What are the common causes of pancreatitis. How to recognize the symptoms of acute and chronic pancreatitis. What are the potential complications of untreated pancreatitis. How is pancreatitis diagnosed and treated. What lifestyle changes can help prevent pancreatitis.

Understanding Pancreatitis: A Comprehensive Overview

Pancreatitis is a condition characterized by inflammation of the pancreas, a vital organ located in the upper left side of the abdomen. This long, thin gland plays a crucial role in digestion by producing enzymes that help break down food. When the pancreas becomes inflamed, it can lead to a range of symptoms and potential complications.

What is the pancreas and its function?

The pancreas is an essential organ in the digestive system, situated behind the stomach. Its primary functions include:

• Producing digestive enzymes to break down fats, proteins, and carbohydrates
• Secreting hormones like insulin and glucagon to regulate blood sugar levels
• Aiding in the absorption of nutrients from food

When the pancreas becomes inflamed, these functions can be disrupted, leading to various health issues.

Types of Pancreatitis: Acute vs. Chronic

Pancreatitis can manifest in two primary forms: acute and chronic. Understanding the differences between these types is crucial for proper diagnosis and treatment.

What is acute pancreatitis?

Acute pancreatitis is characterized by sudden onset inflammation that typically resolves within a few days to weeks. It can be caused by various factors, including:

• Gallstones
• Excessive alcohol consumption
• Certain medications
• High triglyceride levels
• Viral infections

Symptoms of acute pancreatitis often develop rapidly and can be severe, requiring immediate medical attention.

What is chronic pancreatitis?

Chronic pancreatitis is a long-term condition where the pancreas remains inflamed over an extended period. This ongoing inflammation can lead to permanent damage to the organ. Common causes of chronic pancreatitis include:

• Long-term alcohol abuse
• Genetic factors
• Autoimmune disorders
• Recurrent episodes of acute pancreatitis

Symptoms of chronic pancreatitis may develop gradually and persist for years, potentially leading to complications if left untreated.

Recognizing the Symptoms of Pancreatitis

Identifying the symptoms of pancreatitis is crucial for early diagnosis and treatment. While some symptoms may overlap between acute and chronic forms, there are distinct differences to be aware of.

What are the common symptoms of acute pancreatitis?

Acute pancreatitis often presents with the following symptoms:

• Sudden, severe upper abdominal pain that may radiate to the back
• Nausea and vomiting
• Fever
• Rapid heartbeat
• Swollen and tender abdomen
• Worsening pain after eating

These symptoms typically develop quickly and can be intense, prompting individuals to seek immediate medical care.

How do symptoms differ in chronic pancreatitis?

Chronic pancreatitis may present with similar symptoms to acute pancreatitis, but they often develop more gradually and persist over time. Additional symptoms of chronic pancreatitis can include:

• Persistent upper abdominal pain
• Unexplained weight loss
• Oily, foul-smelling stools (steatorrhea)
• Diabetes due to impaired insulin production

It’s important to note that chronic pancreatitis can lead to long-term complications if left untreated.

Causes and Risk Factors for Pancreatitis

Understanding the causes and risk factors associated with pancreatitis can help individuals take preventive measures and seek timely medical attention when necessary.

What are the primary causes of acute pancreatitis?

Acute pancreatitis can be triggered by various factors, including:

• Gallstones obstructing the pancreatic duct
• Excessive alcohol consumption
• Certain medications, such as steroids or antibiotics
• High triglyceride levels
• Abdominal trauma or surgery
• Viral infections, including mumps and hepatitis

In some cases, the exact cause of acute pancreatitis may remain unknown, a condition referred to as idiopathic pancreatitis.

What factors contribute to chronic pancreatitis?

Chronic pancreatitis often develops due to long-term exposure to certain risk factors, such as:

• Prolonged alcohol abuse
• Genetic mutations affecting pancreatic function
• Autoimmune conditions
• Recurrent episodes of acute pancreatitis
• Blockage of the pancreatic duct
• Cystic fibrosis

Identifying and addressing these risk factors can help prevent the development or progression of chronic pancreatitis.

Diagnosis and Medical Assessment of Pancreatitis

Accurate diagnosis of pancreatitis is essential for appropriate treatment and management. Healthcare providers employ various methods to assess and confirm the condition.

How is pancreatitis diagnosed?

Diagnosing pancreatitis typically involves a combination of approaches:

1. Medical history and physical examination
2. Blood tests to check for elevated levels of pancreatic enzymes
3. Imaging studies such as CT scans, MRI, or ultrasound
4. Endoscopic procedures like ERCP (Endoscopic Retrograde Cholangiopancreatography)

These diagnostic tools help healthcare providers determine the presence, severity, and potential causes of pancreatitis.

What additional tests may be required?

In some cases, further testing may be necessary to assess the extent of pancreatic damage or identify underlying causes. These may include:

• Pancreatic function tests
• Genetic testing for hereditary forms of pancreatitis
• Biopsy of pancreatic tissue
• Stool tests to evaluate fat malabsorption

The specific tests ordered will depend on the individual’s symptoms, medical history, and initial diagnostic findings.

Treatment Approaches for Pancreatitis

The treatment of pancreatitis varies depending on whether it is acute or chronic, as well as the severity of the condition. The primary goals of treatment are to alleviate symptoms, prevent complications, and address underlying causes.

How is acute pancreatitis treated?

Treatment for acute pancreatitis typically involves:

• Hospitalization for close monitoring
• Fasting to rest the pancreas
• Intravenous fluids to prevent dehydration
• Pain management with medications
• Nutritional support, potentially through feeding tubes
• Treatment of underlying causes (e.g., gallstone removal)

In severe cases, intensive care may be required to manage complications and support vital organ functions.

What are the treatment options for chronic pancreatitis?

Managing chronic pancreatitis often involves long-term strategies, including:

• Pain management through medications or nerve blocks
• Enzyme replacement therapy to aid digestion
• Dietary modifications to reduce pancreatic strain
• Treatment of diabetes if present
• Lifestyle changes, such as alcohol cessation
• Surgical interventions in severe cases

The treatment plan for chronic pancreatitis is typically tailored to the individual’s specific symptoms and complications.

Preventing Pancreatitis: Lifestyle Modifications and Risk Reduction

While not all cases of pancreatitis can be prevented, certain lifestyle changes and preventive measures can significantly reduce the risk of developing the condition.

How can individuals reduce their risk of pancreatitis?

To lower the risk of pancreatitis, consider the following preventive strategies:

• Limit alcohol consumption or abstain completely
• Maintain a healthy diet low in saturated fats
• Stay hydrated to support pancreatic function
• Quit smoking, as it increases the risk of pancreatic damage
• Manage underlying conditions like high triglycerides
• Exercise regularly to maintain a healthy weight

By adopting these lifestyle modifications, individuals can promote pancreatic health and reduce their risk of developing pancreatitis.

When should you seek medical attention?

It’s crucial to seek immediate medical care if you experience:

• Severe abdominal pain, especially if it radiates to your back
• Persistent nausea and vomiting
• Fever accompanied by abdominal discomfort
• Jaundice (yellowing of the skin or eyes)

Early intervention can prevent complications and improve outcomes for individuals with pancreatitis.

Living with Pancreatitis: Long-term Management and Quality of Life

For individuals diagnosed with chronic pancreatitis, long-term management is essential to maintain quality of life and prevent complications. This often involves a multidisciplinary approach to address various aspects of the condition.

How can patients effectively manage chronic pancreatitis?

Effective management of chronic pancreatitis typically includes:

• Regular follow-up appointments with healthcare providers
• Adherence to prescribed medications and enzyme replacement therapy
• Careful monitoring of blood sugar levels if diabetes develops
• Nutritional counseling to ensure adequate nutrient intake
• Pain management strategies, including non-opioid alternatives when possible
• Support groups or counseling to address the emotional impact of the condition

By actively participating in their care plan, patients can better manage symptoms and improve their overall quality of life.

What dietary considerations are important for pancreatitis patients?

Dietary management plays a crucial role in pancreatitis care. Patients should consider:

• Consuming smaller, more frequent meals to reduce pancreatic strain
• Limiting fat intake, especially saturated and trans fats
• Increasing consumption of lean proteins, fruits, and vegetables
• Avoiding alcohol and tobacco products
• Staying well-hydrated with water and clear fluids

Working with a registered dietitian can help develop a personalized meal plan that supports pancreatic health while ensuring adequate nutrition.

Understanding pancreatitis, its causes, symptoms, and treatment options is crucial for early detection and effective management. By recognizing the signs of pancreatic inflammation and seeking prompt medical attention, individuals can minimize the risk of complications and improve their long-term health outcomes. Additionally, adopting preventive measures and making informed lifestyle choices can significantly reduce the likelihood of developing pancreatitis. For those living with chronic pancreatitis, ongoing management and support are essential to maintaining a good quality of life. Remember, if you experience persistent abdominal pain or other concerning symptoms, don’t hesitate to consult with a healthcare professional for proper evaluation and care.

Pancreatitis: Pain Near Left Side of Belly Button

Feeling pain in any part of the body is worrisome. It’s one thing when you’ve actually been injured. You can tell your doctor that you suffered from a hard blow, a fall, or a car accident. But when the discomfort seems to come out of nowhere, your imagination can run rampant with possible scenarios. Is it possible that it’s nothing and you should just wait it out to see if it goes away on its own? Could it be a serious illness?

What is Pancreatitis?

The pancreas is a long, thin organ located behind the stomach, in the upper left side of the abdomen. It produces enzymes to aid in digestion. If the pancreas becomes inflamed, the condition is known as pancreatitis.

Causes of Pancreatitis

Pancreatitis can be caused by several factors:

Types of Pancreatitis

Acute Pancreatitis

Acute pancreatitis is when the inflammation lasts for only a short period of time. It’s usually a result of gallstones, cystic fibrosis, or excessive alcohol consumption. If the inflammation is caused by alcohol intake, the pain will start gradually and worsen as the days go by.

Chronic Pancreatitis

Chronic pancreatitis is when the damage to the pancreas is so extensive, inflammation lasts for a long time, or symptoms keep recurring.

