Pregnancy
If the pain and spasms in the abdomen always occur in connection with the patient’s monthly menstrual bleeding, the classification is relatively easy in most cases and the affected persons usually already know themselves that the cramps then occur due to menstruation and no further clarification of the cause is necessary. The pain that occurs during menstruation is described by many women as so-called “Mittelschmerz”. Fortunately, this pain is not pathological, but occurs physiologically at monthly ovulation – in some women a little more and in others a little less pronounced. A further cause of pain in the abdominal area can also be inflammation of the fallopian tubes or the uterus. In most cases these are accompanied by an irregular period and, like all irregularities and changes in the menstrual cycle, should be discussed and clarified with the treating gynaecologist.
Left, right, center
Of course, it is only in the rarest of cases that the doctor is able to determine the cause of the pain and spasms from the location of the pain and spasms in the abdomen alone. However, it does provide certain characteristics that can give the doctor an important clue in his search for the right diagnosis. If the pain tends to originate in the right upper abdomen, an inflammation of the gallbladder (a so-called cholecystitis), or a perforation of the gallbladder, for example, may be considered.
Pain and cramps in the right lower abdomen direct the suspicion of a problem concerning the appendix. In most cases, this is appendicitis or, in women, inflammation of the right ovary or fallopian tube (pelvic inflammatory disease). Complaints in the right lower abdomen are also indicative of appendicitis or diverticulitis (an inflammation of pathologically formed sacs in the muscles of the intestinal wall).
The upper middle abdomen could be painful as a result of an inflammation of the stomach, duodenum or pancreas. Pain localized in the middle upper abdomen often indicates inflammation of the lower esophagus, which often occurs in patients with pathological reflux.