Abdominal Pain

What is Abdominal Pain?

Abdominal pain is discomfort or other uncomfortable sensations below the chest or around the belly region. It can vary widely in intensity, duration, and location within the abdomen. Abdominal pain is a common symptom associated with many conditions, from transient and benign to severe, requiring immediate medical attention.

The nature of abdominal pain can be described in several ways, such as acute (severe/ shorter duration) or chronic (long-standing/ recurring). The character of pain can be:

• Burning
• Cramping
• Dull
• Gnawing
• Intense
• Intermittent or episodic
• Sharp/stabbing

What causes Abdominal Pain?

Abdominal pain can stem from a variety of causes, such as:

• Functional digestive issues: conditions such as gastroesophageal reflux disease (GERD), inflammatory bowel disease (IBD), constipation, diarrhoea, food allergies or food intolerance (such as lactose intolerance), and ‘indigestion’. These can lead to discomfort in the abdominal area.
• Infections: various infections can cause abdominal pain. These include food poisoning/ gastroenteritis and urinary tract infections (UTIs).
• Appendicitis: appendicitis is an inflammation of the appendix, a small organ attached to the large intestine, which can cause severe pain in the lower right abdomen and requires immediate medical attention.
• Gallstones: gallstones can cause upper abdominal discomfort, typically after meals, and if it occurs with fever, a gallbladder infection should be suspected. 
• Obstructions and blockages: obstructions in the intestines, such as from a hernia or adhesions, can lead to significant abdominal pain.
• Muscle strain: overexertion or injury to the abdominal muscles can cause pain in your abdomen.
• Other medical conditions: conditions not directly related to the digestive system can also appear as abdominal pain. For example, heart attacks and pneumonia can come with abdominal discomfort. Skin conditions such as shingles can cause pain if they affect the skin around the abdomen. Additionally, problems with stomach muscles can lead to abdominal pain.

Given the wide range of potential causes, diagnosing the exact reason for abdominal pain can sometimes be challenging. It is important for individuals experiencing persistent or severe abdominal pain to seek medical evaluation to determine the underlying cause and receive appropriate treatment.

What are the symptoms associated with Abdominal Pain?

The symptoms associated with abdominal pain vary depending on the cause and severity of the issue; some common symptoms include:

• Persistent fever
• Persistent nausea or vomiting
• Difficulty in passing gas/ distention
• Pulsing sensation near the navel
• Rash
• Stomach growling
• Urgent need to pass stool

Who is at risk of Abdominal Pain in Singapore?

Any individual can experience abdominal pain at some point in their lives, as it can result from a wide array of conditions affecting the digestive, urinary, reproductive, and other structures within the abdomen. However, certain factors may increase the risk of experiencing specific types of abdominal pain or the conditions that lead to it in Singapore.

• Diet and lifestyle choices: individuals who consume a spicy diet or those with a high intake of alcohol or caffeine may be at increased risk of conditions such as gastritis, ulcers or gastroesophageal reflux disease (GERD), all of which can cause abdominal pain.
• Stress and anxiety: high levels of stress or anxiety can worsen conditions such as irritable bowel syndrome (IBS), leading to abdominal discomfort and pain.
• Genetics: some conditions associated with abdominal pain, such as Crohn's disease, coeliac disease, and gallstones, have a genetic component, making individuals with a family history of these conditions more susceptible.
• Medical history: individuals with a history of gastrointestinal problems, such as ulcers, Crohn's disease, and/or previous abdominal surgeries, may be at higher risk for abdominal pain.
• Medications: long-term use of certain medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), can increase the risk of developing conditions such as stomach or intestinal ulcers, which can cause abdominal pain.

How is the cause of Abdominal Pain diagnosed in Singapore?

Diagnosing the cause of abdominal pain starts with gathering detailed information about your symptoms, including the location, intensity, duration, and nature of the pain, as well as any accompanying symptoms such as fever, nausea, or changes in bowel habits. This initial evaluation helps form a preliminary differential diagnosis.

A physical examination typically follows after the evaluation of your medical history. During the physical examination, your doctor will assess your abdomen for tenderness, swelling, and any abnormal sounds while also checking for signs of distress or abnormal vital signs such as fever or tachycardia, which can indicate the severity of the condition. The physical findings and your medical history can determine whether further diagnostic tests are required.

Further tests such as blood, urine, and stool analysis can check for signs of infection, inflammation, or other markers that suggest specific conditions. Imaging studies such as CT scans, ultrasounds, and X-rays provide detailed visuals of the abdominal organs and help identify abnormalities such as blockages, inflammation, or tumours. More specialised procedures such as a gastroscopy, colonoscopy, sigmoidoscopy, or a barium study may be necessary to examine the gastrointestinal tract more closely.

What are the treatment options for Abdominal Pain in Singapore?

Treatment options for abdominal pain in Singapore vary widely depending on the underlying cause.

Treatment options for abdominal pain include medications or procedures to relieve pain and to treat the underlying cause of pain:

• Pain medications: analgesia such as paracetamol, NSAIDs and opiates can be given to relieve pain. However, non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen can sometimes worsen abdominal pain or cause further gastrointestinal irritation, especially in stomach inflammation and ulcers. Hence, it is important to consult a doctor before taking medications. 
• Over-the-counter medications: depending on the specific symptoms, medications with simethicone can help with gas pain or bloating. In contrast, proton pump inhibitors and other acid-reducing medications can alleviate symptoms such as belching and stomach discomfort.
• Antispasmodics: for symptoms including spasms and/or cramps, your specialist may prescribe antispasmodic agents such as buscopan.
• Surgical and medical interventions for the underlying cause of pain: in more severe cases, some conditions, such as gallstones or appendicitis, may require surgical intervention, while most ulcers or infections can be effectively treated with medication.

It is important to receive an accurate diagnosis from your specialist to determine the most appropriate treatment based on the specific cause and symptoms of abdominal pain.

Frequently asked questions

Does abdominal pain always indicate a serious problem?

No. While abdominal pain can be a symptom of a serious condition, it can result from less severe issues such as gas, indigestion, or minor stomach inflammation. However, the context and accompanying symptoms can help determine its seriousness.

When should I see a doctor for abdominal pain?

You should seek medical attention if your abdominal pain is severe, persists for several days, or is accompanied by fever, persistent nausea or vomiting, blood in stool, jaundice, or unexplained weight loss.

Can stress cause abdominal pain?

Yes, stress can contribute to abdominal pain. Stress can exacerbate gastrointestinal issues such as irritable bowel syndrome (IBS) and can lead to stomach cramps, bloating, and other discomforts.

Is abdominal pain serious if it comes and goes?

Abdominal pain that comes and goes is not always serious, but its significance depends on other factors such as pain severity, frequency, and accompanying symptoms. Conditions such as IBS can cause intermittent pain, but recurring pain should not be ignored.

When is surgery necessary for abdominal pain?

Surgery may be necessary if the abdominal pain is caused by conditions that require surgical intervention, such as appendicitis, hernias, gallstones, or certain complications of Crohn's disease. The need for surgery is determined based on diagnosis, severity, and response to other treatments.