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 pattern and character of this symptom is also a useful tool in determining its origin. Constricting pain is usually due to a tubular structure such as the intestine, the ureters or the gall bladder among others. Dull, diffuse pain, on the other hand, is likely to be traced to a solid organ. Associated symptoms may provide more clues. For example, if associated with failure to pass stool, its presence is highly suggestive of intestinal obstruction or constipation.
A number of investigations need to be carried out to differentiate the various possibilities that exist. The nature of these investigations is greatly depended on the problem that is suspected. A septic screen is conducted when an infection is suspected. The screen includes, among other things, a full blood count. This is a determination of levels of cellular components in blood. Of greatest concern is the level of white blood cells. Urine, cerebrospinal spinal fluid are subjected to culture studies as part of this screen.
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.
The treatment varies depending on the underlying condition. A majority of cases can be managed expectantly or may resolve with the administration of over the counter analgesic agents. Antibiotics and other antimicrobial agents are usually administered when an infection is present. If the cause of symptoms is an ulcer then the most appropriate medication will be an antacid or mucosal protective agent. Metastatic tumors such lymphomas may benefit from chemotherapeutic drugs.
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.
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 pattern and character of this symptom is also a useful tool in determining its origin. Constricting pain is usually due to a tubular structure such as the intestine, the ureters or the gall bladder among others. Dull, diffuse pain, on the other hand, is likely to be traced to a solid organ. Associated symptoms may provide more clues. For example, if associated with failure to pass stool, its presence is highly suggestive of intestinal obstruction or constipation.
A number of investigations need to be carried out to differentiate the various possibilities that exist. The nature of these investigations is greatly depended on the problem that is suspected. A septic screen is conducted when an infection is suspected. The screen includes, among other things, a full blood count. This is a determination of levels of cellular components in blood. Of greatest concern is the level of white blood cells. Urine, cerebrospinal spinal fluid are subjected to culture studies as part of this screen.
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.
The treatment varies depending on the underlying condition. A majority of cases can be managed expectantly or may resolve with the administration of over the counter analgesic agents. Antibiotics and other antimicrobial agents are usually administered when an infection is present. If the cause of symptoms is an ulcer then the most appropriate medication will be an antacid or mucosal protective agent. Metastatic tumors such lymphomas may benefit from chemotherapeutic drugs.
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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