Symptoms of Pancreatitis

Symptoms of pancreatitis can vary from one person to the next. Some people will have very mild symptoms, while others may feel debilitating pain that interferes with their daily life. These signs include the following:

• Pain on the upper left side of the abdomen
• Pain increases after meals
• Swollen abdomen
• Tenderness when touching the abdomen
• Pain that radiates to the back
• Rapid heart rate
• Rapid pulse
• Lightheadedness when standing up
• Nausea
• Vomiting
• Fever

If the condition is chronic, additional symptoms include:

• Oily stools
• Heightened unpleasant smell to stool
• Weight loss

Sudden movements, deep breaths, and coughing may worsen the pain. After vomiting, there may still be an urge to throw up even after emptying the stomach, resulting in dry heaves.

Complications of Pancreatitis

Pancreatitis can cause the following complications:

1. Toxins entering the bloodstream. Pancreatitis can cause toxins to enter the bloodstream. This can cause damage to the heart, lungs, and kidneys.
2. Kidney failure. This is more likely to happen in older patients. While a person with acute pancreatitis has about a 16% chance of renal failure, when this does happen, the prognosis has an 80% mortality rate.
3. Necrotized tissue. When the condition is severe, pancreatic tissue can necrotize, causing bacteria to infiltrate the bloodstream. This causes reduced blood flow to the organs and life-threatening septic shock.
4. Pancreatic pseudocysts. Pancreatitis can cause fluid-filled sacs to form on the pancreas and abdominal cavity.  If one of these sacs ruptures, the patient can vomit blood, feel weak, or lose consciousness.
5. Diabetes. Pancreatitis can cause damage to the cells that produce insulin. These cells control the amount of sugar in the blood.

Diagnosis and Treatment for Pancreatitis

Your medical provider will ask detailed questions about your symptoms, examine the abdominal area for swelling or tenderness, and run blood tests. The doctor may also order imaging tests to confirm the diagnosis.

Mild Pancreatitis

If pancreatitis is mild, it can go away on its own. However, due to its potential for serious complications (some of them fatal), always seek medical attention if you are experiencing symptoms of the condition.

Treatment options depend on the severity of pancreatitis. For a mild condition, patients require a short hospitalization, intravenous fluids, analgesics, and soft foods low in fat content.

Moderate Pancreatitis

Moderate pancreatitis requires a longer hospitalization, along with a complete avoidance of food. Meals and medications are administered intravenously. The doctor may also prescribe antibiotics.

Severe Pancreatitis

Severe pancreatitis will keep a patient in an Intensive Care Unit (ICU). Regular blood tests will be run to examine white blood cell count and electrolytes. Depending on the extent of damage, the patient may need a ventilator.

If medication and conservative treatment does not result in improvement, surgery may be necessary to remove portions of the pancreas or drain pseudocysts.

Pancreatitis Prevention

Preventing pancreatitis requires lifestyle changes:

Eat healthy. Limit fried foods, since it’s difficult for your body to digest trans fats. These trans fats not only increases the risk of pancreatitis, but also of heart disease and diabetes.

Limit alcohol intake. Excessive consumption of alcohol is the cause of about 70% of pancreatitis cases.

Quit smoking. Smoking makes pancreatitis progress at a faster rate and increases the risk of pancreatic cancer.

Emergency Services in Pearl, Alamo Heights, and La Vernia, TX

The Emergency Clinic has three convenient locations in the greater San Antonio and La Vernia areas. Texas residents can count on our experienced doctors, nurses, and technicians to provide high-quality medical care.

Find the location nearest you by visiting us online or calling 210-930-4500 today!

Abdominal Pain – Unexplained | Cedars-Sinai

Overview

Pain and other abdominal symptoms can signal any number of problems. These range from indigestion to cancer.

Symptoms

Some of the more serious conditions associated with abdominal pain include:

• Acute pancreatitis may cause general, constant and worsening pain in the upper abdomen. Sometimes the pain moves to the upper back. Other possible symptoms are weakness, shortness of breath and nausea.
• Appendicitis starts as general abdominal pain that settles into the lower right side.
• Biliary colic can cause a steady ache in the upper right abdomen. Sometimes the pain spreads to the upper back. Patients may also experience nausea and vomiting.
• Crohn’s disease can present symptoms similar to appendicitis. These include pain in the lower right side and bloody diarrhea.
• Diverticulitis can cause moderate pain in the lower left side of the abdomen that grows worse over time.
• Gallstones may produce severe, cramping pain in the lower right part of the abdomen. Pain may spread to the back.
• Gastroesophageal reflux disease (GERD) causes a burning sensation or discomfort after eating. This occurs especially when the patient is lying down or bending over. GERD may also produce pain in the chest that awakens the patient at night. Other symptoms can be very similar to those of a heart attack.
• Hepatitis may cause pain in the upper right abdomen, nausea and vomiting.
• Pancreatic cancer may produce the same symptoms as pancreatitis.

Treatment

New technologies, such as video cameras that can be swallowed, are now available. These cameras can help diagnose gastrointestinal problems, including unexplained abdominal pain, bleeding with an unknown cause or anemia.

The tiny video camera is swallowed and then eliminated in about 24 hours. The camera sends data to receivers placed on the patient’s body. A recorder worn on the patient’s belt collects the data. Using special software, the doctor can process the data and produce a video with information from the digestive tract. The camera itself is disposable. Patients can continue normal daily activities while the camera is working.

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

Abdominal Pain – Female

Is this your child’s symptom?

• Pain or discomfort in the stomach or belly area
• Female
• Pain found between the bottom of the rib cage and the groin crease
• The older child complains of stomach pain
• The younger child points to or holds the stomach
• Before 12 months of age, use the Crying care guides

Causes of Acute Stomach Pain

• Eating Too Much. Eating too much can cause an upset stomach and mild stomach pain.
• Hunger Pains. Younger children may complain of stomach pain when they are hungry.
• GI Virus (such as Rotavirus). A GI virus can cause stomach cramps as well as vomiting and/or diarrhea.
• Food Poisoning. This causes sudden vomiting and/or diarrhea within hours after eating the bad food. It is caused by toxins from germs growing in foods left out too long. Most often, symptoms go away in less than 24 hours. It often can be treated at home without the need for medical care.
• Constipation. The need to pass a stool may cause cramps in the lower abdomen.
• Strep Throat. A strep throat infection causes 10% of new onset stomach pain with fever.
• Bladder Infection. Bladder infections usually present with painful urination, urgency and bad smelling urine. Sometimes the only symptom is pain in the lower abdomen.
• Appendicitis (Serious). Suspect appendicitis if pain is low on the right side and walks bent over. Other signs are the child won’t hop and wants to lie still.
• Intussusception (Serious). Sudden attacks of severe pain that switch back and forth with periods of calm. Caused by one segment of bowel telescoping into a lower piece of bowel. Peak age is 6 months to 2 years.

Causes of Recurrent Stomach Pains

• Stress or Worries. The most common cause of frequent stomach pains is stress. Over 10% of children have a “worried stomach.” These children tend to be sensitive and too serious. They often are model children. This can make them more at risk to the normal stresses of life. Examples of these events are changing schools, moving or family fights. The pain is in the pit of the stomach or near the belly button. The pain is real.
• Abdominal Migraine. Attacks of stomach pain and vomiting with sudden onset and offset. Often occur in children who later develop migraine headaches. Strongly genetic.
• Functional Abdominal Pains. Functional means the stomach pains are due to a sensitive GI tract. The GI tract is free of any disease.
• School Avoidance. Stomach pains that mainly occur in the morning on school days. They keep the child from going to school.

Pain Scale

• Mild: Your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
• Moderate: The pain keeps your child from doing some normal activities. It may wake him or her up from sleep.
• Severe: The pain is very bad. It keeps your child from doing all normal activities.

When to Call for Abdominal Pain – Female

Call 911 Now

• Not moving or too weak to stand
• You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

• Pain low on the right side
• Could be pregnant
• Constant pain (or crying) for more than 2 hours
• Recent injury to the stomach
• High-risk child (such as diabetes, sickle cell disease, recent stomach or abdomen surgery)
• Age less than 2 years old
• Fever over 104° F (40° C)
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• Moderate pain that keeps from some normal activities
• Mild pain that comes and goes (cramps), but lasts more than 24 hours
• Fever is present
• Bladder infection (UTI) suspected (passing urine hurts, new onset wetting)
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• Stomach pains are a frequent problem
• You have other questions or concerns

Self Care at Home

Seattle Children’s Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Care Advice for Stomach Pain

1. What You Should Know About Stomach Pain:
   • Mild stomach pain can be caused by something simple. It could be from gas pains or eating too much.
   • Sometimes, stomach pain signals the start of a viral infection. This will lead to vomiting or loose stools.
   • Watching your child for 2 hours will help tell you the cause.
   • Here is some care advice that should help.
2. Lie Down:
   • Have your child lie down and rest until feeling better.
3. Clear Fluids:
   • Offer clear fluids only (such as water, flat soft drinks or half-strength Gatorade).
   • For mild pain, offer a regular diet.
4. Prepare for Vomiting:
   • Keep a vomiting pan handy.
   • Younger children often talk about stomach pain when they have nausea. Nausea is the sick stomach feeling that comes before they throw up.
5. Pass a Stool:
   • Have your child sit on the toilet and try to pass a stool.
   • This may help if the pain is from constipation or diarrhea.
   • Note: for constipation, moving a warm wet cotton ball on the anus may help.
6. Do Not Give Medicines:
   • Any drug (like ibuprofen) could upset the stomach and make the pain worse.
   • Do not give any pain medicines or laxatives for stomach cramps.
   • For fever over 102° F (39° C), acetaminophen (such as Tylenol) can be given.
7. What to Expect:
   • With harmless causes, the pain is most often better or gone in 2 hours.
   • With stomach flu, belly cramps may happen before each bout of vomiting or diarrhea. These cramps may come and go for a few days.
   • With serious causes (such as appendicitis), the pain worsens and becomes constant.
8. Call Your Doctor If:
   • Pain becomes severe
   • Constant pain lasts more than 2 hours
   • Mild pain that comes and goes lasts more than 24 hours
   • You think your child needs to be seen
   • Your child becomes worse
9. Extra Help – Worried Stomach:
   • Help your child talk about events that trigger the stomach pain. Talk to your child about how to cope with these the next time around.
   • Help your child worry less about things she can’t control.
   • To treat the pain, help your child get very relaxed. Lying down in a quiet place and taking slow deep breaths may help. Make the belly go up and down with each breath. Then try to relax all the muscles in the body. Think about something pleasant. Listening to audios that teach how to relax might also help.
   • Make sure your child gets enough sleep.
   • Make sure that your child doesn’t miss any school because of stomach pains. Stressed children tend to want to stay home when the going gets rough.
   • Caution:your child should see her doctor for an exam. Do this before concluding frequent stomach pains are from worrying too much.

