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Acute Abdominal Pain

What is Acute Abdominal Pain?

Many people in Singapore have experienced mild stomach ache (or tummy pain) and recovered from it after some rest and the consumption of over-the-counter painkillers. While stomach aches may be a common ailment, it is important not to dismiss acute abdominal pain, which is often a medical emergency.

The abdomen is the lower part of the human body, between the chest and the pelvis. This body region contains critical organs such as the stomach, intestines, liver, spleen, and other structures. 

Acute abdominal pain refers to sudden and severe discomfort in the abdomen that may require immediate medical attention and, in certain cases, surgery. It is a symptom rather than a specific condition, indicating an underlying issue.

What Causes Acute Abdominal Pain?

One possible cause of acute abdominal pain is the presence of gallstones that obstruct the bile duct, which can lead to intermittent and intense pain.

Acute abdominal pain may be caused by mild problems such as indigestion, trapped wind, or overeating, as well as potentially life-threatening conditions like acute appendicitis , acute cholecystitis and acute peptic ulcer complications.

Both gastrointestinal issues and non-gastrointestinal issues can lead to acute abdominal pain:

Gastrointestinal Causes

  •    Appendicitis
  •    Gallstones
  •    Gastroenteritis
  •    Peptic ulcers
  •    Inflammatory bowel disease
  •    Pancreatitis

Endocrine and Metabolic Causes

  •    Uremia
  •    Diabetes-related ketoacidosis (DKA)
  •    Addison’s disease
  •    Acute intermittent porphyria

Gynaecological Causes

  •    Ovarian cysts
  •    Ectopic pregnancy
  •    Pelvic inflammatory disease

Urinary Causes

  •    Kidney stones
  •    Urinary tract infections

Vascular Causes

  •  Abdominal aortic aneurysm
  •  Arterial emboli
  •  Visceral artery disease

Medical Conditions: Acute myocardial infarction & Severe Pneumonia can also lead to referred pain in Abdomen

How Serious is Acute Abdominal Pain?

Should gallstones remain in the body, they can lead to complications like jaundice.

The seriousness of acute abdominal pain depends on its underlying cause. Some conditions, such as appendicitis or a ruptured abdominal aortic aneurysm, can be fatal and require immediate attention. Ignoring severe abdominal pain may lead to complications and worsen the prognosis.

Leaving acute abdominal pain untreated can result in the progression of the underlying condition. 

  • Untreated appendicitis may lead to a ruptured appendix, causing infection and peritonitis.
  • Left untreated, gallstones can lead to inflammation and infection of the gallbladder as well as jaundice.
  • Untreated peptic ulcers may erode blood vessels in the stomach or duodenum, causing internal bleeding. 

When Should You Visit the A&E for Acute Abdominal Pain?

It is vital to seek urgent medical care from a general surgery clinic or call 995 to contact a nearby hospital’s Accident and Emergency (A&E) Department if you experience sudden and severe abdominal pain, especially if the pain is accompanied by one or more of the following symptoms:

  • Sweating and difficulty breathing
  • Persistent vomiting 
  • Pain associated with vomiting blood
  • Prolonged pain with a high fever
  • Bloody or black stools

This is because timely treatment is crucial to prevent complications and aid recovery. Ace Specialist Surgery and Endoscopy Clinic offers round-the-clock emergency services for acute abdominal pain cases. Patients experiencing acute abdominal pain can seek medical attention at any time for diagnosis and intervention. You can call us any time of the day (24/7), and we will try to arrange an appointment or urgent operation with our general surgeon as soon as possible.

How is Acute Abdominal Pain Diagnosed?

Besides a physical examination of the abdomen, X-ray imaging can be utilised to assess your abdominal condition.

A  general surgeon will employ multiple tests to diagnose your acute abdominal pain, such as the following:

  • Medical History Taking: Understanding the patient's symptoms, medical history, and any recent injury.
  • Physical Examination: Assessing vital signs and examining the abdomen for tenderness, rigidity, or swelling.
  • Diagnostic Imaging: Utilising imaging tests such as ultrasound, CT scans, or X-rays to visualise the internal structures.
  • Laboratory Tests: Conducting blood and urine tests to identify infection, inflammation, or organ dysfunction.

