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Abdomen/Pelvis Pain

ABDOMINAL PAIN

Abdominal pain is a common but often debilitating type of pain. Pain in the abdominal and pelvic areas can result from a variety of causes, and may take many forms, from sharp, stabbing incidents to a persistent ache.
Although most people will experience some form of abdominal or pelvic pain in their lifetime, abdominal pain often can be relieved with rest and an oral NSAID (non-steroidal anti-inflammatory drugs) such as acetaminophen (Tylenol).

If your pain persists, recurs frequently or is severe, see a doctor as quickly as possible.

CAUSES OF ABDOMINAL PAIN

  • Gastroenteritis (stomach flu)
    Where gastroenteritis is suspected, the pain will usually be accompanied by some similarly unpleasant symptoms. A person suffering from stomach flu can expect to fall victim to things like nausea and vomiting.
  • Intestinal gas
    When the tiny bacteria in the small intestine break down certain foods, gas is created within the intestinal tract. Any level of gas that is higher than normal can cause sharp, stabbing pain in the abdominal region. This pain can be accompanied by a tightening of the abdomen, flatulence or belching.
  • Irritable bowel syndrome (IBS)
    A person suffering from irritable bowel syndrome is much less able to process certain foods through their digestive tract. The most common symptom that sufferers complain of is abdominal pain, which is usually only relieved after the movement of the bowels. It can be very unpleasant to have to endure a particularly bad spell of IBS, going back and forth to the bathroom.
  • Acid reflux
    When stomach acids get confused or blocked, they can travel the wrong way and end up moving back up into the throat of a person. This acid reflux can cause extreme abdominal pain, which is most often accompanied by a very unpleasant burning sensation in the throat. Acid reflux can also increase bloating, cause gas and cause a tightening sensation to be experienced.
  • Gastroesophageal reflux disease (GERD)
    Patients with GERD experience a dysfunction in the esophageal sphincter. As a result, stomach acid passes into the lower esophagus. Due to the stomach acid entering the throat, the affected individual may experience pain in their upper abdomen, as well as symptoms of heartburn and acid reflux.
    Most patients notice an exacerbation in their symptoms when lying down, as the sphincter does not close, and stomach acid leaks into the throat. If left untreated, patients with GERD may develop a condition known as “Barrett’s Esophagus,” where the lower esophagus starts to line itself with the tissues found in the stomach lining.
  • Acid reflux
    A stomach ulcer occurs due to inflammation of the stomach lining caused by an Helicobacter pylori (H. pylori) infection. This bacterium enters the body through the mouth, where it takes up residence in the gut. H. pylori bacteria may lay dormant for years before reaching critical mass where they cause problems in the digestive system.
    When the bacteria infect the stomach lining, the infection may persist for years. Peptic ulcers cause significant amounts of pain in the upper abdomen, and patients may find they experience an exacerbation in their symptoms after eating a meal, especially if the meal contains spices.
    Patients who frequently use NSAIDs may also be at a higher risk of developing a stomach ulcer.
  • Crohn’s disease
    This chronic digestive disorder affects more than 1.6 million Americans. As a result of the disease, patients have trouble digesting their food, experiencing digestive discomfort that leads to feelings of abdominal pain, bloating, nausea, vomiting, and gas.
    Some patients may experience relief from their symptoms by eating liquid meals, such as meal replacement shakes or smoothies. Using probiotics with high strain counts may also help to relieve symptoms somewhat.
    Doctors treat patients with Crohn’s disease, using medication to reduce the symptoms of pain and inflammation in the digestive system. Unfortunately, there is no cure, and the best patients can hope for is learning to manage their symptoms.
  • Pancreatitis
    Pancreatitis is inflammation of the pancreas, a large gland behind the stomach. Pancreatitis can be acute or chronic. Either form is serious and can lead to complications.
    Acute pancreatitis occurs suddenly and usually goes away in a few days with treatment. It is often caused by gallstones. Common symptoms are severe pain in the upper abdomen, nausea, and vomiting.
    Chronic pancreatitis does not heal or improve. It gets worse over time and leads to permanent damage. The most common cause is heavy alcohol use. Other causes include cystic fibrosis and other inherited disorders, high levels of calcium or fats in the blood, some medicines, and autoimmune conditions. Symptoms include nausea, vomiting, weight loss and oily stool.

