Many abdominal diseases have a typical distribution and pattern of pain.
Bowel Cancer may occur without any particular pain, but may be suspected in an older person (over 50), with an alteration in bowel habit, not obviously associated with diet or stress, and/or if there is passage of blood or unexplained weight loss. A family history of bowel cancer makes the diagnosis more likely.
The epigastric pain of peptic ulcer is felt under the end of the breast bone and is often described as ‘boring’, like a knife. The pain of a duodenal ulcer is classically relieved by eating or taking antacids, but comes back again about two hours after food. It may be associated with vomiting and may wake a person up at night. The pain of a gastric ulcer is similar but may come on as soon as the patient has eaten.
Biliary colic is caused by blockage of the bile duct by a gallstone. The pain is felt as a discrete bout of particularly severe crampy central abdominal pain that builds to a crescendo and then dies away over the course of several days as the stone is passed.
The pain of pancreatitis often radiates to the middle of the back and may be relieved by sitting upright. Patients with pancreatitis do not feel like eating and vomiting is frequent. It is particularly common in people with gallstones.
Renal colic is caused by the passage of a stone down the ureter. It causes a severe crampy pain that starts in the loins and spreads round and down to the pelvis and dies away when the stone in passed.
Dysmenorrhoea and Endometriosis
Dysmenorrhoea and Endometriosis occurs around period times and is also felt low down above the pubis or in the lower corners of the abdomen .
The pain of appendicitis starts as a severe colicky central abdominal pain, but later locates to the right lower corner of the abdomen, becomes persistent and is associated with fever and feeling very ill.
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