Abdominal Distress

Abdominal distress is a very common complaint. The list of different possible causes is long, and the exact cause is often not clear, especially at first. Symptoms may be mild and of no great concern, or they may signal a life-threatening condition.

There are hundreds of conditions that can cause abdominal discomfort.

The most important aspects that a healthcare provider needs to know about in order to narrow down the list include:

• how severe the pain is
• what makes the pain better or worse, if anything
• what the pain feels like, such as whether the pain is sharp or cramping or burning
• when the pain started
• where the pain is located
• whether or not other symptoms are present
• whether or not the pain moves to other areas
• whether the pain is constant or comes and goes
• whether the pain is related to certain foods or a certain time in the menstrual cycle for women

Abdominal distress often comes from the gut, or the gastrointestinal tract. It may also come from other organs or tissues inside the abdomen.

Other times, conditions totally outside the abdomen, such as a lung infection, cause abdominal distress.

Common causes of abdominal distress include:

• bleeding into the abdominal wall muscles
• spasms of the intestines, known as irritable bowel syndrome
• bowel or abdominal infections, such as diverticulitis or appendicitis
• cancer
• peptic ulcers or acid reflux disease
• gallbladder disease, often, but not always caused by gallstones
• inflammation of the abdominal lining, known as peritonitis
• inflammation of the pancreas, usually due to alcohol use, infection, or drug use
• lack of adequate blood flow to the digestive system, called ischmia
• blockage of the digestive tract, such as adhesions, inflammation, or tumor
• injury or strain to the abdominal wall muscles
• sexually transmitted diseases (STDs), such as gonococcal infections

A healthcare provider's first concern is making sure the pain is not caused by a life-threatening condition. For instance, appendicitis can result in death if diagnosis and treatment are delayed.

Often, nothing can be done to prevent new abdominal discomfort. Some abdominal problems can be avoided by:

• avoiding illegal drugs
• drinking alcohol in moderation if at all
• following safer sex guidelines to prevent STDs
• seeking prompt treatment for infections, diseases, and conditions

A medical history and physical examination often lead a healthcare provider to narrow the list of potential causes for abdominal distress. Further testing depends on the possible remaining causes.

Testing may include blood tests and X-rays. The provider may order an abdominal CT scan or abdominal MRI. Endoscopy of the digestive tract, using a tube with a light and camera chip through the mouth or rectum, may be ordered. In some instances, abdominal exploratory surgery may be needed to make the diagnosis.

Long-term effects can range from none to permanent disability or even to death. This depends on the underlying cause of the abdominal distress.

Abdominal distress itself is not contagious. However, an underlying cause such as bacterial or viral colitis or a sexually transmitted disease may be contagious.

Treatments vary widely depending on the cause of the abdominal discomfort. Treatment may include medicines or surgery.

All medicines have potential side effects, including allergic reactions and stomach upset. Surgery can be complicated by bleeding, infection, or an allergic reaction to the anesthetic.

Follow-up depends on the underlying cause. A person may need no further monitoring or may need treatment for the rest of his or her life.

Monitoring depends on the underlying cause of the problem. Any new or worsening symptoms should be reported to the healthcare provider.