Abdominal Pain, Long-term

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Ongoing or recurrent abdominal pain, also called chronic pain, may be difficult to diagnose, causing frustration for both you and your doctor. Do your symptoms fit one of the diagnoses described in this chart?

SYMPTOMS DIAGNOSIS SELF-CARE
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1. Does your pain get worse after you eat a big meal?


No

Go to Question 10.*

Yes

2. Do you feel pressure in your upper abdomen that gets worse when you bend over or lie down at night?


Yes

Your problem may be a HIATAL HERNIA.

See your doctor. Eat smaller meals, especially at night. Don't lie down right after you eat. Use 2 or 3 pillows, or a foam wedge, or raise the head of your bed to prevent discomfort.

No

3. Is the pain relieved by antacids?


Yes

Your pain may be from GASTRITIS, an ULCER or HEARTBURN; all are irritations of the stomach and esophagus.

Eat smaller meals and use an over-the-counter antacid. If antacids don't help, see your doctor.

No

4. Does the pain start in your upper middle or upper right abdomen, and is it brought on by greasy or fatty foods?


Yes

Your pain may be a sign of GALLSTONES or CHOLECYSTITIS (infection of the gallbladder).

See your doctor.

No

5. Does your pain get worse when you're under stress or do you alternate between loose and hard bowel movements?


Yes

Your pain may be from IRRITABLE BOWEL SYNDROME, also known as SPASTIC COLON.

Try a diet high in soluble FIBER for 2 weeks. Takew steps to reduce your stress and to exercise regularly. If you don't get better, check with your doctor.

No

6. Do you have soft or diarrhea-like bowel movements many times throughout the day and mucus or blood in your stools?


Yes

You may have CROHN'S DISEASE or ULCERATIVE COLITIS, inflammatory diseases of the colon or large intestine.

See your doctor. These disorders are treatable.

No

7. Do you have recurrent bouts of pain in the lower left side of your abdomen along with fever?


Yes

You may have DIVERTICULITIS, an infection of small pockets in the colon.

Any infection of the abdomen can be serious. CALL YOUR DOCTOR RIGHT AWAY.

No

8. Do you have bright red blood in or on your bowel movements?


Yes

Bright red, bloody stools may be caused by a bleeding HEMORRHOID or a bleeding POLYP, but they can also be a sign of a more serious problem such as CANCER of the colon.

See your doctor.

No

9. Has it been a few days or longer since you last had a bowel movement and do you have to strain when you have a bowel movement?


Yes

Your discomfort is probably from CONSTIPATION.

Use a simple bulk-forming laxative and be sure to add lots of FIBER and fluids to your diet. If the constipation persists, call your doctor.

No

*10. Has your appetite decreased, and have you lost 10 to 15 pounds over the past few months without trying?


Yes

Unintentional weight loss can be a sign of a serious condition such as CANCER.

See your doctor.

No

11. Do your skin or eyes have a yellow color, or is your urine dark?


Yes

You may have VIRAL HEPATITIS a serious infection of the liver.

See your doctor.

No

12. Have you had fever, sore throat or extreme tiredness?


Yes

You may have MONONUCLEOSIS ("MONO") or a similar VIRAL INFECTION.

See your doctor. Treatment of mono includes rest, drinking plenty of fluids and taking medicine to treat the symptoms.

No

13. Do you have abdominal bloating and discomfort made worse by milk or wheat products?


Yes

Your problem may be MALABSORPTION, an inability to absorb some foods, or LACTOSE INTOLERANCE or WHEAT INTOLERANCE (CELIAC DISEASE).

Avoid the foods and beverages that cause your symptoms. People who have lactose intolerance can use lactose enzyme tablets or drops to help them digest foods that contain lactose.

No

14. Are your bowel movements yellow and greasy, and do they float in the toilet?


Yes

Your pancreas may not be producing enough enzymes for proper digestion. This condition is called PANCREATIC INSUFFICIENCY.

Call your doctor. He or she may ask for a sample of your bowel movements to confirm pancreatic insufficiency.

No

15. Do you have excess gas that is very foul-smelling and occasional loose bowel movements?

You might have a parasitic infection called GIARDIASIS. Other BOWEL INFECTIONS or MALABSORPTION may also cause these symptoms.

See your doctor. To prevent parasitic infections, don't drink untreated water from lakes or streams, and wash fruits and vegetables thoroughly before eating them.

No

For more information, please talk to your doctor. If you think your problem is serious, call right away.

This tool has been reviewed by doctors and is for general educational purposes only. It is not a substitute for medical advice. The information in this tool should not be relied upon to make decisions about your health. Always consult your family doctor with questions about your individual condition(s) and/or circumstances. Source: American Academy of Family Physicians. Family Health & Medical Guide. Dallas: Word Publishing; 1996.

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