Have you ever had a sudden, unbearable stomachache? Sometimes, you can have a sudden stomachache. Doctors call this condition an "acute abdomen." Sometimes, it can be serious enough to require emergency surgery. So it's important to be aware of this.
What exactly is Acute Abdominal Pain?
Simply put, acute abdominal pain is a sudden, very severe abdominal pain. This can sometimes be a life-threatening emergency. This means you may need to have surgery right away. However, not all acute abdominal pain requires surgery. Some medical conditions can also cause this type of pain.
Doctors use the term "acute abdomen" to describe this kind of sudden, severe stomach pain. It means you need to find out what's going on right away and start treatment if necessary.
Who is most likely to be affected by this situation?
Actually, this sudden abdominal pain can happen to anyone . However, the causes may vary depending on your age, whether you are male or female, and other medical conditions you may have.
Think about it this way:
- Appendicitis is a common condition that affects young people in their 18s and 20s.
- Diverticulitis is common in people over the age of 60.
- For a woman, sometimes this kind of sudden pain can occur due to the rupture of an ectopic pregnancy.
- A man may experience sudden pain due to testicular torsion.
Also, if you have a medical history, you may also experience stomach problems like this.
How common is this condition?
It's hard to say exactly how many people get this sudden stomach pain. However, it's estimated that about 7 to 10 out of 100 people who come to the emergency department have a stomach ache . So, that gives you an idea of how common this is.
What are the symptoms of acute abdominal pain?
Often the main symptom is a sudden, unbearable stomach ache . However, other symptoms may also be present. These include:
- Distended abdomen: This means that the stomach is much more swollen than normal, like a balloon.
- Symptoms of shock: This includes rapid heartbeat, low blood pressure, sweating, and sometimes confusion. This is a very dangerous sign.
- Symptoms of peritonitis: When the lining of the abdomen becomes infected (peritonitis), there may be persistent pain. Or the pain may increase when the abdomen is touched or hit somewhere.
If you have one or more of these symptoms, don't take it lightly.
What causes this sudden abdominal pain (Acute Abdomen)?
Many different health conditions can cause this sudden abdominal pain. Some of these causes may be surgical causes . That is, they will most likely require surgery. Others may be nonsurgical causes .
Reasons why surgery may be needed
This mainly includes bleeding, infections, blood clots, intestinal blockages, and perforations.
1. Bleeding (Hemorrhage)
Hemorrhage is when blood leaks out of a blood vessel due to damage. This can be caused by:
- Esophageal tear (Mallory-Weiss tear)
- A ruptured ectopic pregnancy
- Some kind of accident (Trauma)
- Ruptured spleen
- Ruptured abdominal aortic aneurysm
2. Infections
Sudden abdominal pain can be caused by various infections:
- Appendicitis - the appendicitis we all know
- Cholecystitis
- Peptic ulcer disease (stomach or small intestine ulcers)
- Acute pancreatitis
- Infection of parts of the large intestine (Diverticulitis)
3. Blockage of blood flow (Ischemia)
Ischemia occurs when blood flow to a part of the body is reduced or stopped.
- Buerger's disease
- Inflammation of the large intestine (Colitis)
- Blockage of the blood vessels supplying the intestines (mesenteric ischemia)
- Strangulated hernia
- Testicular torsion
4. Obstructions
An obstruction is when something gets stuck in the digestive tract, preventing the food and liquids we eat from passing through it properly.
- Inflammatory bowel disease (IBD)
- Intussusception (intestinal invagination)
- Small bowel obstruction
- Large bowel obstruction
5. Perforations
This is what happens when holes form in the walls of our body's organs.
- Esophageal rupture (Boerhaave's syndrome)
- Gastrointestinal perforation
- Perforated stomach ulcer
- Malrotation of the intestines
Reasons why surgery is often not necessary
These causes of abdominal pain usually do not require surgery. They can be caused by endocrine and metabolic disorders, blood diseases, and toxins or medications.
1. Endocrine and metabolic disorders
These are issues related to the hormones, chemicals, and glands in our body (Endocrine system).
- Increased urea levels in the blood (Uremia)
- Diabetes-related ketoacidosis (DKA)
- Addison's disease
- Acute intermittent porphyria
2. Hematologic disorders
These are diseases related to our blood, the cells in our blood, lymph nodes, bone marrow, and blood platelets.
- Sickle cell disease
- Acute leukemia
- Certain genetic disorders
- Anemia
3. Toxins
Some medications, chemicals, and poisons from animal bites can also cause sudden stomach upset.
- Lead poisoning
- Other heavy metal intoxications
- Nicotine withdrawal
- Black widow spider bite poisoning
- Some scorpion stings
How do you diagnose this sudden abdominal pain (Acute Abdomen)?
If you go to the emergency room (ETU) with severe stomach pain, the doctors and nurses there will quickly try to find out what is causing it. The doctor will ask you a few questions:
- Your medical history: Previous GI issues and other illnesses.
- Exactly where the pain is: It hurts somewhere in the stomach.
