Duration of upper abdominal pain
The duration of the pain and the treatment depends strongly on the underlying diseases. Probably the most common complaints in the upper abdomen occur every day and are related to the stomach and digestion. These problems usually resolve themselves within a few hours.
If infections and inflammations requiring treatment are present, antibiotic therapy can sometimes last from a few days to a few weeks. This applies to inflammations caused by pathogens, as well as chronic gastritis, inflammation of the liver or other upper abdominal organs. In the case of complaints treated surgically, the healing period can be extended.
In the case of gall bladder operations, the recovery time is relatively short with only a few days. Diseases of the pancreas as well as malignant diseases of all upper abdominal organs are to be taken very seriously. Their cure is not always possible and therapy is usually carried out over a long period of time.
The pain can be treated symptomatically with various drugs. The pain medication usually takes effect after a few minutes up to a few hours. They provide quick relief of the pain.
Diagnostics for upper abdominal pain
X-rays, CT or MRT images can be helpful for further diagnostics. In the case of unexplained, persistent problems, invasive measures can also be used as diagnostic tools. These include a gastroscopy or an endoscopy of the bile ducts (ERCP), as well as minimally invasive operations for diagnosis. These are called explorative laparoscopies.
Treatment of upper abdominal pain
The treatment of upper abdominal pain varies with the cause of the pain. In most cases, a non-prescription painkiller can be taken without hesitation. NSAIDs” such as ibuprofen or diclofenac may be considered.
However, these only treat the symptoms and not the cause. In some cases, the cause of the pain must be eliminated. In the case of digestive problems or comparable complaints, treatment is not necessarily required.
In such cases, a change in diet is often sufficient. However, if the pain is very severe or lasts for a long time, a doctor should determine the cause in order to be able to start a targeted therapy.Some diseases, such as bacterial infections, can be treated with anti-inflammatory drugs and antibiotics. Problems of the liver and gall bladder can often be treated by endoscopic surgery, but also by surgery, for example the removal of the gall bladder.
Malignant changes of the upper abdominal organs must be treated intensively, often also surgically. A signal word for physicians is right-sided upper abdominal pain in pregnant women in the last trimester (pregnancy month 6-9). This can be an indication of a beginning so-called HELLP syndrome.
In addition to high blood pressure (hypertension), HELLP syndrome can lead to liver dysfunction. This is manifested by an increase in liver values and a drop in the number of blood platelets in the blood. In addition, red blood cells are excessively broken down, resulting in so-called hemolysis.
This is described by the abbreviation HELLP (H = haemolysis, EL = elevated liver enzymes, LP = low platelet count). In addition to the usually severe right-sided upper abdominal pain, nausea and vomiting, visual disturbances and headaches can occur. The clinical picture is dangerous for mother and child and must lead to immediate hospitalization.
Furthermore, pregnant women can have upper abdominal pain for the same reasons as non-pregnant women and men. In the case of right-sided pain in the upper abdomen, these include diseases of the gallbladder such as inflammation (cholecystitis) and stones in the gallbladder (cholecystolithiasis). In the case of gallbladder stones, the pain often increases after eating, as the gallbladder empties its secretion and the stones start moving.
Upper abdominal pain in the middle abdomen can also indicate diseases of the stomach in pregnant women. These include inflammation of the stomach (gastritis), which is often accompanied by a feeling of fullness, and stomach or duodenal ulcers (ulcus ventriculi and ulcus duodeni). Pregnant women often experience heartburn.
This can be explained by the altered position of the gastrointestinal tract with more pressure on the lower esophageal sphincter. The heartburn can also be accompanied by mild pain in the upper abdomen. Furthermore, diseases of the pancreas in the sense of inflammation can lead to pain in the middle upper abdomen in pregnant and non-pregnant women.
Pain in the left upper abdomen can also be an indication of a spleen swelling in pregnant women, which in turn can be an indication of an infection. In general, persistent abdominal pain in pregnant women should result in a visit to the doctor, as the doctor can best assess whether this is a harmless symptom or an indication of an illness requiring treatment. Children suffering from abdominal pain may have difficulty locating it, depending on their age but also on the type and intensity of the pain.
However, severe pain can usually be localized roughly to the upper abdomen, for example. In children, pain in the left upper abdomen can be an indication of massive splenomegaly (enlarged spleen), which can occur as a non-specific symptom of chronic myeloid leukemia (CML = a form of blood cancer). Furthermore, gallstones (= cholelithiasis) lead to colicky pain in the upper abdomen.
The stones are localized either in the gallbladder or in the bile ducts leading away from the gall bladder and cause a characteristically radiating pain that can extend from the right upper abdomen to the back. The pain is usually accompanied by nausea and vomiting, and as a complication there may be a ganglion obstruction due to possible gallstones. A very special upper abdominal pain is that of acute pancreatitis (= inflammation of the pancreas).
The pain is belt-like, can radiate into the back and typically occurs very suddenly. Nausea and vomiting also count as accompanying symptoms. After eating, the pain in the upper abdomen may even intensify, so that after the diagnosis, the indication for food abstinence is often given until there is no pain.
With children, it should be kept in mind that upper abdominal pain is not always due to organic causes, but is often psychological in nature. Children like to project mental suffering and anxiety as pain on the abdomen. Stress, for example, can cause abdominal pain in children.
