If you have pain in your central or middle abdomen it could be as a result of gastritis, indigestion, pancreatitis, hiatus hernia, trapped wind, constipation, food poisoning, bowel obstruction or even early stages of appendicitis.
Let's be very clear - central abdominal or tummy pain refers to any ache, irritation or unpleasant sensation, whether colicky, dull, sharp or burning in nature that is felt in the middle of the abdomen, anywhere within a hands length of the umbilicus or belly button.
This means pain anywhere on the belly button or within a span of up to two inches around the belly button.
If you have pain in your abdomen above this area it is an upper central (epigastric) pain and below the area it is a lower central (or suprapubic) pain.
Like in other parts of the abdomen, pain in the centre of the abdomen happens when things go wrong with one of the organs or structures in that area. Organs in this region are mainly:
Pain in this part of the abdomen could also be an extension of pain from the upper or lower central abdomen. It could also come from the heart, lungs, the spinal cord as in tabes dorsalis or even the eye as in acute glaucoma.
The most common cause of central abdominal pain is problems with the small or large bowels. Such problems could be one or more of the following:
Any of the above problems could also affect the other organs listed above as these are found in the middle of the abdomen causing pain here.
In evaluating the possible causes of pain in the centre of the abdomen, more serious causes like heart attack, ruptured abdominal aortic aneurysm, abdominal pain associated with diabetes (diabetic keto acidosis), blood loss to part of the bowels (acute mesenteric ischemia), perforation of a peptic ulcer, lower lobe pneumonia especially in children, and early stage of acute appendicitis need to be excluded.
Do you or your loved one have pain in the middle of the abdomen? Let's take a brief look at the five most common causes of central abdominal pain and then a more comprehensive list below.
As mentioned earlier, the area of the abdomen around the belly button houses the small intestine and the early part of the large intestine. Sometimes following a hurried meal or after eating certain kind of foods, air can become trapped inside the bowel which distends it and causes central abdominal pain.
If you have:
It is most likely that you have trapped wind.
Please note that trapped wind will not usually cause nausea, vomiting, constipation, fever or diarrhoea. So, if you suffer with vomiting, diarrhoea or fever with the above symptoms, it is unlikely that it is trapped wind.
Taking peppermint capsules or drink and some pain killers like Paracetamol (Tylenol) may help the pain.
This is a very common cause of central abdominal pain. The typical story goes like this:
Is that you? The solution might be to take some simple pain killer like paracetamol or Tylenol and see your family doctor, for a one-to-one assessment. You may or may not need some additional medications like antibiotics or antispasmodic.
Does this sound like you?
If this sounds like you then you may have a food intolerance. You can get strips from reputable online laboratories to find out what food you might be intolerant to. It might even be that you have a condition referred to as coeliac disease.
Constipation may be the cause of the pain.
This is one of the serious causes of pain in the central abdominal area and this type of pain must always be excluded by a doctor.
The story goes like this:
This is almost certainly a bowel obstruction or intestinal obstruction.
What should you do? Go to the hospital now. No more, no less.
If you have had a previous abdominal operation, a hernia repaired or caesarean section, your bowel obstruction could have been caused by old scar tissue formation from the surgery you had in the past. This scar tissue could twist your bowels and have caused the blockade. This is a condition called abdominal adhesions. Bowel cancer, unusually long or short bowel loops and worms are other things that could cause bowel obstruction.
Most children under the age of 8 will point to the centre of their tummy, in or around the belly button when they are feeling unwell. Many times, the cause of their pain may actually be far away from the abdomen. They tend to point to the tummy because of poor ability to localise pain (which improves as they grow up).
It is important to take a complaint of central abdominal pain seriously in a child and to locate the possible causes of pain, which are often not serious, but to identify and address any potential serious cause.
The following are the most common causes of central abdominal ache in children:
Central abdominal pain in older children and adults is caused by similar conditions causing pain in the middle part of the abdomen in small children, including:
To find out the causes of your central abdominal pain it is likely that tests and investigations need to be done. The following are the common tests you will expect to be done and why they are done:
These will include:
It is important to do a urine test and certainly a pregnancy test in any woman of child bearing age.
This is the least expensive, easily available and quickest way to demonstrate that there is a bowel obstruction or not. Constipation, bowel obstruction and many other conditions may also require the taking of an x-ray.
An ultrasound will exclude gallstones, pancreatitis (pancreatic cysts etc.).
A stool test will exclude things like H. pylori, worms, or parasites.
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