Abdominal Pain - Symptoms, Causes, and Treatments

Prof. D. Kannan, Senior Consultant Surgical Gastroenterologist at Kauvery Hospital, helps us understand abdominal pain symptoms, its causes, and treatment.

Our abdomen often called the "Temple of Surprises," has nine compartments, in which the upper abdomen, the middle abdomen, and lower abdomen are divided into 3 compartments each. 

Causes of abdominal pain

Abdominal pain is related to the organs underlying a particular area. Depending on the area, the doctor can diagnose the reason.

Upper abdominal pain

The organs in the upper abdomen include the liver, gall bladder, stomach, and spleen. If there is pain in the upper abdomen's right side, it could be a problem with the liver or the gall bladder. Gall stones are a frequent reason. If it is the upper left, it could be the stomach that is affected. 

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Middle abdominal pain

The middle of the abdomen includes the kidneys, pancreas, transverse colon, and small intestine. Any pain around this region could be due to pancreatitis. It could also be an infection or inflammation of the small intestine. If there is shooting pain from the middle of the back to the front and down to the groin, it could be a problem with the kidneys.

Lower abdominal pain

The lower abdomen consists of the appendix, large intestine, rectum, urinary tract, and bladder. If there is localized pain in the left lower abdomen, it could be appendicitis. If the pain is in the lower abdomen above the groin, it could be a UTI or an ovarian problem.

Home care for abdominal pain during the pandemic

Most abdominal pain can be eased with medication and antacids, which your doctor can prescribe over the phone. If it is very severe, it better to go to the hospital.

Tests to Diagnose Stomach Problems

The abdomen is a large area and consists of the liver, gallbladder, spleen, pancreas, kidneys, and blood vessels. There are several tests to detect abdominal problems.

Abdominal ultrasound

· Used to evaluate the cause of stomach pain or bloating

· Check for kidney stones, liver disease, tumors, and many other conditions.

· It is safe, non-invasive, and does not use ionizing radiation.

· Is not useful in detecting problems in the stomach and intestine

Cat Scan (Computerized tomography scan)

· Creates cross-sectional images of internal organs of the abdomen like liver, biliary tract, pancreas, spleen, kidneys, intestines, and pelvic organs

· Shows detailed images of bones, muscles, tissues, and blood vessels

· CT scanning is fast, painless, non-invasive, and accurate

· Best test to diagnose stones

· Uses ionizing radiation (Should not be used for children and pregnant women)

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MRE (Magnetic resonance enterography)

· Shows detailed pictures of the small intestine

· Pinpoints inflammation, bleeding, and other problems.

Barium enema

An X-ray exam that detects changes or abnormalities in the large intestine and rectum.

Barium swallow

An X-ray test that helps examinethe back of your mouth and throat and the esophagus.

Diagnostic laparoscopy

It is used to examine the organs inside the abdomen.

Upper GI endoscopy

It helps diagnose and treat gastrointestinal tract problems that include the esophagus, stomach, and the first part of the small intestine.

Colonoscopy

Detects changes or abnormalities in the large intestine and rectum.

Sigmoidoscopy

Examines rectum and lower part of the large intestine.

Abdominal angiogram

· Images the blood vessels of the abdomen to assess the blood flow to organs of the abdomen, such as the liver and spleen

· It is also used to deliver medication into structures of the abdomen to treat conditions

Liver Transplant – What you should Know

Dr. Siddarth, a consultant for liver diseases and transplantation at Kauvery Hospital, explains the different aspects of a liver transplant. 

When should a liver transplant be considered?

If liver disease is not brought under control, it can lead to liver failure over a while. There are many symptoms and complications associated with liver failure. These include esophageal varices, which cause severe bleeding, hepatic encephalopathy, a decline in brain function that causes confusion and loss of focus, etc., and swelling in the abdomen and legs. In some cases, the liver disease becomes so far advanced that it may affect the kidneys, the lungs, heart, and brain. In such cases of severe liver failure, a liver transplant is the only option. 

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How is a liver transplant done?

The treatment involves surgical removal of your entire liver. It is then replaced with all, or part, of a healthy donor liver. This may come from a living or deceased donor.

Benefits of an elective liver transplant

· It can lead to a better quality of life

· There will be less related complications

· Provides ample time to get a good match or find a donor

· Faster recovery due to fewer complications

It is better to do a liver transplant as an elective surgery rather than an emergency surgery for a positive outcome.

Managing Liver Health

Dr. Arivarasan, Dr. Dinakar Mani, and Dr. Kumaragurubaran of Kauvery Hospital help us understand how to keep the liver healthy and prevent liver disease. The liver acts as production, storage, cleaning, and filtering organ in our body. It is essential for digesting food and ridding our body of toxic substances. 

What causes liver disease?

Common causes include fatty liver (caused by fatty buildup in the liver), liver hepatitis (inflammation of your liver in reaction to alcohol, chemicals, drugs, etc.), and liver cirrhosis (caused by liver diseases like hepatitis and chronic alcoholism). If these problems are not addressed in time, it can lead to liver failure. 

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Preventing liver disease

· Eat foods that can help keep the liver healthy like nuts, leafy vegetables, paneer, plenty of eggs, soya, nuts, lean meat, fish.

· Avoid salty, baked, processed, and deep-fried foodstuff.

· Eat small meals 5 times a day.

· Have a high-calorie snack at night.

· Avoid alcohol

Managing liver disease symptoms

There are three common problems with liver disease.

1. Swelling in the abdomen and legs is one of the first symptoms. Treatment includes diuretics, albumin injection, and finally, an abdominal tap.