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 11/27/2021

Last Revised: 10/21/2021

Copyright 2000-2021. Schmitt Pediatric Guidelines LLC.

Sudden pain around navel | The New Times

Dear doctor;

I experience sudden pain around the navel even when I have eaten nothing except for something like tea. I tried to go for medical checkup but the cost was too prohibitive and now I am having to wait a bit longer. However, could you help me know what it could be that is causing me this pain? It happens about three to four times a week and usually lasts for betwen 30 minutes and an hour.

Nkurunziza, 27.

 Dear Nkurunziza,

At a young age, pain occurring around navel area is mostly due to protozoal or helmenthic infections like amoebiasis, giardiasis or ascaris. In such infestation, the pain is usually intermittent and colicky, that is, cramp-like. It may be associated with diarrhea or constipation. If the infestation is mild, it may occur transiently and subside by itself as some infectious agents form cysts and then lie dormant for sometime. It is only when they multiply inside the bowels that pain recurs again. Such pain can also occur due to food poisoning which is result of consuming contaminated food or water. A simple stool analysis helps to diagnose these conditions and a suitable anti infective agent cures the condition. Good food hygiene helps to prevent such types of infection.

Peptic ulcers usually cause pain in upper part of abdomen but can cause burning pain around umbilical area as well. Simple indigestion can cause pain around navel. It may be associated with sense of bloating of abdomen after food and nausea. One may get pain around navel if there is chronic constipation. If the bowels are not cleared regularly, they tend to be loaded with fecal matter. This causes pain, sense of heaviness and general feeling of dullness and headache or bodyache.

Certain types of food allergies can also cause pain around the belly button (navel area) Food allergies commonly are allergy  to milk and meat products but can be to any type of food. There may be associated skin rashes, running of nose or other features of allergy. All these causes are benign. Apart from causing pain and discomfort, these cause no serious health problem.

But if the pain is excruciating, persistent and is associated with vomiting, one should immediately consult a hospital to rule out sinister causes such as a bowel occlusion, acute pancreatitis or rarely even pain of appendicitis can be in navel area.

Pelvic Pain in Women | Acute & Chronic Pelvic Pain Specialists

The pelvic floor muscles are located between the legs and run from the pubic bone (at the front), right through to the base of the spine (at the back). They are shaped like a sling of muscles and nerve endings, and their job is to hold the pelvic organs (uterus, vagina, rectum, bowel and bladder) in place.

What Does Pelvic Pain Feel like?

Pelvic pain is much more common in women than men and can be caused by a wide variety of health conditions or diseases. It is felt in the lowest part of the abdomen and pelvis, below the belly button.

A woman may briefly experience a dull or sharp pain, which comes on suddenly and is severe (acute pelvic pain), or as a constant or intermittent pain which lasts for six months or longer (chronic pelvic pain).

Pelvic pain can also vary in its severity. In fact, sometimes it is so intense that it feels like a hot poker is inside the vagina. In any scenario, the pain may also transfer to the lower back, buttocks or thighs.

Pelvic Pain Causes

There are many causes of pelvic pain, some of which are much more serious than others. Gynaecologists have, in recent years, reported that chronic pelvic pain can arise from multiple conditions.

Acute Pelvic Pain

Acute pelvic pain is pain which manifests itself suddenly and for the first time. If you are experiencing this type of pelvic pain, it is important to seek immediate medical attention.

In women who are not pregnant, there are several common causes of acute pelvic pain, which includes:

• Ovarian Cysts – which are fluid-filled sacs that develop on an ovary.
• Pelvic Inflammatory Disease (PID) – which are bacterial infections in the womb, often occurring as a result of a sexually transmitted infection, particularly Chlamydia or Gonorrhoea. PID requires immediate treatment via antibiotics, as leaving it untreated can lead to infertility.
• Urinary Tract Infection (UTI) – an infection of the urinary system which causes a painful burning sensation when using the toilet, or the need for frequent urination.
• Constipation – which causes pain in the abdomen and normally occurs because of dietary changes, some medications, or Irritable Bowel Syndrome (IBS).
• Appendicitis – where the appendix swells up. This is normally very painful on the right-hand side of the lower abdomen.
• Peritonitis – which is the inflammation of the peritoneum; the tissue which lines the inside of the abdomen. Symptoms are sharp, sudden pain in the abdomen which slowly gets worse. Immediate treatment is vital.

Other, less common causes of acute pelvic pain are:

• Pelvic abscesses – which is a collection of pus between the vagina and womb. This requires urgent medical treatment in A&E.
• Endometriosis – a chronic, long-term condition where the tissue which lines the womb grows outside of the uterus and causes frequent pain, particularly during menstruation.

Chronic Pelvic Pain

Pelvic pain which has lasted for six months or more is known as chronic and affects around 1 in 6 women. It can either come or go, or may be constant, and is normally more severe than normal pain experienced during a woman’s period.

If you are experiencing chronic pelvic pain, you should speak to your GP at the soonest opportunity.

There are several common causes of this type of pelvic pain, some of which are the same as acute pelvic pain:

• Endometriosis
• Pelvic Inflammatory Disease
• Irritable Bowel Syndrome – which is a long-term condition affecting many people. Symptoms include bloating, abdominal (stomach) cramps, constipation and diarrhoea.

Other, less common causes of chronic pelvic pain include:

• Recurrent ovarian cysts
• Recurrent UTIs
• Pain of the lower back
• Fibroids – which are tumours growing in or around the womb. They are typically non-cancerous, but in a few cases, can cause pain, particularly where they have become twisted.
• Womb prolapse – which is where the womb has slipped down into a different position, causing a ‘dragging’ feeling.
• Adenomyosis – which is endometriosis that is affecting the womb muscles and causing heavy, painful periods.
• Chronic Interstitial Cystitis – which is a long-term condition where the bladder is inflamed.
• Inflammatory bowel disease – which includes two chronic conditions; Crohn’s disease and Ulcerative Colitis.
• A hernia – which means an internal body part has pushed through into the muscle or tissue wall surrounding it

When to see a doctor

In most cases, pelvic pain is caused by benign conditions which are non-cancerous, but that is not to say that pelvic pain which is not cancer-related cannot still be very serious. For instance, some situations causing sudden, severe pelvic pain, like ectopic pregnancy or appendicitis, need to be dealt with as a matter of urgency, as they can be life-threatening.

In other instances, such as where severe pelvic pain suddenly develops, where you do not know what the underlying cause of the abdominal pain is, or where the pain keeps coming back, you should also seek medical attention as soon as possible, as it can be a sign of something very serious.

In certain cases, your GP might refer you to a specialist gynaecologist, particularly if the cause of the pelvic pain is not immediately clear.

To help your GP come to an accurate diagnosis, it is a good idea to keep a record of where your pain occurs, how severe it is and what you were doing when it took place. You can also write down what helped relieve the pain, such as paracetamol or a hot compress. Creating pain diaries are particularly useful for those who experience chronic pelvic pain.

Investigation and clinical diagnosis

When seeking medical attention for pelvic pain, your GP will ask several questions, such as medical and family history, and you will also undergo a medical examination. Based on what is found, you may be treated, or you may have to undergo further tests or be referred to a specialist.

Because one of the most common causes of pelvic pain is a urinary infection, your GP will normally ask for a urine sample. You may also be screened for various common sexually transmitted infections, including Chlamydia and Gonorrhoea. Blood tests may also be necessary to diagnose certain causes.

Your doctor will probably want to undertake a pelvic examination too, which might include a cervical screening test, which allows them to check for possible abnormalities of the cervix, vagina, uterus and ovaries.

If there is a chance you might be pregnant, a pregnancy test might be undertaken. Where the patient is pregnant, an emergency ultrasound may be necessary to determine if a miscarriage or ectopic pregnancy is the cause of pelvic pain. In such cases, you will likely be referred to a local hospital which has such scanning devices. Routine ultrasound scans can also be used to help diagnose other common causes of pelvic pain, such as ovarian cysts.

In some cases, further investigations may be required and patients may be referred to specialist gynaecologists for a diagnostic laparoscopy (keyhole surgery). This is undertaken when pain is persistent, severe and an underlying cause cannot be found be normal medical investigative means.

A laparoscopy involves making small incisions in the abdomen and then passing through a small telescope to be able to see inside the body.

15 possible causes and treatments

Lower abdominal pain in women generally refers to pain, discomfort or cramps below the belly button. From appendicitis to period cramps, there are a number of potential causes for lower abdominal pain in women and the right treatment depends on the correct diagnosis.

Dr Juliet McGrattan looks at 15 possible causes of lower abdominal pain in women, so you know when to reach for the hot water bottle or when to call your doctor:

What is lower abdominal pain?

When we talk about lower abdominal pain, we generally mean pain that you feel below the level of your belly button. It can come from any of the tissues and organ systems in that area, which is why it can be very confusing. Pain which is very low down is termed pelvic pain but we’ll be including it as lower abdominal pain for this guide.

Describing your lower abdominal pain

When a doctor asks you about your pain, they will want to know where exactly you are feeling the pain. This can be a useful indicator of what the cause might be.

They’ll also want to know how long you’ve had the pain, the severity and the nature of the pain; is it coming or going or is it continuous? They will ask you to describe how the pain feels, is it sharp, dull, crampy or burning for example.

Associated symptoms such as diarrhoea, vomiting and urinary symptoms can all help to distinguish the cause so your doctor will question you about these as well.

15 possible causes of lower abdominal pain in women

We’ll explore the causes of lower abdominal pain by their location to make it easier to work out what is causing your pain.

Pain around the belly button

If you experience pain around the belly button (peri-umbilical) it could be one of the following:

• Early appendicitis

Inflammation of the appendix is often initially felt around the belly button. It may come and go and gradually move to the right side. It gets more severe over 24 hours and is worse on movement. You may feel nauseated, have slight loose stools and a temperature. Surgery is often required to remove an inflamed appendix so don’t wait at home if you think this may be the diagnosis.

