Acute Abdominal Pain JAMA Patient Page

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JAMA Patient Page
Acute Abdominal Pain
John L. Zeller, MD, PhD, Writer; Alison E. Burke, MA, Illustrator;
Richard M. Glass, MD, Editor

KEYWORDS: ABDOMINAL PAIN, ABDOMEN, ACUTE, PAIN.

Acute abdominal pain has a sudden onset, can persist for several hours
or days, and may be caused by a variety of conditions or diseases.
This type of abdominal pain is a common physical complaint and
prompted more than 7 million emergency department visits last year in
the United States. Sometimes abdominal pain stems from constipation or
overeating and goes away without medical treatment. In other cases,
however, the pain may be a warning sign of something more serious.
Accompanying symptoms of nausea, vomiting, or fever along with certain
physical indications (see below) suggest abdominal problems that could
require surgical treatment. It is this situation that doctors often
refer to as an acute abdomen. There are also special and additional
concerns when abdominal pain occurs in infants, children, women, and
elderly persons.

The October 11, 2006, issue of JAMA includes an article about the use
of pain medications and how they may affect the evaluation of patients
with acute abdominal pain.

Next SectionINDICATIONS OF AN ACUTE ABDOMEN
•Abdominal pain

•Guarding (contraction of abdominal muscles and discomfort when the
doctor presses on the abdomen)

•Rigidity (hardness) of abdominal muscles

•Rebound tenderness (an increase in severe pain and discomfort when
the doctor abruptly stops pressing on a localized region of the
abdomen)

•Leukocytosis (increase in white blood cell count)


Previous SectionNext SectionDIAGNOSTIC TESTS FOR EVALUATING ABDOMINAL
PAIN
•Laboratory examinations of blood and urine specimens

•X-rays of the chest and abdomen

•Ultrasound (evaluation of abdominal organs and spaces with sound
waves)

•CT scans (x-ray technique using computer programming to provide
detailed images)

•Endoscopy (a tube passed into the mouth to inspect the upper
gastrointestinal tract or inserted into the rectum to view the lower
gastrointestinal tract)

•Angiography (dye studies exploring major blood vessels)

•Radionuclide scans (injected dyes that identify sources of intestinal
bleeding)


Previous SectionNext SectionCONSULT YOUR DOCTOR IF
•The pain is severe, recurrent, or persistent (lasting more than 6
hours)

•The pain gets worse and stops you from eating or from moving

•Your abdomen is swollen and tender

•The pain is associated with inability to urinate, move your bowels,
or pass gas


Previous SectionNext SectionSEEK EMERGENCY HELP IF
•The pain is accompanied by shortness of breath, dizziness, vomiting,
or high fever

•Pain radiates to your chest, neck, or shoulder

•You vomit blood

•You have vaginal bleeding along with the pain

•You find blood in your stool or urine


Previous SectionNext SectionFOR MORE INFORMATION
•American Academy of Family Physicians
http://familydoctor.org/527.xml

•American College of Surgeons
http://www.facs.org


Previous Section INFORM YOURSELF To find this and previous JAMA
Patient Pages, go to the Patient Page Index on JAMA's Web site at
http://www.jama.com. Many are available in English and Spanish.

Sources: American College of Surgeons, American Academy of Family
Physicians

The JAMA Patient Page is a public service of JAMA. The information and
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TOPIC: PAIN
http://jama.ama-assn.org/content/296/14/1800.ful