Stomach cancer

This is a rare form of cancer that often presents no symptoms in its earliest stages, when it may be mistaken for a common stomach virus. Early signs of stomach cancer may include a sense of “fullness” after eating small meals; heartburn, indigestion similar to an ulcer; swelling or fluid build-up in the abdomen; nausea and vomiting; or unexplained weight loss.

Chronic abdominal pain

Chronic abdominal pain is pain that is present for more than three months. It may be present all the time (chronic) or come and go (recurring). Chronic abdominal pain usually occurs in children beginning after age 5 years. About 10 to 15% of children aged 5 to 16 years, particularly those aged 8 to 12 years, have chronic or recurring abdominal pain. It is somewhat more common among girls. Chronic abdominal pain is also common among adults, affecting women more often than men.

Colitis

Colitis is an inflammatory bowel disease (IBD) that causes long-lasting inflammation and ulcers in your digestive tract. Ulcerative colitis affects the innermost lining of your large intestine (colon) and rectum. Symptoms usually develop over time, rather than suddenly.
Colitis can be debilitating and lead to serious complications. While it has no known cure, treatment can greatly reduce signs and symptoms of the disease and even bring about long-term remission.

Kidney pain

The kidneys are located in the back of the abdomen, just under the rib cage, on each side of the spine. It is possible to have pain on only one side if only one kidney has a problem, or both sides if both kidneys are affected.
Problems that can cause kidney pain include urinary tract infection (UTI); a kidney infection; polycystic kidney disease (PKD); blood clots in one of both kidney(s); or bleeding in one or both kidney(s).

Abdominal muscle spasms

Abdominal muscle spasm (or abdominal rigidity) is a powerful, involuntary contraction of the muscles of the abdomen. During a spasm, the muscle will feel stiff and tender if you apply pressure.
Abdominal muscle strain is a common injury among athletes and can cause spasms. However, because the colon and small intestine are the predominant organs in the lower abdomen, most abnormal abdominal spasms are due to acute disorders of the intestines, such as bowel obstruction, perforation or diverticulitis. Other causes originating in the organs within the abdomen include gallstones, hernia and ruptured abdominal aortic aneurysm.
When related to a known cause such as strenuous exercise, abdominal muscle spasms are usually not serious. However, because they can indicate a serious disorder, you should contact your doctor if you have any spasm that appears unrelated to overexertion or if an exercise-induced spasm does not stop quickly.

Gastritis

Gastritis is an inflammation, irritation, or erosion of the lining of the stomach. It can occur suddenly (acute) or gradually (chronic).
Gastritis can be caused by irritation due to excessive alcohol use, chronic vomiting, stress, or the use of certain medications such as aspirin or other anti-inflammatory drugs. It may also be caused by Helicobacter pylori (H. pylori), a bacteria that lives in the mucous lining of the stomach; bile reflux, a backflow of bile into the stomach from the bile tract; or infections caused by other bacteria or viruses.

PELVIC PAIN

Pelvic pain occurs less frequently than does abdominal pain, and is more common among women than in men. But as is true of abdominal pain, when it occurs, it can be debilitating.

Pelvic pain often can be relieved with rest and an oral NSAID such as acetaminophen (Tylenol). If your pain persists, recurs frequently or is severe, see a doctor as quickly as possible.