• Stomach ulcers

Conditions of the stomach lining such as inflammation (gastritis) or ulcers may be felt in the centre of your abdomen. The pain is often burning in nature. Nausea, indigestion, belching and even vomiting are common. Blood in the vomit or black, tar-like stools are worrying signs and need urgent assessment. Treatment to stop acid production and ease pain are required so see your doctor.

altrendo imagesGetty Images

Pain just above the pubic bone

If you experience pain just above the pubic bone (supra-pubic) it could be one of the following:

• Bladder pain

Bladder pain is generally a low central pain. Cramping and burning during or after passing urine might indicate an infection. With a urine infection you might need to go for a wee more often, notice blood in your urine and feel tired and sick. If your symptoms aren’t settling with plenty of fluids, then you need to see your doctor for possible antibiotics. Bladder stones can cause pain in this area too with a sharper, more severe pain and difficulty passing urine.

• Period pain

Crampy, low, central pain is typical of menstrual pain (dysmenorrhoea) although it may radiate across to the sides too. Period pain can start in the days leading up to bleeding commencing but usually eases up after a few days of blood loss. Pain killers from the pharmacist, a hot water bottle and gentle exercise can all help.

• Pelvic Inflammatory Disease (PID)

An infection in your womb, tubes or ovaries can be quite mild with occasional pain or more severe with intense pain and fever. Other symptoms include discoloured vaginal discharge, bleeding unexpectedly and pain when having sex (dyspareunia) or passing urine. A quarter of cases are due to a sexually transmitted infection so a full sexual health screen is needed if this is a possibility. Attend your local sexual health clinic or GP if you think you have PID.

Pain on one side

Sometimes low abdominal pain is felt on one side. It can be anywhere from just beside of your belly button, right down to your groin, and could be one of the following:

• Ovulation pain

Also known as mittelschmerz, this sharp pain can occur when your ovary is releasing an egg in the middle of your menstrual cycle, so about two weeks before your period. It may be on the right or the left side, depending on which ovary is releasing an egg that month. Although it can be severe, it is usually short lived and is normal and not harmful.

• Ovarian cysts

Ovarian cysts are rarely painful. Most will go away on their own and it’s only if they become particularly large, twist or rupture that they produce pain. You might experience bloating, pain during sex or need to keep passing urine frequently. Thankfully only a small minority of ovarian cysts are cancerous and this is usually in women who have been through the menopause. You should see your doctor however if you think you may have an ovarian cyst.

• Ectopic pregnancy

This is where a fertilised egg doesn’t make it as far as the womb and tries to grow a foetus in the fallopian tube. The pregnancy cannot continue and surgery is often required to remove it. If left untreated ectopic pregnancy can pose a threat to the mother’s life as well as her future fertility. If you have low one-sided abdominal pain and have missed your period or think you may be pregnant then you should see a doctor as soon as possible.

PhotoAlto/Laurence MoutonGetty Images

• Endometriosis

Tissue from the lining of the womb (endometrium) is sometimes found elsewhere in the abdomen and pelvis and causes pain when it bleeds during menstruation. This pain may be central and generalised but as the ovary and fallopian tubes are common sites for endometriosis then pain is often one sided. Treatments include pain killers, hormonal therapies and surgery.

• Appendicitis

As mentioned above, the pain from appendicitis can start centrally but usually settles low down on the right hand side of the abdomen where the appendix is located. It hurts to press in this area and is also worse when you cough, sneeze or move.

• Pyelonephritis

Infection in a kidney gives pain on one side which may originate from or spread through to your back. You may have urinary symptoms such as pain on weeing, have blood in your urine and feel generally unwell. It’s common to feel nauseated, vomit and have a high temperature. These infections are usually bacterial and require antibiotics so don’t delay seeing your doctor.

• Muscular pain

It’s easy to forget that a simple muscle strain can cause pain in the abdomen. The pain can be quite severe when the muscle is moved so consider it if you have been working out or the pain has a muscular feel to it. Warm baths and pain killers will usually settle muscular pains.

Generalised pain

Lots of conditions produce more of an all over pain which doesn’t seem to focus on one location, and could be one of the following:

• Constipation

A common cause of abdominal pain and often associated with nausea, loss of appetite and bloating. The pain is often all over but may be felt on the left hand side where the large bowel descends to the rectum. Treatment involves drinking plenty of fluids, taking exercise and eating fibrous foods. Speak to your pharmacist about laxatives if you are struggling to get your bowels working.

• Irritable Bowel Syndrome (IBS)

Pain from IBS can be anywhere in your abdomen and is often associated with bloating, constipation or diarrhoea. It can be constant or colicky (in waves). IBS is a long term condition and treatment focuses on spotting triggers such as stress and learning to manage the condition through diet and a healthy lifestyle.

• Gastroenteritis

Infections of the bowel such as viruses and food poisoning can cause generalised abdominal pain. It can be a dull ache but often crescendos and cramps up prior to episodes of diarrhoea, vomiting or both. Most bouts of gastroenteritis settle in a few days and the priority for treatment is to avoid dehydration so small amounts of fluids often is advised. If you are concerned you are getting dehydrated or your symptoms are getting worse or not settling after a week then see your doctor.

Abdominal pain examination and investigations

Your doctor will have a good idea as to what might be causing your pain after listening to your description and asking questions. They will usually examine your abdomen too to see if there is any pain on pressing on certain areas of your tummy and to check for any lumps.

They may be able to give you a diagnosis and recommend treatment but if any further clarification is needed then further tests will be arranged. These will vary according to what condition is suspected but may involve:

• Taking urine, stool or blood samples
• Taking vaginal swabs
• Arranging a scan of your abdomen
• Possibly referring you to a specialist

It can be a tricky business figuring out exactly what the cause of lower abdominal pain is so do make an appointment if you are concerned and always go back to your doctor if your symptoms aren’t resolving.

When to see a doctor for lower abdominal pain

Rather than trying to diagnose your own pain, if you have any of the following symptoms then see your doctor as soon as possible:

• Severe pain
• Pain that continues to get worse
• A high temperature
• Blood in your poo – either fresh or black and smelly
• Pain when you are pregnant or think you could be
• Inability to walk around due to the pain
• Recurrent vomiting especially if there is blood in your vomit
• A persistent change in your bowel habit

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Last updated: 18-08-2020

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Pregnancy symptoms you should never ignore

Even if you’ve read lots about pregnancy and spoken to other mums about your pregnancy symptoms, there will still be times when you wonder if what you’re feeling is normal or not.

The following pregnancy symptoms should set off a few alarm bells. If you experience them you should call your midwife, doctor, or your maternity unit straight away.

Add the number of your maternity unit to your phone contacts so you can speak to a midwife without delay if you need to.

I have a pain in my middle

Severe or sharp pain in your middle or upper tummy, with or without nausea or vomiting, could mean one of several things. You could have:
If you’re in the second half of your pregnancy, pain in your middle, usually just under your ribs, could indicate severe pre-eclampsia (August and Sibai 2019, NICE 2019a). This is a serious condition for which you’ll need immediate medical help.

I have a pain in my lower belly

Severe pain on either side or both sides of your lower belly needs investigating, to be sure it’s nothing serious. You could have pulled or stretched a ligament (Aguilera 2018, NHS 2018a), which is common in pregnancy.

Conditions that may cause stomach pain, and need to be checked urgently, include:

• Ectopic pregnancy. Symptoms typically appear between four weeks and 12 weeks of pregnancy (NHS 2018a, RCOG 2016a).
• Miscarriage. Cramping pains and bleeding before 24 weeks of pregnancy (NHS 2018a, RCOG 2016b).
• Pre-eclampsia. It typically starts after 20 weeks or just after the baby is born (NHS 2018a).
• Premature labour. If you’re less than 37 weeks pregnant and you’re having regular abdominal cramps or tightenings, call your midwife straightaway (NHS 2018a, NICE 2015a).
• Fibroids. These may cause abdominal pain at any point during pregnancy (NHS 2018b, Todd 2018a).
• Placental abruption. This is a serious condition when the placenta separates from the lining of your womb (uterus). It is most likely to happen in late pregnancy and means your baby may have to be delivered urgently (NHS 2018c, Gaufberg 2015).

I have a fever

If you have a fever and your temperature is above 37.5 degrees C, but with no cold symptoms, call your doctor the same day (Tommy’s 2018).

If your temperature is more than 39 degrees C, call your local maternity unit straight away (Todd 2018b). You probably have an infection which may need treating urgently with antibiotics. If your temperature rises higher than 39 degrees C for a long time it may be harmful to your baby (Dreier et al 2014).

My vision is blurred and I see flashing spots

Call your doctor or midwife if, in the second half of your pregnancy, your eyesight is affected by:

• double vision
• blurring
• dimming
• flashing spots or lights before your eyes

These visual disturbances may be a sign of pre-eclampsia (August and Sibai 2019, NICE 2019a).

My hands and feet are swollen

Swelling or puffiness (oedema) in your hands, face and eyes is common in late pregnancy (NHS 2018d). In most cases, it’s not a cause for concern (NHS 2018d). But if your swelling comes on suddenly, or has become more severe, and you have a headache or problems with your vision, you may have pre-eclampsia (NHS 2018d, NICE 2019a). If you notice any of these symptoms, call your doctor or midwife straight away.

I have a headache that won’t go away

If your headache doesn’t stop or is recurring, and you have visual disturbances and sudden swelling in your body, you may have pre-eclampsia (August and Sibai 2019, NICE 2019a). If pre-eclampsia occurs, it is usually in the second half of your pregnancy or soon after your baby is born (August and Sibai 2019, NICE 2019a).

My leg feels tender and swollen

Pain, tenderness or swelling in your leg could be a sign of a clot or deep vein thrombosis (DVT) (NICE 2018a, RCOG 2015). This is more common in the left leg during pregnancy than the right (Malhotra and Weinberger 2018). Other signs of a DVT include redness or warmth in the affected area and veins that look larger than normal (NICE 2018a).

I have vaginal bleeding

Spotting or very light bleeding with or without pain is common in early pregnancy (Norwitz and Park 2019). Light bleeding in very early pregnancy usually resolves itself and is unlikely to harm your baby (NHS 2018e, Norwitz and Park 2019).