Treatment Options for Acute Abdominal Pain in Singapore

After our surgeon does a detailed assessment of your condition, he will recommend a personalised treatment plan tailored to your underlying cause of acute abdominal pain. In many cases, it may be advisable for patients to undergo immediate surgery. 

These are the common treatments for acute abdominal pain:

  • Surgery: Removal of the appendix, gallbladder, or treatment of other surgical conditions. You can consider opting for laparoscopic surgery, or minimally invasive surgery (MIS),  a modern surgical technique that uses smaller incisions and specialised instruments. Laparoscopic surgery typically leads to multiple benefits, such as reduced pain, faster recovery, less scarring and fewer complications than open surgery.
  • Medications: Antibiotics for infections, pain relievers, and medications may be prescribed to alleviate specific conditions.
  • Lifestyle Changes: Dietary and lifestyle adjustments are beneficial for treating chronic conditions.

Summary

In conclusion, acute abdominal pain, which refers to the sudden and severe discomfort in the abdomen, is often a medical emergency that needs immediate surgery.  Individuals with acute abdominal pain are advised to seek medical attention as soon as possible to prevent complications.

Visit Ace Specialist Surgery and Endoscopy

Ace Specialist Surgery and Endoscopy Clinic is experienced in managing emergency cases of acute abdominal pain. If you are suffering from acute abdominal pain, call us anytime, day or night, and we will schedule an appointment or urgent surgery with our Senior Consultant Endocrine and General Surgeon, Dr Reyaz Singaporewalla, as soon as possible. 

Dr Reyaz has more than 25 years of experience in the field of General and Endocrine-Head Neck Surgery. He acquired valuable experience and training in Minimally Invasive and laparoscopic surgery as well as Endocrine (Thyroid / Parathyroid / Adrenal) and Breast Surgery under Professor Martin K. Walz and Professor Tom Lennard. Importantly, the veteran surgeon is skilled in dealing with emergency acute abdominal pain cases.

Frequently Asked Questions

Who is at Risk of Acute Abdominal Pain in Singapore?

Risk factors for acute abdominal pain in Singapore include:

  • Age: Certain abdominal conditions, such as diverticulitis, bowel ischemia, and biliary disease, become more prevalent with advancing age. Elderly individuals are more prone to developing these conditions, contributing to the overall risk of acute abdominal pain.
  • Gender: Gynaecological issues, such as ovarian cysts, ectopic pregnancy and pelvic inflammatory disease, are women’s health issues that may lead to acute abdominal pain.
  • Personal or family history: Having a personal medical history of certain conditions, like appendicitis, cholecystitis and peptic ulcer complications, can make people susceptible to suffering from acute abdominal pain.
Can Acute Abdominal Pain be Prevented?

While some causes of acute abdominal pain are not preventable, certain lifestyle modifications can reduce the risk:

  • Maintain a Balanced Diet: Eat a well-balanced diet to ensure adequate nutrition and digestive health, reducing the risk of abdominal discomfort.
  • Hydration: Stay well hydrated by drinking plenty of water, as dehydration can contribute to abdominal pain.
  • Avoid Trigger Foods: Be aware of any food allergies or intolerances and avoid trigger foods that may cause abdominal distress.
  • Stress Management: Practise stress-reduction techniques to alleviate psychological stress, a known contributor to abdominal pain.
  • Limit Alcohol Intake: Consume alcoholic drinks in moderation, as binge drinking can irritate the digestive system.
Can Acute Abdominal Pain Recur After Treatment?

Recurrence depends on the underlying cause. Conditions like kidney stones, once treated, may have a lower recurrence risk with proper management. However, chronic conditions like inflammatory bowel disease may require ongoing care to prevent flare-ups.

References

1. Abdominal pain. www.healthhub.sg. Accessed January 23, 2024. 
https://www.healthhub.sg/a-z/diseases-and-conditions/abdominal-pain#:~:text=Causes%20of%20Abdominal%20Pain

‌2.  Acute Abdomen: What It Is, Symptoms & Causes. Cleveland Clinic.
https://my.clevelandclinic.org/health/diseases/25064-acute-abdomen