lundi 18 juillet 2016

How To Manage Abdominal Pain

By Stephen Bennett


Symptoms related to the gastrointestinal system are the result of varied medical conditions. Examples include, among others, inflammatory diseases, infections, cancerous processes and ulcers among others. Most of us (if not all)in Greenbelt, MD, have had to deal with abdominal pain at one time or the other. The majority of these cases are due to disorders affecting the underlying structures. We will explore the various types of this pain and how to manage them.

One of the first steps in the identification of the source of pain is to determine the region in which it is most severe. It is very likely that the source of the discomfort is related to the underlying anatomical structures. For example, if the symptom is most severe in the flanks, the source is likely to be the kidneys, the liver (on the right) or the spleen (on the left). More central pain often has its origin on the intestines.

The character and pattern of the symptom also helps determine the source in a big way. For instance, pain that is predominantly constricting is most likely related to a hollow organ such as the intestines, the gall bladder or the ureters. On the other hand, dull and diffuse pain is often due to conditions affecting solid internal organs. Associated symptoms may also help shape the pattern. If pain is associated with diarrhea, for instance, an infection is most likely present.

There are a number of investigations that become useful when investigating the cause of this complaint. In the event that an infective process is suspected, a septic screen is usually done. Among the components of this screening is a full blood count. The objective here is to determine whether there is an increase in the number of white blood cells and if so which particular subtypes are affected. Other components include a blood culture, urine analysis and cerebrospinal fluid culture.

Radiological studies are also useful in the identification of the source of pain. For instance, X-rays (also known as plain radiographs) are an important tool in the diagnosis of intestinal obstruction. Typical findings include the presence of gaseous distension. Tumors within the abdominal cavity are best assessed using ultrasound, CT scans and MRI. Specimens may also be collected under the guidance of some of these radiological modalities.

Management of this condition is widely varied. It is mostly dependent on the underlying diagnosis. For a majority of the conditions no form of treatment is needed. Others may just require a few over the counter drugs. Persons with peptic ulcers will experience relief when they take antacids. Those in whom an infection has been demonstrated antimicrobial agents such as antibiotics, antifungals and antiviral drugs will be administered depending on which of these pathogens is present.

Surgical intervention has two main benefits. It may be used in making the diagnosis such as in the case of acute appendicitis, ectopic pregnancies, tumors and abscesses and may be a therapeutic intervention. Surgery not only allows the surgeon to see where the problem is through direct visualization but also ensures that the area is accessible for any interventions to be undertaken. Both open and laparoscopic approaches can be used.

Pain originating from the abdomen has numerous sources. The important is that one gives a comprehensive history and undergoes a physical examination to help identify the origin. The management will be guided by what is identified or suspected.




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