Even so, always check with your doctor or midwife if you bleed at any stage during your pregnancy (NHS 2018e, RCOG 2011a). It may indicate a serious complication if it is:

• Bleeding that’s different from your normal period, so lighter in flow or darker in colour than usual. This, with severe, persistent, one-sided pain in your tummy, may be a sign of an ectopic pregnancy (NHS 2018e, RCOG 2016a).
• Heavy bleeding, combined with persistent back pain or abdominal pain. This may be a sign of miscarriage (NHS 2018e, NICE 2019b).
• Sudden, painless bleeding. This may happen if you have a low-lying placenta (placenta praevia) (NHS 2018e, RCOG 2018), which will have been seen at your 20-week scan (RCOG 2018).
• Sudden light to heavy bleeding in later pregnancy could mean you have placental abruption (Ananth and Kinzler 2019, RCOG 2011a). This is when the placenta starts to separate from the wall of your womb. Depending on the position and extent of the separation, it can cause either a small amount of bleeding or a gush, as well as pain and tenderness (Ananth and Kinzler 2019, Gaufberg 2015).
• Heavy bleeding, or the mucus plug coming away (bloody show) may mean you’re going into premature labour, if you’re less than 37 weeks pregnant (NICE 2015a, RCOG 2011a).

Bleeding in the last trimester may be less of a concern if it only happens after sex or you’re past 37 weeks and it’s part of the mucus plug coming away. However, you must call your midwife straightaway if the bleeding is sudden, bright red or heavy (NHS 2018e, RCOG 2011a).

Find out more about bleeding in the later stages of pregnancy.

I’m leaking fluid from my vagina

If you are leaking fluid from your vagina before 37 weeks it may mean that your waters have broken early. Contact your maternity unit so that a doctor or midwife can check on your baby’s health (RCOG 2019). You may need treatment if there are signs of an infection (RCOG 2019).
Once your waters have broken, your baby has less protection against infection. Or you could already have an infection that has made your waters break (RCOG 2019). You may need to prepare for a premature birth (RCOG 2019). You’ll have a specialist team on hand in the hospital to make sure you and your baby get the right care.

When your waters break after 37 weeks, you’re likely to go into labour within the next day or so (NICE 2014). Call your midwife or maternity unit to tell them what’s happened. You’ll probably be asked to go to hospital to be checked over, and to discuss what’s best to do if your labour doesn’t start within 24 hours (NICE 2014).

It’s normal to have plenty of clear or milky white vaginal discharge during pregnancy and a show as the mucus plug comes away towards the end of your pregnancy (NHS 2018f). However, thick, white discharge with itching or irritation around your vagina could be a sign of thrush (NHS 2018f). While discharge that becomes smelly or a green or yellow colour could indicate an infection (NHS 2018f), such as bacterial vaginosis.

I’m suddenly really thirsty

If you’re suddenly thirsty, and your wee is dark yellow, it could be a sign of dehydration (BDA 2017, RCOG 2016c). You need to drink more fluid when you’re pregnant.

If you’re thirsty and weeing a lot more than usual it could be a sign of gestational diabetes, although this often doesn’t cause symptoms (NHS 2019a).

Gestational diabetes can increase the risk of complications for you and your baby (NHS 2019a, NICE 2015b), so tell your doctor or midwife.

I feel a burning sensation when I wee

You may have a urinary tract infection (UTI) if you:

• feel a painful or burning sensation when weeing
• have a frequent urge to wee, even if you’ve only just been, and may be wetting yourself when you get the urge
• pass cloudy, bloody or smelly wee
• have a fever, pain in your abdomen, back or sides, and shivers
  (NICE 2019c)

If you have any of these symptoms, see your doctor, as she can give you antibiotics to treat your UTI (NICE 2019c).

I’m constantly vomiting

Vomiting more than a couple of times a day could dehydrate and weaken you, although it’s unlikely to hurt your baby. You need to speak to your midwife or GP about severe and persistent vomiting (hyperemesis gravidarum), especially if you can’t keep down any food or drink. You may need treatment, possibly in hospital (NICE 2018b, RCOG 2016c).

If you’re vomiting during the second half of your pregnancy, you may also have severe pain just below the ribs, and sudden swelling in your face, hands or feet. These symptoms may be a sign of pre-eclampsia (NHS 2018g, NICE 2018b).

Vomiting and diarrhoea could be a sign of food poisoning or a tummy bug (NICE 2019d).

If you’re vomiting, feverish and have pain in your side, lower back or around your genitals, it could mean you have a kidney infection. If you have these symptoms you should contact your doctor (NHS 2018h, NICE 2018b).

I feel faint and dizzy

Fainting or feeling light-headed may be a sign that you haven’t eaten enough that day. But it could also mean that you have low blood pressure, which is common in early pregnancy (Marks 2019, Stöppler 2016). That’s because the pregnancy hormone progesterone relaxes the walls of your blood vessels (Stöppler 2016).

Many women feel dizzy during pregnancy, but if you faint you should see your doctor afterwards to make sure all is well.

My baby’s movements have changed

If you are between 24 and 28 weeks and you’ve noticed that your baby’s pattern of movements have changed, contact your midwife or hospital, as it may mean he’s in distress. If you’re over 28 weeks, do this immediately, day or night (RCOG 2012a). Read more about your baby’s movements, including when to seek help if you haven’t felt your baby move yet.

Head over to Tommy’s website to find out what should happen when you report reduced fetal movement.

Should I count my baby’s kicks?

You may have heard that you should count your baby’s kicks, but is this really what midwives recommend? Watch our video.More pregnancy videos

I itch all over

If you have severe itching all over, particularly at night, you may have obstetric cholestasis (OC) (NICE 2015c, RCOG 2012b). OC is a condition of the liver. You may develop jaundice with OC, which can make your wee dark and your poo paler than usual (NICE 2015c, RCOG 2012b).

If you have mild itching, try not to worry too much. Some itching is normal and may be caused by pregnancy hormones (NHS 2019b). Or it may be caused by your skin stretching to accommodate your growing baby (NHS 2019b).

However, it’s best to have intense itching checked out. This is especially the case if the itching is worse at night and centres on the soles of your feet and the palms of your hands (NHS 2019b, RCOG 2012b).

I fell and hit my belly

Falls or blows aren’t always dangerous, but always call your doctor or midwife straight away to explain what happened (Kilpatrick 2019, Krywko and Kiel 2017).

If you had a light fall and didn’t bump yourself hard, such as a slight slip on the stairs, you probably don’t need to worry (Krywko and Kiel 2017, Nall 2016). Your baby is well cushioned by your womb and amniotic fluid.

However, blows to your abdomen may result in complications, such as bleeding (Kilpatrick 2019, NHS 2018c, RCOG 2011a) .

Falls that cause you to bump your head, chest or may have resulted in a sprain or fracture also need checking out (Nall 2016).

If you notice contractions, leaking fluid, changes in your baby’s pattern of movements or any bleeding, call your doctor or midwife right away, or go to your nearest accident and emergency department (A&E) (Kilpatrick 2019, Sakamoto et al 2019).

I just don’t feel right

If you’re not sure about a symptom, don’t feel like yourself, or simply feel uneasy, trust your instincts and call your doctor or midwife (Todd 2018b). If there’s a problem, you’ll get help right away. If nothing’s wrong, you’ll go home reassured.

Your doctor or midwife expects to get calls like these, and will be happy to give you advice. Your body is changing so rapidly that it’s sometimes difficult to know if what you’re experiencing is normal, or if it’s something to worry about.

Discover how to cope with these other pregnancy aches and pains:

Don’t forget to download our free app for a day-by-day guide to your pregnancy. My Pregnancy & Baby Today gives you all the expert advice you need, right at your fingertips.

References

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Ananth CV, Kinzler WL. 2019. Placental abruption: Pathophysiology, clinical features, diagnosis, and consequences. UpToDate. www.uptodate.com [Accessed February 2020]

August P, Sibai BM. 2019. Preeclampsia: clinical features and diagnosis. UpToDate. www.uptodate.com [Accessed February 2020]

BDA. 2017. Fluid (water and drinks): food fact sheet. The Association of UK Dietitians. www.bda.uk.com [Accessed February 2020]

Dreier JW, Andersen AM, Berg-Beckhoff G. 2014. Systematic review and meta-analyses: fever in pregnancy and health impacts in the offspring. Pediatrics 133(3):e674-88

Gaufberg SV. 2015. Emergent management of abruptio placentae.Medscape. emedicine.medscape.com [Accessed February 2020]

Kilpatrick SJ. 2019. Initial evaluation and management of pregnant women with major trauma. UpToDate. www.uptodate.com [Accessed February 2020]

Krywko DM, Kiel J. 2017. Pregnancy trauma. StatPearls. europepmc.org [Accessed February 2020]]

Malhotra A, Weinberger SE. 2018. Deep vein thrombosis in pregnancy: epidemiology, pathogenesis, and diagnosis. UpToDate. www.uptodate.com [Accessed February 2020]

Marks J. 2019. Is it dangerous to have low blood pressure during pregnancy? Healthline, Parenthood. www.healthline.com [Accessed February 2020]

Nall R. 2016. When to be concerned about falling while pregnant. Healthline. www.healthline.com [Accessed February 2020]

NHS. 2018a. Stomach pain in pregnancy. NHS, Health A-Z, Pregnancy and baby. www.nhs.uk [Accessed February 2020]

NHS. 2018b. Fibroids: complications – problems during pregnancy. NHS, Health A-Z, Pregnancy and baby. www.nhs.uk [Accessed February 2020]

NHS. 2018c. What complications can affect the placenta? NHS, Common health questions, Pregnancy. www.nhs.uk [Accessed February 2020]

NHS. 2018d. Swollen ankles feet and fingers in pregnancy. NHS, Health A-Z, Pregnancy and baby. www.nhs.uk [Accessed February 2020]

NHS. 2018e. Vaginal bleeding in pregnancy. NHS, Health A-Z, Pregnancy and baby. www.nhs.uk [Accessed February 2020]

NHS. 2018f. Vaginal discharge in pregnancy. NHS, Health A-Z, Pregnancy and baby. www.nhs.uk [Accessed February 2020]

NHS. 2018g. Pre-eclampsia. NHS, Health A-Z, Pregnancy and baby. www.nhs.uk [Accessed February 2020]

NHS. 2018h. Kidney infection. NHS, Health A-Z. www.nhs.uk [Accessed February 2020]

NHS. 2019a. Gestational diabetes. NHS, Health A-Z. www.nhs.uk [Accessed February 2020]

