Duration | Central abdominal pain

Duration

Due to the large number of different causes of central abdominal pain, it is difficult to give a general duration of the disease. While the pain caused by a kidney stone after treatment or spontaneous stone loss disappears after just a few hours, in the case of inflammation of the pancreas or gastro-enteritis it can last from several days to a few weeks. In the case of endometriosis, on the other hand, without adequate therapy, the pain can recur repeatedly during the menstrual cycle and represent a long-term burden for the patient.

Abdominal pain after exact localization

In the upper abdomen are the lower parts of the esophagus, the stomach and the upper parts of the small intestine as well as the colon and the pancreas. On the right side are the liver and bile ducts, on the left side the spleen. These organs can be the cause of pain in the upper abdomen.

Other possible causes of upper abdominal pain are a heart attack or an aortic aneurysm. – The most common cause of abdominal pain is functional bowel problems, called dyspepsia, in about 50% of cases. Symptoms of dyspepsia usually occur after eating and manifest themselves as abdominal pain in the upper abdomen, malaise and a feeling of fullness.

There are no organic causes for the dyspepsia. – Esophagus: In reflux disease, acid stomach contents reflux into the esophagus, resulting in heartburn, acid regurgitation and pain in the middle upper abdomen. Inflammation and tumours of the lower oesophagus can also cause pain in the middle upper abdomen.

(see reflux disease)

Ulcers in the stomach and small intestine can perforate (break through). The associated perforation pain begins suddenly and violently, after which patients experience a phase of pain relief before the pain increases again. Tumours of the stomach can cause a feeling of pressure in the upper abdomen, tumours of the small intestine rather pain.

(see gastritis and gastric ulcer)

  • Pancreas: In many cases, an inflammation of the pancreas begins suddenly with severe pain in the upper abdomen, which radiates in all directions and extends around the body like a belt. Other diseases of the pancreas cause similar symptoms. A pancreatic tumour is more likely to cause pain radiating into the back than abdominal pain.

(see pancreatitis)

  • Gall bladder: An inflammation of the gall bladder, often caused by a gall stone, can also lead to abdominal pain under the rib. Some patients still report that the pain radiates to the right arm. (see inflammation of the gall bladder)
  • Intestine: In the case of intestinal obstruction (ileus), the movement of the intestine comes to a halt, either through mechanical displacement or through paralysis of the intestinal loops.

An intestinal obstruction has many causes and is an absolute emergency! The intestinal obstruction can be accompanied by pain, but it can also be painless. If left untreated, peritonitis develops in the course of the disease, and the abdomen becomes hard as a board without the patient’s intervention, which is a clear sign for the doctor to detect the intestinal obstruction.

(see intestinal obstruction)

  • Other causes: Central pain in the upper abdomen can be caused by a heart attack, a radiation into the left arm may be present. Other causes coming from the chest are Pulmonary embolism, pneumonia, pleurisy, pneumothorax, inflammation of the renal pelvis
  • Pulmonary embolism,
  • Pneumonia,
  • Pleurisy,
  • Pneumothorax,
  • Inflammation of the renal pelvis
  • Pulmonary embolism,
  • Pneumonia,
  • Pleurisy,
  • Pneumothorax,
  • Inflammation of the renal pelvis

In the lower abdomen are the lower parts of the small intestine and the large intestine. The bladder and ureters are also located here.

In women, the uterus, ovaries and fallopian tubes are also located here. – Large intestine: The two most common inflammatory diseases of the large intestine are Crohn’s disease and ulcerative colitis. In most cases Crohn’s disease affects the transition from the small to the large intestine, causing colicky pain in the right lower abdomen.

Diarrhoea and flatulence can also occur. In ulcerative colitis, which mainly affects the rectum and the lower sections of the colon, the cramp-like pain occurs mainly in the left lower abdomen, and patients also have bloody-mucus diarrhoea. Diverticulitis is an inflammation of bulges of the colon wall, these bulges are favoured by a low-fibre diet.

In 95% of the cases the diverticulitis takes place in the left lower abdomen (sigmoid diverticulitis) and causes intermittent pain. The remaining cases cause pain in the middle abdomen or in the right lower abdomen. – Appendicitis: Colloquially called appendicitis, it takes place in the right lower abdomen.

In the beginning it causes diffuse pain around the navel, which then moves down. – Bladder and ureter: A bladder infection causes cramp-like pain in the middle lower abdomen, patients complain of burning sensation when urinating, and the urine test often shows inflammatory cells and red blood cells. Ureteral stones cause colicky pain on the affected side, which can radiate into the lower abdomen and groin.

