Abdominal pain left, right, above, below or in the middle: what is behind it?
Harmless or signs of a serious illness - here two doctors from Munich explain common symptoms and causes of abdominal pain depending on the abdominal region.
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professor dr
Franz Bader heads the Surgery Clinic at the Munich Isar Clinic.
He specializes in minimally invasive surgeries.
© Isar Clinic
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Privatdozent Dr.
Maximilian Sohn is the managing senior physician at the Munich Isar Clinic.
© private
Fatty food, too much sweet or sour - the stomach can press or the intestines rumble.
Such complaints are usually quickly overcome.
But what to do if the abdominal pain does not subside after a few hours or even increases?
If home remedies such as tea or a hot-water bottle do not help and even painkillers such as Buscopan or Paracetamol do not bring about any improvement, you should see a doctor – with some symptoms as quickly as possible.
These alarm signals include: frequent vomiting, especially of blood or black sputum, high fever (measured from 39 degrees under the armpit and from 38.5 degrees rectally), bloody stool and/or diarrhea, tar-black stool., severe back and or Flank pain, extreme constipation that lasts for days and poor circulation.
Abdominal pain can be caused by serious illnesses.
How to recognize them, where they cause pain and how to treat them is explained here by clinic director Prof. Franz Bader and private lecturer Dr.
Maximilian Sohn from the Munich Isar Clinic.
First an important note:
This overview is only for an initial assessment and cannot replace a medical examination or thorough diagnostics!
Stomach pain: right upper abdomen
Cramping pains that become more and more severe, along with nausea and vomiting - this could be biliary colic.
Gallstones, which have formed from fat crystals (cholesterol) or bile pigment (bilirubin), are usually the trigger.
They block the exit of the gallbladder or the bile duct.
As a result, the gallbladder cannot expel its fluid, which is needed to digest fat.
"The musculature of the gallbladder repeatedly contracts in vain, which causes the spasms," explains PD Dr.
Son.
The gallbladder can become inflamed due to the backlog of bile and other processes.
In acute cases, the patient should be on the operating table within 72 hours.
In this way, pain and the consequences of inflammation, such as a tear in the gallbladder in the worst case, can be prevented.
After a tear, a mixture of bile and pus can enter the abdominal cavity.
"This can be life-threatening," says Prof. Bader.
Gallstones are also often removed in a minimally invasive operation, along with the entire gallbladder.
They are difficult to break up in any other way, unlike some kidney stones, which cause pain on the right and left side of the body and can be shattered by shock waves.
The stones in the bile and kidneys have one thing in common: They can soon cause brutal pain.
"In the case of kidney stones, they sometimes radiate into the genital area," explains PD Dr.
Son.
It can also be dramatic if a stomach or duodenal ulcer ruptures.
Alarm signs are acute, unbearable pain and a hard stomach.
Is the stool tar black?
This could be a sign of bleeding from a stomach ulcer.
However, inflammation of the gastric mucosa is much more common.
"Patients should pay attention to their diet, for example avoid coffee and reduce stress," advises PD Dr.
Son.
Buscopan or paracetamol can help against the pain.
Ibuprofen and Voltaren should be avoided if you have abdominal pain because they can exacerbate problems in the stomach and intestines.
Abdominal pain: middle upper abdomen
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The stomach can cause pain in the middle of the upper abdomen, among other things.
© CLIPAREA/Panther Media
Here, too, the stomach often causes problems, but be careful: it could also be the heart!
Older women in particular are more likely to have abdominal pain, nausea and vomiting than chest pain when they have a heart attack - the main symptom in most men.
Belt-like pain indicates inflammation of the pancreas.
"The most common trigger is alcohol," says Dr.
Son.
"But it is also possible for the pancreatic duct to be blocked by gallstones." If there is a burning sensation behind the breastbone and the heart is healthy, one often suffers from heartburn.
This causes stomach acid to flow back into the esophagus.
Sometimes those affected also have a sore throat and cough.
You should reduce stress, eat less spicy foods and stop smoking.
Many patients swallow the gastric acid blocker pantoprazole.
"Anyone who struggles with heartburn over the long term should do a gastroscopy," advises Prof. Bader.
Because over a long period of time, the reflux of stomach acid in the esophagus can also develop cancer.
Abdominal pain: Upper left abdomen
"It's not a typical pain site," says Dr.
Son.
Here lies the spleen, which rarely hurts.
More like the stomach.
The kink in the colon, known in technical terms as the colon flexure, runs nearby, so that colon diseases can also lead to symptoms here.
As on the right side of the body, kidney stones on the left side can cause severe discomfort.
Abdominal pain: Lower left abdomen
The classic pain in this area is sigmoid diverticulitis.
Protrusions of the intestinal mucosa become inflamed;
they usually occur in the sigmoid, the lowest section of the large intestine.
Diverticulitis can also cause diarrhea, fever, and chills.
It often goes in spurts.
"Especially if you are affected for the first time, you should definitely go to the doctor quickly, because this is where the highest risk of complications is," recommends PD Dr.
Son.
“If the course is complicated, there is a risk that the intestine will tear and the contents of the intestine will get into the abdominal cavity.
You can die from it.” That is why the doctor usually orders a computed tomography (CT) if a serious case is suspected.
If it is confirmed, patients will have to stay in the hospital for a few days.
You get antibiotic infusions.
“When the acute inflammation has healed, you should go to a colonoscopy to take a close look at the sigmoid colon and the entire colon.
In some cases, it then makes sense to surgically remove the sigmoid to avoid further complications,” reports Prof. Bader.
In women, twisted ovaries, cysts, inflammation of the fallopian tubes or an ectopic pregnancy can be very painful in the lower abdomen.
Abdominal pain: lower abdomen middle
Bladder infections often occur here – with burning when urinating.
Be careful if there is blood in your urine.
The prostate can also be inflamed.
Women sometimes suffer severe menstrual pain in this area.
Abdominal pain: Right lower abdomen
This is where the appendix sits.
When it is inflamed, it often causes fever, nausea and vomiting in addition to pain.
“Today, the appendix is surgically removed less often than it used to be – only if the inflammation is complicated.
In less severe cases, antibiotic treatment is usually sufficient.
However, around 40 percent of patients suffer from renewed inflammation within five years,” reports PD Dr.
Son.