NHS. 2019b. Itching and intrahepatic cholestasis of pregnancy. NHS, Health A-Z. www.nhs.uk [Accessed February 2020]

NICE. 2014. Intrapartum care for healthy women and babies. National Institute for Health and Care Excellence, Guideline 190. www.nice.org.uk [Accessed February 2020]

NICE. 2015a.Preterm labour and birth. National Institute for Health and Care Excellence, Guideline 25. www.nice.org.uk [Accessed February 2020]

NICE. 2015b.Diabetes in pregnancy: management from preconception to the postnatal period. National Institute for Health and Care Excellence, Guideline 3. www.nice.org.uk [Accessed February 2020]

NICE. 2015c.Itch in pregnancy. National Institute for Health and Care Excellence, Clinical Knowledge Summaries. www.nice.org.uk [Accessed February 2020]

NICE. 2017. Dyspepsia – pregnancy-associated. National Institute for Health and Care Excellence, Clinical Knowledge Summaries. cks.nice.org.uk [Accessed February 2020]

NICE. 2018a. Deep vein thrombosis. National Institute for Health and Care Excellence, Clinical Knowledge Summaries. cks.nice.org.uk [Accessed February 2020]

NICE. 2018b. Nausea/vomiting in pregnancy. National Institute for Health and Care Excellence, Clinical Knowledge Summaries. cks.nice.org.uk [Accessed February 2020]

NICE. 2019a. Hypertension in pregnancy: diagnosis and management. National Institute for Health and Care Excellence, Guideline 133. www.nice.org.uk [Accessed February 2020]

NICE. 2019b. Ectopic pregnancy and miscarriage: diagnosis and initial management. National Institute for Health and Care Excellence, Guideline 126. www.nice.org.uk [Accessed February 2020]

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RCOG. 2015. Information for you: diagnosis and treatment of venous thrombosis in pregnancy and after birth. Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk [Accessed February 2020]

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Sakamoto J, Michels C, Eisfelder B, et al. 2019. Trauma in pregnancy. Emerg Med Clin N Am 37: 317-38. dl.uswr.ac.ir [Accessed February 2020]

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Tommy’s. 2018. High temperature in pregnancy. www.tommys.org [Accessed February 2020]

Pancreatitis: symptoms, treatment, diagnosis

How pancreatitis manifests itself: symptoms and signs

The main list of symptoms in acute form:

• severe pain in the hypochondrium – taking into account the cause of the disease and accompanying pathologies, it can be encircling, right- or left-sided;
• reactions from the digestive tract – hiccups, belching with an unpleasant odor, nausea and repeated bouts of vomiting, constipation or diarrhea;
• general deterioration of the condition – dehydration, a feeling of dry mouth, weakness, increase or decrease in blood pressure, shortness of breath, increased sweating, high temperature;
• external manifestations – dull, sallow skin, cyanotic or brownish spots in the lumbar region and supra-umbilical zone, obstructive jaundice is possible.

Attention! The acute form requires urgent hospitalization followed by hospital treatment.

In the chronic form, the signs of pancreatitis are less pronounced:

• pain appears only after eating fried and fatty foods or alcohol; the rest of the time in the hypochondrium region, slight discomfort may be observed;
• reactions from the digestive system are manifested only in dyspeptic form in the form of flatulence, diarrhea or constipation;
• external skin manifestations in the form of mild yellowness; with prolonged absence of treatment, weight loss, anemia, type 2 diabetes mellitus are observed.

In the latent stage, the disease is asymptomatic; with a fibrous form, scar tissue can grow with the formation of pseudotumor structures.

Important! Pancreatitis of the pancreas rarely manifests itself as an independent disease. Usually, the pathological process unites several digestive organs, involving the hepatobiliary system (liver, gallbladder and ducts), duodenum, and stomach in it.This fact requires diagnostics of the entire human digestive system.

How is the examination of pancreatitis

Diagnosis and treatment of pancreatitis are in the competence of the gastroenterologist. To make a diagnosis, the doctor collects anamnesis, conducts an examination and prescribes diagnostic procedures.

Doctor’s examination

The procedure includes an assessment of the condition of the skin, eye sclera, tongue, salivary glands.Then the patient is placed on a couch and palpated and tapped to identify the objective symptoms of pancreatitis:

• Mussey-Georgievsky symptom, or phrenicus symptom – painful sensations when pressed with fingertips in the area above the left collarbone – where the phrenic nerve passes between the legs of the sternocleidomastoid muscles;
• sensitivity in the Shoffard zone – in the area of ​​the pancreatic head projection, 5-6 cm above and to the right of the navel;
• Gubergrits-Skulsky symptom – soreness manifests itself in the projection zone of the pancreas body, slightly to the left of the Shoffard zone;
• soreness in the Mayo-Robson area – left costal-vertebral angle – the area of ​​the tail of the pancreas;
• Desjardins symptom – sensitivity at a point located 5-6 cm above the navel along the line connecting the navel and the armpit; like the Shoffard zone, the point is a projection of the head of the pancreas;
• Grotta’s hypotrophic sign – lack of subcutaneous fat in the area of ​​the gland projection;
• Tuzhilin’s hemorrhagic symptom, or a symptom of “red droplets”, manifests itself in the form of small burgundy rashes or brown pigmentation over the gland area;
• Kacha’s symptom – pain on palpation at the outlet of the nerve processes at the level of the thoracic vertebrae: 8-9th – on the left, 9-11 – on the right.
• Voskresensky’s symptom – with an enlargement of the pancreas with edema of the tissue, the pulse of the abdominal aorta is not palpable.

Together with the survey, palpation allows you to determine the presence of dyspeptic phenomena from the digestive tract: flatulence, belching, nausea, diarrhea, constipation.

Attention! Severe weight loss can be a sign of chronic pancreatitis. It develops as a result of a violation of the process of digestion of food against the background of a decrease in the secretory function of the gland and a deficiency of enzymes.It is accompanied by increased dry skin, anemia, dizziness.

Diagnostic procedures

Laboratory diagnostic methods:

• a general blood test reveals signs of inflammation – a high level of leukocytes, low ESR;
• biochemical blood test determines the level of pancreatic enzymes – amylase, alkaline phosphatase, as well as bilirubin pigment;
• urinalysis shows the residual content of amylase and diastase enzymes;
• probeless diagnostic methods assess the activity of the digestive process by introducing substrates for pancreatic enzymes with subsequent monitoring of their assimilation;
• analysis of feces for parasites is carried out as needed.

Instrumental set of techniques:

• Ultrasound – determines the shape and size of the organ, the presence of seals and fibrous areas;
• gastroscopy – assesses the degree of inflammation of the walls of the stomach and duodenum;
• X-ray and its type – endoscopic retrograde cholangiopancreatography – help to detect accumulations of clots or stones in the ducts that cause blockage;
• probe methods for determining the exocrine function of the gland – secretin-pancreozymin test, Lund test;
• CT or MRI allows you to assess the degree of tissue necrosis in severe patients;
• laparoscopy is used in difficult cases for visual assessment and tissue biopsy.

How to treat pancreatitis

Three rules for the treatment of this pathology – rest, cold and hunger:

• rest slows down blood circulation and reduces blood flow to the diseased organ;
• cold compresses on the hypochondrium lower the temperature of inflammation and the severity of pain;
• fasting for 1-6 days stops the production of enzymes that cause inflammation.

Additionally, conservative treatment is prescribed using medications, physiotherapy and herbal medicine.

Drug treatment:

• antispasmodics and NSAIDs to eliminate spasms of the gastrointestinal tract and inflamed pancreas;
• antibiotics – with an active infectious process;
• antisecretory drugs – to suppress external (enzymatic) and internal (hormonal) secretion;
• pancreatic enzymes – to maintain healthy digestion during the treatment period, as well as in case of significant degeneration of the gland tissues;
• insulin preparations – in case of damage to the zones of hormone production.

Physiotherapy is connected to treatment after the acute phase of inflammation has been removed. The most effective techniques:

• electrophoresis with anesthetic and anti-inflammatory drugs increases the intensity of their action, better relieves pain and inflammation;
• ultrasound is used as a pain reliever for herpes zoster;
• diadynamic currents – exposure to low-frequency pulses improves blood supply, enhances tissue metabolism, relieves pain;
• laser and UV irradiation of blood relieve inflammation, improve microcirculation of liquid media and tissue regeneration;
• variable magnetic field successfully helps to eliminate swelling and inflammation.

Phytotherapy is used as an accompanying treatment – to enhance the effect of medications and eliminate possible “side effects”. For these purposes, plants with anti-inflammatory, detoxifying, antispasmodic, and sedative effects are used. These include chamomile, calendula, St. John’s wort, wormwood, dandelion, burdock, golden mustache, motherwort, immortelle, barberry, caraway seeds and a number of other herbs, which are used both singly and as part of complex collections.

In severe cases, when conservative methods of treatment do not help, they resort to surgical removal of an organ or part of it, followed by the appointment of enzyme replacement therapy on an ongoing basis. Indications: complete disintegration of the organ, the presence of cysts, necrosis, tumors, abscesses, fistulas, persistent blockage of the ducts with stones.

After the acute inflammation has been relieved, a special dietary meal is prescribed. In chronic pancreatitis or in the case of surgical treatment of the gland, it should be lifelong.

Diet No. 5 for pancreatitis

With pancreatitis, the gland is not able to cope with a large set of varied foods, so the best way out is to split meals. Completely exclude products that stimulate increased secretion: fatty, salty, fried, smoked, spices, chocolate, coffee, strong tea, meat, fish, mushroom broths, coarse fiber in the form of fresh fruits and vegetables, as well as any alcoholic beverages.

A strict diet number 5p (according to Pevzner) is relevant in the first days after exacerbations.Peculiarities:

• fractional meals in small portions 8 times a day; single serving size – no more than 300 g;
• food structure – thermally processed products crushed into gruel: mashed potatoes, jelly, puddings, slimy porridges in water, rusks softened in tea;
• food composition – vegetables boiled in water or steamed (carrots, potatoes, zucchini, pumpkin), lean meat and fish, low-fat dairy products, chicken protein, vegetable broths, pasta, cereals, semi-sweet berries and fruits; the emphasis should be on protein foods low in fat and carbohydrates;
• salt consumption – no more than 10 g per day; instead of sugar, it is advisable to use a sweetener;
• food should be warm – temperature 20-52 degrees; you can’t eat hot and cold!