Accompanying nausea, vomiting and fever are frequent. – Inguinal hernia: An inguinal hernia causes pulling pain in the lower abdomen, which can radiate into the thigh. The pain improves when lying down and becomes worse when standing.

If parts of the intestine are trapped in the inguinal hernia, severe cramp-like pain occurs. – Vessels: In pelvic vein thrombosis, a vascular occlusion in the venous system causes pain in the lower abdomen, back and groin. Patients have the feeling that their thigh is tight and swollen.

The diagnosis can be made by an ultrasound examination. An aortic aneurysm can also be detected by an ultrasound examination. It causes either diffuse or ripping pain, which can start either suddenly or slowly.

Tumours and cystic diseases of the liver can also cause pressure pain in the upper abdomen. After an accident, a rupture of the liver (liver rupture) can occur, the pain begins suddenly. Patients often suffer a circulatory shock.

The spleen is located in the left upper abdomen. After an accident, a rupture of the spleen can cause pain in the left upper abdomen. Patients develop a circulatory shock because blood runs into the abdominal cavity.

In the case of a large tear, the circulatory shock begins a few moments after the accident; in the case of a small tear, hours or days may pass before the situation becomes critical. If the arteria lienalis, the artery that supplies the spleen with blood, or one of its smaller lower branches is closed by an embolus in the bloodstream, a splenic infarction occurs. In a splenic infarction, spleen tissue dies because it is not supplied with oxygen.

The splenic infarction causes pain in the left upper abdomen with radiation into the shoulder. In many cases it is caused by an inflammation of the heart valves, from which inflammatory components detach and end up in the spleen. In the left lower abdomen, diverticulitis and ulcerative colitis are frequent causes of pain, see “Lower abdomen”.

Diseases of the kidney and the draining urinary tract can also cause abdominal pain on the left side. Various causes are conceivable for abdominal pain under the thorax. – Reflux disease: In reflux disease, acid stomach contents reflux into the oesophagus, resulting in heartburn, acid regurgitation and pain in the middle upper abdomen.

  • Abscesses (encapsulated accumulation of pus): An abscess of the liver can be caused by various infections. An abscess of the spleen is rare, but can also be caused by various infections. If these abscesses spread, a subphrenic (located below the diaphragm) abscess may develop.

Patients suffer from abdominal pain under the thorax and high fever. The pain is often dependent on breathing. – Pneumonia: Pneumonia affecting the lower sections of the lungs can cause pain under the rib cage and can be detected by the typical examination with a stethoscope.

  • Pleurisy (inflammation of the pleura): If the lower parts of the pleura are mainly affected, patients experience pain under the rib cage, which is usually dependent on breathing. Abdominal pain during pregnancy can be caused by the pregnancy or have to do with other organs of the abdominal cavity. During pregnancy, the skin of the abdomen may tear due to stretching, which is perceived as a rather superficial pain.

Towards the end of the pregnancy exercise and down pains are quite normal. Pregnant women, just like other women, can of course suffer from all the diseases described here that cause abdominal pain: gallstones, cholecystitis, pelvic inflammatory disease, kidney stone, etc. The life-threatening HELLP syndrome causes pain in the right upper abdomen.

The patients feel ill, they feel nauseous and they are sensitive to light. The blood clotting deteriorates. A visit to the doctor is absolutely necessary!

  • Appendicitis: Appendicitis often begins with abdominal pain around the navel, which then moves towards the right lower abdomen. – Chronic inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis can also manifest themselves through abdominal pain around the abdomen. Acute inflammatory bowel diseases such as gastroenteritis are often accompanied by abdominal pain around the navel.
  • Mesenteric infarction: An occlusion of the arteries that supply the intestine with blood can be caused by an embolus in atrial fibrillation or by an inflammation of the heart valves, for example. Arteriosclerosis is also a possible cause. A mesenteric infarction causes diarrhoea and cramp-like pain in the middle abdomen and around the navel.

If left untreated, it can lead to peritonitis and paralyzing intestinal obstruction. – In children and adolescents, a volvulus (twisted intestine) or intussusception (intestinal invagination) can be the cause of abdominal pain around the navel.

All articles in this series:

  1. Central abdominal pain
  2. Accompanying complaints
  3. Diagnosis
  4. Duration