Introducing abdominal pain in Emergency Department (ED)
Abdominal pain is the pain which occurs in the abdomen and is one of the common complaints of emergency patients. In most cases of gastrointestinal emergencies, a complaint of mild or moderate pain is usually a minor issue caused by constipation of flatulence. Whereas a complaint of acute/severe abdominal pain that requires medication or immediate surgery, such as bowel obstruction, hernia, or intestinal perforation should be treated on time, otherwise it can easily cause sepsis which is life-threatening.
Your doctor may ask following questions:
- Do you have nausea/vomiting, change in appetite, change in bowel habits, rectal bleeding, jaundice, abdominal distension, any unusual abdominal mass or pain?
- Pain assessment is one of the most important components and should be evaluated thoroughly. Communal questions related to pain history including:
- Location – where is the pain?
- Quality – cramping, dull, sharp
- Timing – when did it start?
- Severity - on a scale of 0 (no pain) to 10 (the worst pain ever)
- Other factors that can aggravate or alleviate the pain; Last bowel movement (BM) or any other significant change/consistency of BM, e.g. melena, blood in stool; hematemesis, oral intake, nausea, vomiting, urological symptoms and any recent travel history.
If you have mild abdominal pain, these following tips might be helpful:
- Avoid solid food for the first 4-6 hours.
- After that you can sip water or other clear fluids.
- If you have been vomiting, wait till 6 hours later to start eating small amounts of bland foods such as rice, applesauce, or crackers. Avoid dairy products.
- If the pain is in upper abdominal region and occurs after meals, antacids may help, especially if you feel heartburn or indigestion. Avoid citrus, high-fat foods, fried or greasy foods, tomato products, caffeine, alcohol and carbonated beverages.
- Avoid aspirin, ibuprofen or other anti-inflammatory medications and narcotic pain medications unless your health care provider prescribes them. If you know that your pain is not related to your liver, you can try acetaminophen.
- Pain management in case of acute abdominal pain can be a challenge for health care providers because of the fact that analgesia may mask or eliminate the very symptoms that aid in the diagnosis.
The following steps may prevent some amount of abdominal pain:
- Avoid fatty or greasy foods, chew carefully and swallow slowly.
- Drink 1500-2000cc of water each day.
- Eat more meals throughout the day with smaller portion
- Exercise regularly.
- Avoid food that produce gas such as onions, green peppers, sweet potatoes, soda, cola, fried and high-sugar desserts.
- Make sure that your meals are well-balanced and high in fiber content. Eat plenty of fruits and vegetables such as cereals, beans and dried fruits, which have high fiber content.
- Ahmad, M.,Islam, A.,Msbah, M., & Samy, A.,N. (2017). Knowledge based system for long-term abdominal pain (stomach pain) diagnosis and treatment. International Journal of Engineering and Information Systems, 1(4), 71-88.
- Jonathan, S.S. (2018).Urachal remnants in patients presenting to the emergency department with abdominal pain. The Journal of Emergency Medicine, 55(3), 333-338. doi.org/10.1016/j. jemermed.2018.05.023
- Zao,Z., Heath,C., &Ting, Gong. T. (2019). Fever, abdominal pain, and jaundice in a pacific islander woman. The Journal of the American Medical Association, 323(3), 272-273. doi:10.1001/jama.2019.20118