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Abdominal pain
Last reviewed: 12.07.2025
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Abdominal pain is a symptom of many diseases, which has a wide range of clinical significance: from functional disorders to conditions that threaten the patient's life. Being a common symptom in outpatient practice, abdominal pain requires a rational diagnostic strategy, primarily from the standpoint of a general practitioner, who is often the first to encounter such patients.
Pain impulses arising in the abdominal cavity are transmitted through the nerve fibers of the autonomic nervous system, as well as through the anterior and lateral spinothalamic tracts. Autonomic pains most often cannot be definitely localized by the patient, they are often diffuse in nature, localized in the middle part of the abdomen. Pains transmitted through the anterior and lateral spinothalamic tracts are characterized by clear localization, occur with irritation of the parietal peritoneum. In this case, patients clearly indicate pain points with one, less often two fingers. This pain is usually associated with an intra-abdominal inflammatory process spreading to the parietal peritoneum.
It should be noted that in diagnostics, differential diagnostics, determining the localization of pain syndrome is a very important factor. When examining a patient, the doctor should immediately mentally divide the abdominal area into three large sections: epigastric in the upper third, mesogastric or periumbilical, and hypogastric, represented by the suprapubic part and the pelvic area.
Causes of abdominal pain
The causes of abdominal pain may be surgical, gynecological, mental illnesses and many other internal diseases. Abdominal pain is an alarming symptom. It is practically important to distinguish between acute and chronic abdominal pain and their intensity. Acute intense abdominal pain may indicate a dangerous disease, in which a quick assessment of the situation ensures the implementation of life-saving emergency treatment measures.
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Diagnosis of abdominal pain
In the presence of acute intense abdominal pain, the general practitioner is faced with the task not so much of establishing a nosological diagnosis, but of immediately assessing the urgency of the disease and the need for urgent surgical care. The solution to this issue is the surgeon's prerogative, but a preliminary conclusion is made by the general practitioner. If the urgency of the situation is not obvious, it is necessary to establish a presumptive diagnosis, provide assistance and outline a plan for additional diagnostic measures, possible in an outpatient setting or in a hospital, judging by the patient's condition.
Treatment of abdominal pain
The therapeutic tasks of a general practitioner for abdominal pain are reduced to: eliminating the cause of pain, reducing pain, changing lifestyle, determining clinical cases when a referral to a specialist for further examination is needed, clarifying whether there is a connection between taking any medications and symptoms of dyspepsia, monitoring the level of hemoglobin in the blood.
Non-drug methods of treating abdominal pain: stop smoking, change your lifestyle, limit alcohol intake, eat small meals, educate the patient about the functioning of the gastrointestinal tract (including the topic of normal bowel movements).