When remission is achieved, the dietary requirements are slightly softened:

• the number of meals is reduced to 5 times a day with an increase in portions;
• it is allowed to use non-crushed products, stews and baked dishes, milk porridges;
• you can increase the amount of carbohydrates.

Attention! Quitting smoking is of great importance, especially if the disease is triggered by poor vascular health.

A single case of acute pancreatitis with timely and high-quality treatment can pass without consequences for the body. With the transition of the disease to a chronic form, complete restoration of the pancreas is impossible. However, with a strict diet and recommendations for drug treatment, you can achieve sustained remission with a significant improvement in the quality of life.

Abdominal pain – the main causes of the syndrome and first aid – Dobrobut clinic

Severe acute abdominal pain: causes and treatment

Pain is an indicator that some pathological process is taking place in the body. Unfortunately, many people ignore the recommendation to see a doctor right away and begin to fight the pain on their own, using drugs with analgesic effect. But there is a number of pains that cannot be tolerated in any case, because they may indicate a condition requiring emergency medical care.For example, severe acute pain in the abdomen is a sign of inflammation of the appendix, and delay can lead to the development of peritonitis and, in extreme cases, death.

The nature of pain and their “decoding”

In medicine, it is customary to distinguish between several types of pain. Using the classification, an experienced physician can make a diagnosis without further examining the patient.

Here are just a few types of abdominal pain and their “decoding”:

1. Drawing pains in the lower abdomen during menstruation in women.In principle, this may be a physiological norm, but often this syndrome indicates progressive endometriosis or the presence of an inflammatory or infectious process in the organs of the reproductive system.
2. Pain in the navel. This is an alarming sign that may indicate a progressive inflammation of the appendix. If such pain is permanent, it is intensified, then you need to get an appointment with the surgeon as soon as possible. Most likely, the patient will undergo emergency surgery.
3. Pain in the abdomen and lower back at the same time. This combination of symptoms will indicate an ongoing inflammatory process in the kidneys, bladder or uterus and ovary. Often the question arises in women, why does the stomach and lower back hurt during menstruation? Any gynecologist will answer that this is a sign of pathology in the tissues of the uterus or ovaries. And what kind of pathology develops in the patient, you can find out only after a full examination.
4. Pain in the right hypochondrium. It is almost always associated with impaired functionality of the liver or gallbladder.The causes of severe pain in the right hypochondrium may be the formation of stones in the gallbladder and the beginning of their movement along the bile ducts.
5. Pain syndrome after eating. This sign will indicate many pathologies. Firstly, it may be a banal poisoning, but in this case, a person will be worried about fever, nausea or diarrhea. Secondly, the syndrome in question is a sign of ulcerative lesions of the gastric mucosa or progressive gastritis (inflammation).
6. Abdominal pain on the left. This type of pain is rare, but may indicate problems in the ovary or fallopian tube in women. Aching pain in the left hypochondrium is a sign of pathology in the tissues of the spleen.

What to do in case of abdominal pain

Let’s make a reservation right away that a person may experience spontaneous abdominal pain. If it is single and there are no other uncomfortable sensations, then most likely it was a spasm. But if pains periodically appear, bother you for 5-7 days every day, then you definitely need to visit a doctor and find out their true cause.In case of acute, sharp pains in the abdomen, you cannot hesitate a minute – you need to call an ambulance team to your house.

What you can do before visiting a doctor:

• take a comfortable position and just rest a little;
• Apply a heating pad or ice pack to the site of pain localization – but for no more than 10 minutes;
• take any antispasmodic pain relievers;
• give up coffee and strong black tea for a couple of days;
• do not drink alcohol.

What to do if a child has a stomach ache in the navel area? You need to immediately resort to qualified medical care. No pain relievers should be given to the child; deny food and drink until the doctor arrives. Most likely, such a syndrome indicates inflammation of the appendix and the patient will undergo an urgent operation to remove it.

Pain in the lower abdomen during early pregnancy can be acute and pulling, not intense. In the first case, we again call the ambulance team, since the syndrome may be a sign of a spontaneous abortion or miscarriage that has begun.If the pain is mild and pulling, then you need to visit a gynecologist – perhaps the woman will be admitted to a hospital for observation. In any case, only qualified medical care will help to keep the child.

When should a doctor be called immediately:

• pain in the navel is accompanied by vomiting of brown contents, sharp pallor of the skin and profuse sweating;
• belly hurts at the bottom left, the pain is acute, unbearable, leading to short-term loss of consciousness and dizziness;
• against the background of pain in a person, the face turns pale, the pulse becomes threadlike, breathing is shallow, loss of consciousness is possible;
• pain in the abdomen is accompanied by dark urine, frequent stools, yellowness of the skin.

Only a specialist can make an accurate diagnosis and prescribe an adequate and effective treatment. Self-administration of painkillers or enemas will “lubricate” the clinical picture and it will be very difficult for the doctor to make an accurate diagnosis. But in most cases, abdominal pain indicates a rather serious health problem that requires immediate surgical intervention.

You can contact experienced doctors, find out why the stomach hurts after eating and which specialist is better to contact for diagnosis, on the pages of our website https: // www.dobrobut.com/.

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Tashkent clinics, Dentistry, Obstetrics, Allergology, Andrology, Anesthesiology, Venereology

Why can a man have pain in the left side of the lower abdomen?

Pain in the lower left abdomen in men is quite common and causes a lot of discomfort and discomfort. At the same time, a person cannot understand why it appeared and how it threatens.Usually, instead of consulting a doctor, the patient endlessly swallows painkillers, uses the advice of friends and relatives, simply tries not to pay attention to his health.

Such pains can be caused by a variety of reasons and can be both temporary health problems and symptoms of serious disorders. Complaints of patients about the fact that they are pulling the lower abdomen are regularly encountered during medical examinations. Pain sensations differ in nature, duration, intensity.In any case, you are unlikely to be able to accurately determine the cause of the violation on your own, so it is better not to postpone the trip to the clinic. Indeed, in the absence of therapy, the painful manifestations are aggravated, sooner or later you will still have to seek medical help, only the treatment will be much more complicated and expensive.

Pain in the lower abdomen is of this nature: Aching – most often occurs with diseases of the intestines and kidneys. It can be caused by an ordinary intestinal disorder as a result of eating poor-quality foods, too spicy, fatty foods.

Renal inflammation, which is characterized by similar symptoms, does not tolerate self-medication, and only a specialist can accurately diagnose, after a series of tests and examinations. Please note that taking painkillers is also undesirable, since in this case the pathology picture is blurred.

Stitching – usually caused by an inflammatory process in the large intestine, which has arisen due to the use of foods that are difficult to digest, seasoned with a lot of spices.It is also caused by inflammation of the organs of the genitourinary system.

Pulling – pulling pain in the lower abdomen is a symptom of an inflammatory process in the genitourinary organs, kidney disease or intestinal disorders.

Acute – signals an acute form of infectious diseases of the reproductive organs, renal colic, problems with the digestive system. Often accompanied by other painful symptoms: bleeding, vomiting, blood in the urine, fainting.In case of a serious condition of the patient, it is necessary to immediately call an ambulance.

Cutting – most often appears with intestinal diseases, but also noted with prostatitis, urolithiasis.

Dull – occurs with a chronic course of genitourinary infections, intestinal disorders, pathologies of the pancreas and gallbladder.

To understand the causes of pain, you need to know what is in the lower left abdomen.Since the genitourinary system and the lower intestine are located in this area, painful sensations are a symptom:

Urological diseases.

Disorders of the functioning of the digestive organs.

Pathologies of the peripheral nervous system.

Urological problems

As we have already said, one of the main causes of such pain sensations is inflammation of the organs of the urinary and reproductive systems.Pain syndrome is typical for such pathologies:

Prostatitis – since the inflamed prostate gland is anatomically located in the immediate vicinity of the bladder and rectum, pain spreads to these organs and occurs in the sacrum, penis, and groin area. The man feels the cuts in the lower abdomen on the left side, since it is here that the projection of the rectum is determined. Also, the patient is tormented by frequent and painful urination, high fever, and other manifestations of inflammation.The main reason for the onset of pathology is infectious pathogens that have penetrated into the gland from the urethra, bladder, brought in by blood flow from the affected intestine and distant organs. In addition, the disorder is caused by sexually transmitted infections, develops due to constant sitting, excess weight, irregular intimate life and other factors. When painful sensations appear, you should try to find out their cause. To do this, you need to exclude spicy and fatty foods, fried and smoked foods from the diet.In the case of the disappearance of pain, it can be concluded that they were caused precisely by improper diet.

Urolithiasis (urolithiasis) is the formation of calculi in the kidneys, bladder and excretory tract, and the passage of stones through the excretory ducts causes a burning sensation in the lower abdomen in men. The cause of the disorder is metabolic disorders, unhealthy diet, vitamin deficiency. The occurrence of stones is promoted by pyelonephritis, prostatitis, prostate adenoma, cystitis.That subsiding, then increasing constant pain, accompanied by painful urination, blood in the urine, nausea, bouts of vomiting.

Urethritis – in addition to pain in the abdomen, a man complains of frequent and painful urination, bloody urine, mucus secretion from the urethra. There may also be soreness during erection. Pathology is of an infectious nature, it can develop with hypothermia, allergies to drugs, hygiene products.Complications include prostatitis, epididymitis and infertility.

Epididymitis (inflammation of the appendages of the testicles) – the disease is manifested by severe pain, swelling of the scrotum, high fever. It is caused by infectious pathogens, improper placement of the urinary catheter, hypothermia, lack of vitamins.

Benign and malignant neoplasms of the genitourinary system.Read also:

Diseases of the digestive organs

The human digestive system is very vulnerable and susceptible to negative influences associated with the use of low-quality food, addiction to fatty and fried foods, spices, fast food, sweets. All this affects the condition of the gastrointestinal tract, causes intestinal disorders. In this case, the man feels heaviness in the lower abdomen, pains of a different nature, nausea, flatulence.Pain syndrome manifests itself in the following diseases:

Proctitis.

Ulcerative colitis.

Hernia.

Bowel obstruction.

Development of benign or malignant tumors in the intestine.

Pain can occur not due to illness, but after a plentiful meal, eating heavy food for digestion, fried and spicy foods.Pains that have been observed for a long time indicate the course of a serious illness. Most often, these are pathologies of the excretory and reproductive organs, but there may be problems with the intestines. To find out the cause of the onset of painful sensations, you should contact a urologist or proctologist, undergo the examinations prescribed by him and follow all recommendations for treatment.