- Time of onset of pain and a description of the pain: When did it start and what kind of pain is it (aching, cutting, squeezing).
- What to do to reduce the pain, and what to do to increase it.
- Have you ever had symptoms like this before?
- Are there any new features?
- What medications (prescription and nonprescription drugs) do you take?
- Have you had any previous abdominal surgeries?
- Have you had any recent changes in bowel or urinary habits?
Also, they will definitely ask if you are pregnant or if there is a possibility of pregnancy.
The doctor will then do a physical exam, especially of your abdomen. He will look at the skin of your abdomen for any visible abnormalities. He will use a stethoscope to listen to the sounds of your intestines. He will then palpate your abdomen for any tenderness or lumps.
The location of your pain can help your doctor determine the cause of your pain. For example, acute diverticulitis pain is usually felt in the lower left side of your abdomen, while cholecystitis pain is usually felt in the upper right side of your abdomen.
If a digestive or prostate problem is suspected, a digital rectal exam may be performed. If a gynecological problem is suspected, a pelvic exam may be performed. If a testicular torsion is suspected, a testicular exam may be performed.
Based on your answers to these questions and the findings from the physical examination, the doctor can get an idea of what the illness might be. Based on that, he will decide what diagnostic tests to perform.
What kind of tests are done for this?
Sometimes, if your doctor can clearly identify the cause of your symptoms, he or she may be able to refer you directly to surgery without any further testing. However, if you are not sure about the cause of your condition, you may need to have several tests done to confirm the diagnosis. The tests you will need to do will depend on what you find during your physical examination and the suspected condition.
Blood and urine tests (Laboratory tests) may include:
- Complete blood count (CBC)
- Comprehensive metabolic panel (CMP)
- Arterial blood gas (ABG) test
- Amylase test
- Liver function tests
- Kidney function tests
- Urinalysis
Imaging tests may include:
- Abdominal ultrasound
- Abdominal computed tomography (CT scan)
- Endoscopic ultrasound
How do you treat this sudden abdominal pain (Acute Abdomen)?
Treatment varies depending on the cause . Whatever the cause, it is important to diagnose the condition and start treatment as soon as possible. If an emergency surgery is needed, the doctor will quickly refer you to a surgeon for advice and may even take you to the operating theatre.
If the cause of sudden abdominal pain is not surgical, the following treatments may be recommended:
- Stabilizing and monitoring your vital signs.
- Providing the body with the fluids and electrolytes it needs.
- Giving broad-spectrum antibiotics.
- Giving pain relievers.
- Giving anti-emetics to reduce vomiting and nausea.
What happens if I have sudden abdominal pain (Acute Abdomen)?
Your prognosis depends on the cause of the disease. The sooner you get treatment, the higher your chances of recovery.
If sudden abdominal pain is left untreated, dangerous complications can occur. These include:
- Abnormal connections between parts of the body that should not be connected to each other (Fistula).
- Necrosis of your bowels.
- Blood poisoning (Sepsis).
- Even death can occur.
Therefore, if you experience sudden stomach pain, never ignore it. The best thing to do is to seek medical advice immediately.
Can I prevent this sudden abdominal pain (Acute Abdomen)?
Since there are many causes of sudden abdominal pain, it is difficult to prevent all of them. However, you can reduce this risk by following a healthy lifestyle . That means:
- Eating a balanced diet.
- Exercising regularly.
- Going for regular medical checkups.
- Quitting smoking.
When should I see a doctor?
If you have chronic stomach pain, meaning pain that has been going on for weeks and doesn't seem to be getting better, you should definitely see a doctor. There are many causes of stomach pain. A doctor can diagnose your condition and recommend the right treatment.
When should I go to an Emergency Treatment Unit (ETU) ?
If you have sudden, severe stomach pain, call 911 (1990 in Sri Lanka) immediately, or go to the nearest emergency room. This can be a life-threatening condition, so prompt treatment is essential.
What questions should I ask my doctor?
If you have sudden abdominal pain, you can ask your doctor these questions:
- Why did I suddenly have this stomach ache?
- Will I need further treatment?
- What can I do to prevent something like this from happening again?
- What is the difference between acute abdominal pain and chronic abdominal pain?
Almost everyone experiences stomach pain at some point in their life. Most of the time, it is not serious and will go away on its own. However, acute abdominal pain can be a sign of a medical emergency. If you suddenly experience severe abdominal pain, it is important to go to the emergency room right away. This way, doctors can find the cause of your pain and start treatment right away. If left untreated, acute abdominal pain can lead to serious complications.
Remember the most important thing (Take-Home Message)
Sudden, severe stomach pain is never something to ignore . There could be a serious underlying cause. So, if you or someone you know suddenly experiences severe stomach pain, seek medical attention immediately . Prompt treatment can save a life. Living a healthy lifestyle can also help protect you from these conditions to some extent. Above all, take care of your body and pay attention to anything unusual.
` Abdominal pain, sudden abdominal pain, stomach ache, surgery, hospitalization, abdominal symptoms, Acute Abdomen
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