Abdominal Pain Diagnosis
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Accurate abdominal pain diagnosis is required for any case of abdominal pain lasting more than an hour, or causing moderate to severe pain and affecting the normal function of the sufferer.It could be difficult, but with a systematic approach, this could be achieved.
We will divide the steps of diagnosis of abdominal pain along the above lines into the stages of History Taking, Physical Examination and Investigations.
A Detailed History
At first contact, many patients expect their doctor to be able to tell exactly what is wrong. No. Your doctor can only come to an accurate diagnosis if you are able to describe in detail, how you have been experiencing. This is the fist of the three steps described here.You should be prepared to describe the pain in terms of the following:- Is the pain all over the abdomen (diffused) or in a particular part of the abdomen (localized)? A diffused abdominal pain will suggest problems like
- Constipation
- Bowel Ischaemia
- Leaking peptic ulcer
- Spontaneous Bacterial Peritonitis
- What part of the abdomen is the pain located if it is not diffused? Right, Left, upper or lower abdomen? Pain is usually fairly well localised to the region of the abdomen where the injured organ is located. An abdominal pain in the upper right abdomen for example could be due to
- Cholecystitis
- Biliary Colic
- Liver disease
- Peptic ulcer
- Time of onset.
- The severity of the pain(best measured on a scale of 0 to 10, with 0 being no pain, and 10 been the most severe pain ever)
- Duration of the pain when it comes on
- Does it spread from one point or part of the abdomen across to another point or area
- What are the things or activities that makes the pain worse or bring it on?
- Is there any positioning, activity or medication or indeed any other factor that help relieve the pain?
- Are there any other associated symptoms like nausea and vomiting, distension or swelling of the abdomen, loose stools, increased frequency of urination, pain on passing urine, fever or weight loss.
The Physical Examination
Abdominal pain diagnosis often requires that the doctor carries out what is referred to as a physical examination. It involves taking a trained look at the patient, performing some manoeuvre and then listening with the stethoscope.It is often very important to carry out an examination of the rectum (back passage or anus) in many instances of abdominal pain in men and women.
Taking about women, a vaginal examination may be necessary, especially in cases of miscarriage or pelvic inflammatory disease.
Investigations
In most cases of abdominal pain, it may be necessary to carry out some blood and urine test, stool examination, endocscopy, biopsy, radiography and other scans to help come to an accurate abdominal pain diagnosis.