CAUSES OF PELVIC PAIN

  • Bladder and urinary tract infection (UTI)
    A urinary tract infection is not a serious condition, in most cases of the disease. Most forms of viral UTI tend to fade after a few days, but the patient may notice sensations of burning and pain while urinating. However, a bacterial infection of the urethra with chlamydia or gonorrhea bacteria found in some STIs does not resolve without the use of antibiotics to kill the disease.
    Some patients with bacterial UTI may notice that they develop symptoms of abdominal pain. The bacteria responsible for causing the infection may migrate upward from the urethra into the bladder or cervix in women, resulting in pain in the lower abdomen.
  • Endometriosis or menstrual cramps
    Women who experience the onset of a heavy period due to hormonal imbalance find that they develop symptoms of severe abdominal pain and discomfort. Menstruation can cause pain and inflammation in significant amounts, depending on the hormonal state of the patient. Women who have lower levels of estrogen may experience painful symptoms, as the body struggles to deal with the changes in hormone levels during your period.
    Some women may also experience pelvic and reproductive dysfunctions that result in the onset of abdominal pain as well. Endometriosis is a condition where the lining of the uterus starts to grow on the outside of the organ. As a result, the patient may experience severe pain and cramp in their abdomen. Endometriosis requires immediate hospitalization and treatment with hormone replacement drugs to reverse the disorder.
    Doctors also treat women with painful menstruation by examining their hormone profile. If the physician finds that the patient has low estrogen levels, they may opt for hormone replacement therapy to resolve the condition.

Uterine fibroids

Fibroids are muscular tumors that grow in the wall of the uterus. Fibroids are almost always benign (not cancerous). Not all women with fibroids have symptoms, but when symptoms do present, they may include pain and heavy menstrual bleeding.

No one knows for sure what causes fibroids. We do know that they are under hormonal control — both estrogen and progesterone. They grow rapidly during pregnancy, when hormone levels are high, and shrink when anti-hormone medication is used. They also stop growing or shrink once a woman reaches menopause.

Ovarian cysts

Ovarian cysts are fluid-filled sacs in the ovary. They are common and usually form during ovulation, when the ovary releases an egg each month. Many women with ovarian cysts don’t have symptoms. The cysts are usually harmless.

The most common causes of ovarian cysts include hormonal problems (including drugs used to help you ovulate); endometriosis (see above); pregnancy; and severe pelvic infections.

Bladder dysfunction

Bladder incontinence means a problem holding in urine. When the bladder functions normally, nerves tell certain muscles when to tense up and when to relax. Nerves in the spinal cord send messages from the brain to the bladder. Sphincter muscles control the flow of urine. These nerve and muscle processes allow urine to be removed when you want it to.

Many conditions may affect the nerves and muscles that control the bladder. Bladder incontinence can be caused by damage to nerves in sphincter muscles; holding urine in too long (urine retention), which can damage the bladder; having to urinate many times during day and night, often urgently (overactive bladder); diarrhea; or constipation.

Cervical cancer

This cancer can affect the deeper tissues of the cervix and may spread to other parts of the body (metastasize), including the lungs, liver, bladder, vagina and rectum.

Most cases of cervical cancer are caused by infection with human papillomavirus (HPV), which is preventable with a vaccine. Cervical cancer grows slowly and kills fewer and fewer women each year, thanks to improved screening through Pap tests. Women 35 to 44 years old are most likely to get it.

Cystitis

Cystitis is the most common type of urinary tract infection (UTI). Bacteria in your bladder cause it to swell and get irritated, which leads to symptoms like the urge to pee way more often than normal.

Women tend to get cystitis much more than men do. Typically, it’s more annoying than it is serious, and it’s treated with antibiotics. But bacteria can travel from the bladder to the kidneys and cause more severe problems.

Cystitis is typically caused when bacteria such as E. coli get into the urethra, which is the tube that carries pee out of your body, and travel up to your bladder.

Symptoms include burning when you pee; a constant urge to pee; a low fever; reduced flow of urine; dark, cloudy or strong-smelling urine; or pressure in the lower abdomen.

Pelvic inflammatory disease (PID)

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs. It most often occurs when sexually transmitted bacteria spread from the vagina to the uterus, fallopian tubes or ovaries.

Some women don’t have any signs or symptoms. When signs and symptoms of PID are present, they most often include pain in the lower abdomen and pelvis; abnormal or heavy vaginal discharge that may have an unpleasant odor; abnormal uterine bleeding, especially during or after intercourse, or between menstrual cycles; pain during intercourse ; fever, sometimes with chills; or painful, frequent or difficult urination.

Seek urgent medical care if you experience severe pain in your lower abdomen; nausea and vomiting; fever, with a temperature higher than 101 degrees F; or foul vaginal discharge.

TREATMENT OPTIONS FOR ABDOMINAL PAIN

TREATMENT OPTIONS FOR PELVIC PAIN