I. What is abdominal pain?
Abdominal pain, commonly referred to as stomach pain, is a clinical symptom or a subjective feeling of the patient’s self. Abdominal pain, like fever, is actually only a clinical symptom, rather it is a common symptom of a disease group, not a disease name, but only a provisional diagnosis before the diagnosis of the disease causing abdominal pain is established. However, unlike fever, which has objective manifestations (measured by thermometers, etc.) in addition to sensory perceptions, there are no objective indicators such as instruments that can be measured, so abdominal pain is more difficult to diagnose.
Second, before understanding abdominal pain we should first briefly understand some medical knowledge related to abdominal pain
The abdominal organs are innervated by the visceral nerves, and the peritoneum and abdominal wall are innervated by the somatic nerves
1. Characteristics of visceral pain.
① inexact location, close to the abdominal midline
② vague sensation
③It can be accompanied by discharge pain (pain caused by abdominal organs, stimulated by visceral nerve afferents, affecting the corresponding spinal cord segments depending on the location on the body surface, sharp and intense, with a clear location)
④ often accompanied by nausea, vomiting, sweating and other symptoms of autonomic excitation
2. Pain characteristics of the abdominal wall and peritoneum.
① accurate positioning
② intense and continuous
③ aggravated by cough and position change
3. Why is abdominal pain (causes of abdominal pain)?
1.Acute abdominal pain
(1) acute inflammation of abdominal organs, such as: appendicitis, cholecystitis
(2) obstruction or dilatation of cavity organs, such as: gastric dilatation, intestinal obstruction
(3) organ torsion or rupture, intestinal torsion, intestinal rupture
(4) Peritoneal inflammation: gastric perforation, appendiceal perforation
(5) Intra-abdominal vascular obstruction: mesenteric vascular embolism
(6) Abdominal wall disease: abdominal wall trauma
(7) Thoracic diseases causing involvement pain: renal colic, acute myocardial infarction
(8) trauma: abdominal wall or visceral rupture due to open and closed abdominal injuries
2.Chronic abdominal pain
(1) chronic inflammation of abdominal organs: chronic gastritis
(2) Tension changes in the cavernous organs: colonic enteritis
(3) peptic ulcer: duodenal ulcer
(4) Chronic torsion or obstruction of abdominal organs: chronic torsion of the sigmoid colon, intestinal luminal tumors
(5) Organ peritoneal distension: chronic cholecystitis
(6) Intoxication and metabolic disorders: hyperglycemia, uremia
(7) Tumor compression and infiltration: intestinal cancer, pancreatic cancer
(8) Neuropsychiatric diseases: neurosis
What kind of abdominal pain means what diseases may be present?
1. From the point of view of the pain site: it may indicate the corresponding part of the disease.
(1) left upper abdominal pain may be: diseases of the pancreas, spleen, left subdiaphragm, left lung, heart
(2) Upper middle abdominal pain: because of the complex nerve travel concern, it may be diseases of the stomach, duodenum, pancreas, and other abdominal organs.
(3) right upper abdominal pain may be: gallbladder, liver, duodenum, right kidney and other diseases
(4) right lower abdominal pain may be: right colon, appendix, right ureter and other diseases
(5) lower abdominal pain may be: small intestine, bladder, gynecological diseases
(6) Left lower abdominal pain may be: left hemi-colon, left ureter and other diseases
2. From the viewpoint of the nature, degree and rhythm of pain.
(1) persistent pain: mostly parenchymal organ (liver, pancreas, spleen, kidney, etc.) diseases
(2) Paroxysmal pain: mostly diseases of empty organs (gallbladder, stomach, duodenum, small and large intestine, bladder, etc.)
(3) Persistent pain with paroxysmal intensification: Mostly inflammation and obstruction exist simultaneously
(4) Severe pain like cutting: mostly due to ulcer perforation
(5) Paroxysmal colic: Mostly gastrointestinal spasm, stones, etc.
(6) paroxysmal drill-like pain under the subxiphoid process: biliary tract ascariasis
(7) persistent widespread severe abdominal pain: mostly diffuse peritonitis
(8) vague pain: change in gastrointestinal tone or mild inflammation.
3.From the accompanying symptoms and signs.
(1) vomiting: esophageal and gastrointestinal lesions.
(2) acid reflux, belching: ulcer, gastritis.
(3) diarrhea: digestive and absorption disorders, intestinal lesions.
(4) fever and chills: acute inflammation
(5) jaundice: liver, biliary and pancreatic diseases
(6) shock, anemia: organ rupture
(7) Shock without anemia: gastrointestinal perforation, strangulated intestinal obstruction.
(8) Heart rate disorders: heart attack.
(9) hematuria: urinary system diseases
4. In terms of age of onset.
(1) The common causes of abdominal pain in children are ascariasis, mesenteric lymphadenitis and intussusception, etc.
(2) In young adults, ulcer disease, gastroenteritis and pancreatitis are more common.
(3) In middle-aged and old people, cholecystitis and gallstones are more common. In addition, attention should be paid to the possibility of gastrointestinal tract, liver cancer and myocardial infarction.
5. From the gender point of view.
Renal colic is more often seen in men, while ovarian cyst torsion and ruptured corpus luteum cyst are common causes of acute abdominal disease in women, and ectopic pregnancy should be considered if the woman is of childbearing age.
V. What external factors can induce abdominal pain?
(1) weather (temperature) changes: sudden drop or rise in temperature
(2) After alcohol abuse
(3) Eating unclean food
(4) Eating a lot of greasy food
(5) Binge drinking and overeating
(6) Trauma
(7) Overwork, lack of sleep, etc.
VI. What should I do when abdominal pain occurs?
Because of the complexity of abdominal pain, the disease is easily misdiagnosed or missed, so when you have abdominal pain symptoms, it is best to go to the hospital for consultation and treatment in the first place. If abdominal pain persists without relief, you must seek urgent medical attention. In addition, when seeking medical attention, you should present your symptoms and accompanying symptoms to the doctor, and never mislead the doctor after self-diagnosis, or even stubbornly believe that the doctor’s diagnosis is wrong.