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Abdominal pain
Last reviewed: 11.04.2020
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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 frequent symptom in outpatient practice, abdominal pain requires a rational diagnostic strategy, primarily from the position of a general practitioner, who is often the first to encounter such patients.
Pain pulses that arise in the abdominal cavity are transmitted through the nerve fibers of the autonomic nervous system, as well as through the front and side spino-talamic tracts. Vegetative pains most often can not be definitely localized by the patient, they are often diffuse, localized in the middle part of the abdomen. The pains transmitted through the front and side spino-thalamic tracts are characterized by a clear localization, arise when the parietal peritoneal leaf is irritated. In this case, patients clearly indicate the pain points with one, rarely two fingers. This pain is associated, as a rule, with an intra-abdominal inflammatory process that spreads to the parietal peritoneum.
It should be noted that in the diagnosis, differential diagnosis, the localization of pain syndrome is a very important factor. When starting the examination of the patient, the doctor should immediately mentally divide the abdomen into three large departments: epigastric in the upper third, mesogastric or peripump and hypogastric, represented by the suprapubic part and the pelvic region.
[Causes of abdominal pain
The causes of abdominal pain can be surgical, gynecological, mental illness and many other internal diseases. Pain in the abdomen is an alarming symptom. It is practically important to distinguish acute and chronic pain in the abdomen and their intensity. Acute intense abdominal pain can indicate a dangerous disease, in which a quick assessment of the situation ensures the holding of life-saving urgent medical interventions.
Diagnosis of abdominal pain
In the presence of acute intense pain in the abdomen, the general practitioner is faced with the task not only of establishing a nosological diagnosis, but also an immediate assessment of the urgency of the disease and the need for urgent surgical care. The solution of this question is the prerogative of the surgeon, but the preliminary conclusion is made by a general practitioner. If the urgency of the situation is not obvious, it is required to establish a presumptive diagnosis, to help 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
Therapeutic tasks of a general practitioner for abdominal pain are reduced to: elimination of the cause of pain, easing of pain, changing lifestyle, identifying clinical cases when referral to a specialist for further examination, clarifying whether there is a connection between taking any medications and symptoms of dyspepsia , control of hemoglobin level of blood.
Non-drug treatment of abdominal pain : stop smoking, change the way of life, limit alcohol intake, fractional nutrition, health education work with the patient about the work of the gastrointestinal tract (including the topic of normal defecation).