The abdomen is a very essential part of the body. It lodges some of the most important organs of the body which carry on the processes of digestion and excretion, and influence metabolism of the body in various ways. Abdominal pain serves as a signal to indicate that there is something wrong with some part inside. Abdominal pain can be due to something as simple as indigestion or constipation. It can be because of inflammation or malignancy of some part of the abdomen. Constipation, if present in an individual, can cause pain in the lower abdomen or generalised. There can be associated nausea or vomiting. Inflammation or ulcer of the stomach or oesophagus, or ulcer in proximal part of small intestine, is the reason for burning pain in the chest and or upper part of abdomen. Inflammation of the pancreas also causes pain in the upper middle part of the abdomen, which is aggravated by bending forwards. Pain in the right upper part of the abdomen, aggravated by meals, is commonly due to inflammation of the gall bladder, more so in middle aged obese women. Diseases of the intestines usually produce pain in the middle or the sides of the abdomen. There may be associated diarrhoea or constipation. At times, the lumen of the intestines may get occluded, leading to severe pain and vomiting. Pain in the flanks, radiating to groin, and or pain in lower abdomen, is mostly due to inflammation or stones present in kidneys, ureters or urinary bladder. This is associated with burning in urination or difficulty to pass urine. Infections or inflammation of the reproductive organs results in pain in the lower abdomen with associated itching, ulcer and or discharge. Infections of the bowels, like amoebiasis, giardiasis or ascaris, cause a cramp-like pain in the sides or upper or lower part of the abdomen, depending on the part of the intestines affected. Depending on the underlying cause, abdominal pain can be sudden or gradual in onset. The intensity varies according to the extent of inflammation or the severity of infection of the underlying part. Severe pain is usually accompanied by nausea, vomiting and sweating. It needs a strong index of suspicion to diagnose the root cause of abdominal pain. At times it becomes difficult to ascertain even the fact that the site of pain and discomfort for a person is in the abdomen. Severe pain occurring in the upper abdomen, along with nausea and sweating, mimics heart attack of inferior surface of the heart. Pain in the right or left side can be confused with pneumonia of the lower part of the lungs. Affections of liver are comparatively easy to diagnose. Pain in right upper part with yellow discolouration of eyes and enlarged liver are characteristics of inflammation of liver. Further investigations like blood tests, stool tests and ultrasound of the abdomen reveal the exact cause for pain. Some of the causes of abdominal pain need surgical correction, like severe inflammation of gall bladder or intestinal occlusion. But many conditions are treatable by drugs. Most of these causes for abdominal pain are preventable. If one takes a balanced diet with lot of fibre and drinks an adequate amount of water, constipation and bloating of abdomen can be prevented. Intake of small frequent meals with very little pepper and spices reduces the possibility of acute or chronic gastritis. Avoiding alcohol helps to avoid gastritis, as well as pancreatitis and liver disorders. Good food hygiene maintained at the level of preparation, serving and eating of food, helps in prevention of infections of the intestines. Drinking enough water reduces the risk of stone formation and also infection in the urinary system. Observing good hygiene of private parts, disciplined and hygienic sexual activity, helps in preventing infection of the pelvic parts and resultant pain. Consuming a smaller amount of red and white meat also diminishes the chances of stone formation. Thus, with small measures taken in one’s day-to-day life, a person can reduce the risk of having abdominal pain. Dr Rachna Pande, Specialist, internal medicine rachna212002@yahoo.co.uk
