
  • Heart failure
  • Myocarditis- inflammation of heart muscle
  • Empyema-collection of pus between the lungs
  • Esophageal disease, all in all

D) Psychiatric causes:

  • Psychiatric disorders
  • Herpes zoster
  • Spinal cord compression

Additionally, For more such blogs, click here

Furthermore, To get a detailed description of the diseases please refer: Harrison manual of internal medicine

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