Abdominal Pain: Just Gas Or An Emergency?

Most of us have had some kind of stomach or side pain; it's usually a stitch or a cramp and passes with time and rest.  But how do you know if it's something more serious-or even something that should be evaluated in the emergency room?  Dr. Donnica discusses the different types of stomach and side pain, from having eaten too much to having a ruptured appendix, and how you can tell if you should see your doctor soon rather than later. 

For some women, a pain in the side of the abdomen is a common symptom of indigestion; for others it heralds the beginning of a trip to emergency surgery.  Telling the difference between the two is not always easy.  There are several organs in the abdomen.  Irritation, inflammation, or infection of any of them can irritate the nerves that surround them and refer pain to other areas of the abdomen, the pelvis, and even to the back or between the shoulder blades.  Often, the amount of pain perceived is not directly related to the magnitude of the problem.  For example, a tiny amount of blood in the abdomen (from a leaking ovarian cyst, for example) can cause a great deal of pain whereas a large ovarian cyst may only cause a twinge of pain when it moves in a certain direction.  Gas pain can be extremely painful, whereas a woman might not feel the symptoms of a tubal pregnancy until it's fairly developed.  In addition, organs outside the abdomen can refer pain to the abdomen.  The most common serious example is the pain of angina (insufficient blood flow to the heart) which can mimic indigestion or even the early signs of a heart attack.

The most important rule of thumb to follow is that if you think it's an emergency, it is.  When in doubt, call your health care provider immediately.  If it turns out to be "just indigestion", be grateful.  Too often serious warning signs are missed because people don't take their symptoms seriously enough or act soon enough.  The guidelines below should help.

The diagnoses of acute abdominal pain are numerous and diverse.  They include the following:

• indigestion/gas pain
• constipation
• menstrual or cramps
• gallbladder pain
• bladder or kidney infection
• pelvic inflammatory disease
• endometriosis
• ectopic (tubal) pregnancy
• appendicitis
• ovarian cysts
• ulcers
• other rare conditions presenting with abdominal pain:  angina, heart attack, abdominal aneurysm, abdominal migraine, pericarditis, pancreatitis, hepatitis, certain tumors.