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Abdominal pain

Abdominal pain can be characterized by the region it affects.
ICD-10 R10
ICD-9 789.0
MedlinePlus 003120

Abdominal pain (or stomach ache) is a common symptom associated with transient disorders or serious disease. Diagnosing the cause of pain in the abdomen can be difficult, because many diseases can cause this symptom. Most frequently the cause is benign and/or self-limiting, but more serious causes may require urgent intervention.

Differential diagnosis[edit | edit source]

Acute abdominal pain[edit | edit source]

Acute abdomen can be defined as severe, persistent abdominal pain of sudden onset that is likely to require surgical intervention to treat its cause. The pain may frequently be associated with nausea and vomiting, abdominal distention, fever and signs of shock. One of the most common conditions associated with acute abdominal pain is acute appendicitis.

Selected causes of acute abdomen

By location[edit | edit source]


  • Upper middle abdominal pain
  • Upper right abdominal pain
  • Upper left abdominal pain
    • Spleen pain (splenomegaly)
    • Pancreas
    • Colon pain (below the area of spleen - bowel obstruction, functional disorders, gas accumulation, spasm, inflammation, colon cancer)
  • Middle abdominal pain (pain in the area around belly button)
    • Appendicitis (starts here)
    • Small intestine pain (inflammation, intestinal spasm, functional disorders)
  • Lower abdominal pain (diarrhea and dysentery)
  • Lower right abdominal pain
  • Lower left abdominal pain
    • Sigmoid colon (polyp), sigmoid volvulus, obstruction or gas accumulation)
  • Pelvic pain
  • Right lumbago and back pain
    • liver pain (hepatomegaly)
    • right kidney pain (its location below the area of liver pain)
  • Left lumbago and back pain
    • less in spleen pain
    • left kidney pain
  • Low back pain

Diagnostic approach[edit | edit source]

When a physician assesses a patient to determine the etiology and subsequent treatment for abdominal pain the patient's history of the presenting complaint and physical examination should derive a diagnosis in over 90% of cases.

It is important also for a physician to remember that abdominal pain can be caused by problems outside the abdomen, especially heart attacks and pneumonias which can occasionally present as abdominal pain.

Investigations that would aid diagnosis include

If diagnosis remains unclear after history, examination and basic investigations as above then more advanced investigations may reveal a diagnosis. These as such would include

Management[edit | edit source]

Butylscopolamine (Buscopan) is used to treat cramping abdominal pain with some success.[2]

See also[edit | edit source]

References[edit | edit source]

  1. Richard F.LeBlond. Diagnostics, US: McGraw-Hill Companies, Inc..
  2. Tytgat GN (2007). Hyoscine butylbromide: a review of its use in the treatment of abdominal cramping and pain. Drugs 67 (9): 1343–57.

Further reading[edit | edit source]

  • Boyle, J. T. (2001). Biopsychosocial issues in functional abdominal pain. Pediatr Ann 30 (1): 32–40..

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