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Abdominal Pains

Abdominal pains can have a large number of different causes.  We must reiterate the comment that this site cannot substitute for consultation with your doctor or give diagnosis, but will be including links below which we hope you will find useful.

Some of the causes of abdominal pain also cross over with pelvic pain.  

Referred pain and sensitisation

Particularly in the abdomen and pelvis, but also in organs such as the heart, nerve impulses carrying pain information do not all travel in the same sort of nerves as those carrying information from the body surface and other structures, which we call somatic nerves.  The nerves carrying information from the organs (viscera) are called visceral nerves.  These two classes of nerves travel in different routes, but feed into the same parts of the spinal cord and central nervous system.  This is why sometimes pain from the viscera is felt in other areas (such as a "stitch" or gall-bladder pain being felt in the tip of the shoulder).  This is called referred pain.  

The nerves in the viscera and their central nervous system connections are prone to become "jumpy" and sensitised with continuing pain, so that they react more painfully.  This mechanism can underlie conditions such as Irritable Bowel Syndrome, bladder irritability and pain including Interstitial Cystitis, and other conditions.  This may also be the reason why some patients have ongoing troublesome abdominal pain without any obvious cause being found despite extensive investigation.  Also, because the visceral and somatic nerves share connections in the central nervous system, visceral nerve sensitisation can make the overlying body surface nerves more "jumpy" and vice versa.  This effect on the abdominal wall can also lead to the development of painful myofascial trigger points in the muscles.

Types of abdominal pain

Because the abdomen contains a complex variety of organs, there are a large number of potential causes of pain.  More information on these can be obtained from the links below and the menu on the right.

As well as pain from organs within the abdomen and pelvis, the surface of the abdomen and its muscles and other tissues is a potent cause of pain, including Abdominal Cutaneous Nerve Entrapment syndrome which we see frequently, and the development of myofascial trigger points in the muscles.

 

Links

Patient.co.uk page on abdominal pain

Patient.co.uk page on irritable bowel syndrome

Further information on interstitial cystitis here and here

The patient information pages from the International Foundation for Functional Gastrointestinal Disorders have some very useful resources.

Further Reading

review article by Farmer and Aziz, although written for a medical audience, may be of use if you want to read further about gut pain and visceral hypersensitisation.

For professionals, the Rome III Criteria for Functional Gastrointestinal Disorders may be a useful resource.

 

 

 

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Pain Service Website, Gloucestershire Hospitals NHS Foundation Trust
Webmaster Dr J G de Courcy, Consultant in Pain Medicine and Anaesthesia
email: pain.webmaster[at]glos.nhs.uk

Page updated 4/7/2016