Abdominal Pain:

What is abdominal pain?

Abdominal pain is pain that is felt in the abdomen.  The abdomen is an anatomical area that extends from the lower margin of the ribs above, the pelvic bone below, and the flanks on each side.  Although abdominal pain can arise from the tissues of the abdominal wall that surround the abdominal cavity, the term abdominal pain typically is used to describe pain originating from organs within the abdominal cavity.  These organs may include the stomach, bowels, liver, gallbladder, and pancreas.  Sometimes, pain may be present in the abdomen even though it is arising from organs that are close to but not within the abdominal cavity, for example, the lower lungs, the kidneys, and the uterus or ovaries. 

What causes abdominal pain?

Abdominal pain is caused by inflammation, by stretching or distention of an organ, or by loss of the supply of blood to an organ.  Occasionally, abdominal pain also can occur without inflammation, distention or loss of blood supply.  An important example of this latter type of pain is the irritable bowel syndrome (IBS).  It is not clear what causes the abdominal pain in IBS, but it is believed to be due either to abnormal contractions of the intestinal muscles (known as spasms) or abnormally sensitive nerves within the intestines that give rise to painful sensations.  Other common causes may be:

• excessive gas
• chronic constipation
• lactose intolerance
• heartburn
• indigestion
• ulcers
• Crohn’s disease
• Ulcerative colitis

Inform your physician if…

You should be prepared to tell your physician about any of the following items:

• Medications you are currently taking, including herbs, vitamins, minerals, and food supplements
• Allergies
• The medications that you have tried for your abdominal pain
• Important medical illnesses
• Previous surgeries
• Previous medical procedures
• Previous hospitalizations
• Ill family members who have symptoms similar to yours
• Family members with gastrointestinal diseases (involving the esophagus, stomach, intestines, liver, pancreas, and gallbladder).

Also be prepared to the following items to your physician:

• When the pain first started
• If there were previous episodes of similar pain.
• How frequently episodes of pain occur
• If each episode of pain starts gradually or suddenly
• The severity of the pain
• What causes the pain and what makes the pain worse
• What relieves the pain
• The characteristics of the pain. Is the pain sharp or dull, burning or pressure like? Is the pain jabbing and fleeting, steady and unrelenting or crampy (coming and going)?
• If the pain is associated with fever, chills, sweats, diarrhea, weight loss, constipation, rectal bleeding, loss of appetite, nausea or loss of energy

Treatment options:

Your treatment depends on what is causing your pain, but may include:

• Pain relief - your pain may not go away fully with painkillers but it should ease
• Fluids - you may have fluids given into a vein to correct fluid loss and rest your bowel
• Medicines - for example, you may be given something to stop you vomiting
• Fasting - your doctor may ask you not to eat or drink anything until the cause of your pain is known

Treatment options:

The treatment options will be determined by a physician and may be dictated by the stage of liver cancer and the overall condition of the patient.  The only proven cure for liver cancer is liver transplantation for a solitary, small (<3cm) tumor.  Presentely, many physicians may dispute this statement.  They may argue that a small tumor can be surgically removed (partial hepatic resection) without the need for a liver transplantation.  Moreover, they may claim that the one and three year survival rates for resection are perhaps comparable to those for liver transplantation. 

However, most patients with liver cancer also have cirrhosis of the liver and would not tolerate liver resection surgery.  The patient may, however, be able to tolerate the transplantation operation, which involves removal of the patient's entire diseased liver just prior to transplanting a donor liver. Furthermore, many patients who undergo hepatic resections will develop a recurrence of liver cancer elsewhere in the liver within several years.  In fact, some experts believe that once a liver develops liver cancer, there is a tendency for that liver to develop other tumors at the same time or sometime in the future.  Other treatment methods may include:

• Chemotherapy
• Chemoembolization (trans-arterial chemoembolization or TACE)
• Ablation techniques
• Proton beam therapy
• Surgery
• Liver transplantation
• Liver resection

Additional patient resources:

• Functions of the bowel
• The American Pain Foundation
• eMedicineHealth.Com
• Abdominal Pain in Children
• Lower Abdominal Pain in Women
• More patient resources

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Last Revised: 06/27/2007