Nervous pathologies

Often, soreness is due to infringement and subsequent inflammation of the sciatic nerve with an intervertebral hernia.First, the patient develops pain in the lumbar region when walking, then in the lower abdomen, on the left or right side. In medicine, there is the term “cauda equina” meaning forty nerve endings that stretch from the lumbar spine to the coccyx and are responsible for the innervation of the legs and organs located in the small pelvis. Lesions of these nerves manifest as pain in the lower abdomen, groin, and perineum. The appearance of an intervertebral hernia is facilitated by osteochondrosis, weakening of the muscles of the back, curvature of the spine, and trauma.The disorder is handled by specialists such as a vertebrologist and a neurologist.

For questions, please call + (998 71) 140-03-03, + (998 71) 140-01-60 and at Chilanzar, 12th quarter, st. M. Shaikhzoda, 7.

Pain around the navel

Pain around the navel

Pain in the mesogastric region (around the navel) most often occurs in the case of damage to the duodenum and stomach.Also, pain in the umbilical region can accompany helminthic and parasitic invasions (more often in children), damage to the intestinal lymph nodes (mesenteric lymphadenitis), diseases of the small and large intestines, in some cases – diseases of the pancreas and kidneys.

Reasons

• damage to an organ of an inflammatory nature;
• ischemic organ damage;
• violation of patency of hollow organs, mainly intestines;
• increase in pressure in the lumen of the intestine and stomach;
• overstretching of an organ;
• psychogenic pain;
• reduction of the muscular apparatus of the organ.

Classification

• visceral pain arising from functional disorders of the activity of organs and their organic lesions; occurs most often with an increase in pressure in the gastric and intestinal cavities or with a violation of their blood supply; pain is usually dull at first, later becomes “gnawing” or cramping;
• parietal pain resulting from irritation of the nerve endings of the spinal cord that innervate the peritoneum or mesenteric root; often accompanied by a spasm of the muscles of the abdominal wall;
• reflex, or reflected pain – pain localized in areas of the body remote from pathological processes; typical for diseases of the pancreas, stomach, gallbladder, intestines;
• psychogenic pain – pain with a constant dull aching character, localized in the abdominal cavity, can last for months or even years; there are no objective changes in the abdominal organs; typical for persons with psychoemotional disorders; stops or decreases in conditions of mental rest or during sleep; there is a positive effect of treatment with psychotropic drugs.

Features

for dissecting aneurysm of the abdominal aorta:

• sudden onset of pain;
• acceptance of a forced situation by the patient;
• for mobile caecum syndrome:
• sudden cramping pain,
• pain associated with changes in body position,
• exercise-related pain,
• short-term nature of pain;

for acute appendicitis:

• wave-like intensity of pain in the mesogastrium,
• short-term,
• subsequently moving pain to the lower right quadrant;

for perforation of the stomach or intestines:

• sudden onset of pain;
• acceptance of a forced situation by the patient;

with adhesive process:

• pain associated with changes in body position,
• sudden cramping pain,
• exercise-related pain,
• short-term nature of pain;

for ovarian torsion:

• sudden onset of pain,
• acceptance of a forced situation by the patient;

for diverticulitis:

• pain in the mesogastrium,
• pain irradiation to the lower left quadrant;

with low small bowel obstruction:

• pain in the mesogastrium,
• downward irradiation of pain;

for strangulated inguinal hernia:

• pain in the mesogastrium,
• irradiation of pain towards the lesion;

for terminal sludge:

• pain in the mesogastrium,
• irradiation of pain;

for renal colic:

• pain in the mesogastrium,
• irradiation of pain towards the lesion;

for inflammation of the epididymis:

• pain in the mesogastrium,
• irradiation of pain towards the lesion;

for an ectopic pregnancy:

• pain in the mesogastrium,
• irradiation of pain;

for thrombosis / embolism of mesenteric vessels:

• pain in the mesogastrium,
• gradual onset of abdominal pain;

in case of pipe rupture:

• sudden onset of pain;
• acceptance of a forced situation by the patient;

for intra-abdominal abscesses:

• pain in the mesogastrium,
• gradual onset of abdominal pain;

for colon diverticulitis:

• pain in the mesogastrium,
• gradual onset of abdominal pain;

for Crohn’s disease:

• pain in the mesogastrium,
• gradual onset of abdominal pain;

for intestinal patency (tumor or Crohn’s disease):

• slowly increasing pain,
• previous large meal,
• previous physical activity;

with peritonitis:

• increased abdominal pain with slight movement of the body,
• temperature,
• tachycardia,
• hypotension;

for ischemic abdominal syndrome:

• pain in the mesogastrium,
• unsuccessful attempts to find a position of the body in which the pain would decrease;

for chronic pancreatitis:

• knee – elbow position of the patient,
• pain in the mesogastrium,
• pain radiating to the right and up;

for an ectopic pregnancy:

• sudden onset of pain,
• acceptance of a forced situation by the patient;

for functional spasm of the stomach, gallbladder or intestines:

• pain in the mesogastrium,
• paroxysmal nature of pain;

with curvature of the spine:

• pain in the mesogastrium,
• irradiation towards the affected spine;

for arthritis, displacement of intervertebral discs, arthrosis and tuberculosis:

• pain in the mesogastrium,
• irradiation towards defeat.

What diseases occur

• dissecting aneurysm of the abdominal aorta;
• mobile caecum syndrome;
• adhesive process;
• helminthic and parasitic infestations;
• acute appendicitis;
• mesenteric lymphadenitis;
• perforation of the stomach or intestines;
• ovarian torsion;
• diverticulitis;
• low intestinal obstruction;
• restrained inguinal hernia;
• terminal ileitis;
• renal colic;
• inflammation of the epididymis;
• thrombosis / embolism of mesenteric vessels;
• pipe rupture;
• intra-abdominal abscesses;
• Crohn’s disease;
• colon diverticulitis;
• intestinal permeability;
• tumor or Crohn’s disease;
• peritonitis;
• ischemic abdominal syndrome;
• chronic pancreatitis;
• ectopic pregnancy;
• functional spasm of the stomach, gallbladder or intestines;
• curvature of the spine;
• arthritis of the spine;
• displacement of the intervertebral discs;
• psychogenic pain;
• arthrosis and tuberculosis of the spine.

Which doctors should be consulted

• gastroenterologist;
• therapist;
• gynecologist.
• surgeon
• pediatrician.

Diastasis (divergence) of the rectus abdominis muscles

The disease in question occurs in approximately 1 in 100 people, and women are most susceptible to it, especially after childbirth.

Diastasis of the rectus abdominis muscles – divergence or weakening of the fibers of the aponeuroses, forming a “white line” vertically in the middle of the abdomen, in which the navel is located.At the same time, the rectus muscles diverge to the sides. Those who go in for sports and monitor their figure, these muscles are visible in the form of so-called “cubes”. And the aponeurosis is a dense shell of rectus muscles. With the formation of diastasis of the rectus muscles, the abdomen acquires a “round” shape, an increase in the volume of the abdominal cavity occurs. Because of this, the organs of the abdominal cavity begin to shift relative to their fixation points, their anatomical relationships change, and their function is disrupted. Therefore, diastasis is not only a cosmetic defect, but also leads to the development of many chronic diseases and reduces the quality of life of patients.

What are the risk factors for men?

Any reasons after which the pressure in the abdominal cavity rises – hacking cough, hard work, chronic constipation, heavy lifting, male obesity, with the formation of a “beer belly”.

What are the risk factors for women?

In addition to the above – caesarean section (trauma to the aponeurosis), early intense training and hard work after childbirth.

In addition, there are patients who have defects of ligaments and tendons from birth, which leads to hernias and diastasis.

Classification and manifestations

There are three degrees of diastasis of the rectus abdominis muscles, depending on the magnitude of the discrepancy:

1. Up to 7 centimeters. Often observed in women after childbirth, little changes the appearance of the abdomen. It is accompanied by dull pain in the epigastric region, shortness of breath when walking, nausea, bloating and constipation.
2. 7 to 10 centimeters. The lateral muscles are relaxed, the abdomen sags, the depression is clearly visible in the supine position.
3. More than 10 centimeters.Serious aesthetic defect. Weak abdominal muscles, increased abdominal volume. In addition, prolapse of organs develops. This is accompanied by constipation, shortness of breath, disorders of the genitourinary system, abdominal pain. In addition, umbilical hernia or hernia of the white line may occur. This requires urgent surgery.

At the first signs of diastasis, you should consult a doctor, because it is much easier to cope with the disease before it leads to serious consequences.

Diastasis does not disappear on its own, but only progresses over time. And if at its first stage the problem can sometimes be corrected with the help of specially selected exercises, then in more advanced cases, surgical intervention is needed.

Surgical treatment methods

They are divided into traditional and minimally invasive ones.

Traditional interventions

In traditional operations, a long incision is made on the abdominal wall.After the diastasis is corrected, a long rehabilitation is required. The first three months there are restrictions on lifting weights and playing sports. Another serious disadvantage of traditional interventions is the risk of relapse and complications.

Minimally invasive interventions

Endoscopic methods of getting rid of diastasis are the most preferred at the present time. The reasons are simple: a short hospital stay, absence of pain and noticeable scars, a quick opportunity to return to the usual rhythm of life.

In addition, endoscopic techniques rarely lead to recurrence of the disease, it is only 1% of all cases. There is a possibility of joint operations – for example, to remove an ovarian cyst. The instruments are inserted through small punctures in the abdominal wall.

In patients who underwent a cesarean section with a horizontal scar in the lower abdomen, during endoscopic surgery, the scar is excised and a new suture is applied with a cosmetic suture. Thus, the number of scars on the abdomen remains the same, and its shape becomes correct.

Endoscopic elimination of the defect is carried out either under general anesthesia or under epidural anesthesia. This allows such an operation to be performed in people with severe concomitant diseases or in elderly patients. It is recommended to use a bandage for a month after the intervention.

You can get out of bed on the day of surgery. The next day after the operation, the patient goes home on his own, and after another 8-9 days he comes for a control examination and removal of stitches.

In “MaxKlinik” there are all , all conditions are created that is necessary for minimally invasive treatment of diastasis.