2. Hepatic encephalopathy is a decline in brain function because your liver can't adequately remove toxins from your blood, leading to sleepiness, lethargy, lack of focus, and blood poisoning. An enema will be given to rid the body of toxins


3. Bleeding problems like bleeding in gums, increased clotting time, vomiting blood, and blood in faeces. Endoscopy will be done to help deal with it.


If liver disease is severe, a liver transplant may be the only option.

Diseases of the Digestive System and Treatments

Dr. Arivarasan, Dr. Dinakar Mani, and Dr. Kumaragurubaran of Kauvery Hospital help us understand what causes digestive problems and how to deal with it. 

Common digestive problems

GERD

Gastroesophageal reflux disease occurs when stomach acid frequently flows back into the esophagus. This can irritate the lining of your esophagus.

Gastritis

Irritations to the stomach can cause indigestion, constipation, ulcers, burning sensation, and bloating.

IBS

Irritable bowel syndrome can cause diarrhea, constipation, pain in the stomach, and bloating.

Causes of digestive problems

Stress is one of the leading causes of digestive complaints, and during the pandemic, stress levels have been alarmingly high, and patients presenting with digestive problems have increased. The doctors comfort patients with the advice that, most times, digestive problems are not symptoms of a major disease but can be eased with some lifestyle changes.

Managing digestive problems

· Lower stress with meditation/yoga

· Avoid spicy/oily food

· Eat a light meal at dinner

· Instead of 3 big meals, have 5 smaller meals

· Be more active

· Avoid smoking/drinking

· Identify your triggers and avoid them

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When to see a Doctor

If your symptoms are long-lasting, chronic, or are causing other complications, see a doctor. You may need to have tests done, which may include:-

Diagnostic endoscopy – a nonsurgical procedure used to examine a person's digestive tract.

Therapeutic endoscopy - an endoscopic procedure that can diagnose as well as treat the disease.

Colonoscopy - used to detect changes or abnormalities in the large intestine and rectum.

ERCP (endoscopic retrograde cholangiopancreatography) - used to diagnose diseases of the gallbladder, biliary system, pancreas, and liver.

Most times, digestive problems can be managed and eased with small lifestyle changes.

Functions and Diseases of the Liver and how to keep it Healthy

Dr. V.S. Hemamala, gastroenterologist, liver specialist, and liver transplant physician at Kauvery Hospital, explains the importance of good liver health.

Liver overview

The liver is an organ that sits under your rib cage on the right side of your abdomen. It regulates chemical levels in the blood and excretes a product called bile. This helps carry away waste products from the liver. All the blood leaving the stomach and intestines pass through the liver. It is essential for digesting food and ridding your body of toxic substances. 

Common Liver Problems

Fatty Liver - caused by fatty buildup in the liver.

Liver Hepatitis - Inflammation of your liver in reaction to certain substances to which you're exposed, like alcohol, chemicals, drugs, or nutritional supplements.

Liver Cirrhosis - Scarring of the liver is caused by many liver diseases and conditions, such as hepatitis and chronic alcoholism. 

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Preventing liver disease

The liver is a regenerative organ. It can heal itself. Most of the liver problems are caused by some abuse of the liver. If avoided, the liver gets better. Here are some ways to prevent liver disease:-

· Maintain a healthy weight

· Eat a balanced diet

· Exercise regularly

· Avoid toxins

· Use alcohol responsibly

· Avoid contaminated needles

· Practice safe sex

· Follow directions on all medications

The Importance of Salt in Your Diet

For World Salt Awareness Week, February 29th to March 6th, Dr. R. Balasubramaniam helps us understand the importance of regulating salt in our diet.

The average intake of salt in a day for a person should be 10-14 gms. We ingest much more than that. Why is that not good for health? Let’s find out. 

Why do we need salt?

It helps balance our fluid levels, helps our nerves transmit impulses, and enables our muscles to contract and relax.

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What happens when you ingest too much salt?

It can raise blood pressure, and high blood pressure (hypertension) is a significant risk factor for heart disease and stroke. Too much salt can also affect our brain, heart, kidney, and blood vessels.

What are different ways to reduce salt intake?

• Eat less junk food

• Add salt at the table

• Avoid unprocessed food

• Don’t buy ready to eat foodstuff

• Incorporate more fresh, leafy vegetables and fruits

• Avoid eating out

• Use more spices instead of salt

On World Salt Week, it is crucial to becoming aware of how much salt we take daily and find a way to reduce it. This can help prevent many health problems and complications.

Bone Health and Osteoporosis | Dr. Aravindan Selvaraj, Chief Ortho Surgeon

On October 28th, 2020, World Osteoporosis Day, Dr. Aravindan Selvaraj and Dr. Kathir Azhagan of Kauvery Hospital discuss the importance of raising awareness of osteoporosis.

Dr. Aravindan feels that in India, the diagnosis of osteoporosis is made very late. This is because people find out that they have osteoporosis only after returning to the hospital with a fracture. He stresses that the disease can be managed better with an earlier diagnosis. All it would take is a simple blood test and a scan. 

Understanding osteoporosis

Osteoporosis causes the bones to become brittle, and due to this, the chances of a fracture increases. It is common among post-menopausal women but can affect men too.

Causes

• Vitamin D deficiency
• Calcium deficiency
• A decrease in estrogen (in post-menopausal women)

Diagnosis 

• Physical examination
• Blood test
• Dexa Scan or bone densitometry

Prevention

Keeping the bone strong and healthy is essential. This means having foods rich in calcium and Vitamin D. If there is a deficiency, supplements need to be taken to ensure that optimum levels are maintained.

It is essential to be aware of osteoporosis, get a yearly bone density test done, and maintain good bone health. Once you have osteoporosis, it is difficult to manage as it can lead to multiple fractures and related complications.