Pinpointing Your Abdominal Pain: What Is The Cause?

Few pain sensors in the human body are as intense as those in the human abdomen. For that reason, when certain medical emergencies (and non-emergencies) occur inside a person's abdominal cavity, pain can often be unbearable. Many people want to write certain pains off as "gas" pains, but there are several severe emergencies that can exhibit severe abdominal pain.

The human abdomen is divited into 4 quadrants: the Right Upper Quadrant, the Right Lower Quadrant, the Left Lower Quadrant, and the Left Upper Quadrant. These quadrants are separated by an imaginary horizontal line at the level of the bellybutton and a vertical line that intersects the other line at the bellybutton.
 

Knowing what organs lie in each of these quadrants along with their etiologies can help you know whether your or a loved one's abdominal pain is an emergency or a "wait and see." Below you will find a breakdown of which organs are in which quardrants, along with descriptions of their symptoms, risk and more.

Lower Left Side Abdominal Pain

Although lower left abdominal pain is most often associated with large intestine pain, the cause can come from several other organs. The appendix can even cause Left Lower Abdomen pain in cases of Situs Inversus, a condition where a person's organs are on the opposite side from their normal position, although this occurs in less than 1 in 10,000 people. Causes of Left Lower Abdominal Pain can be:

• Large Intestine (Colon) pain from a bleed, blockage or Diverticulitis
• Small Intestine pain from a bleed or blockage
• Pain associated with Female Reproductive Organs
• Kidney Stone passing through the left ureter
• Blood in the abdominal cavity
• Blood clot in the Left Lower Abdominal area

Diverticulitis is a common cause of Left Lower Abdominal Pain that is usually closer to the center of the lower abdomen. Diverticulitis is usually caused by pouches in the colon or large intestine that get stretched (Diverticuli) and then catch undigested food (popcorn, sunflower seeds, peanuts) and become infected. This causes extremely sharp lower abdomen pain that will not subside.

Upper Left Side Abdominal Pain

Upper Left Side Abdomen Pain can be caused by a few different organs the the previous two. Some causes include:

• Pancreatic pain
• Splenic pain
• Large Intestine Pain
• Small Intestine Pain
• Stomach Pain
• Pain related to Female reproductive organs

The most common cause of Pancreatic pain, pain from the pancreas, is Pancreatitis, or an inflammation of the pancreas. Pancreatitis can be an isolated case or can be a chronic problem. Due to the makeup of the organ, surgical repair can be difficult so chronic pain is usually handled with long term pain management medication.

Although splenic pain can be caused due to infections and other medical causes, the more common cause of sudden severe pain from the spleen is actually trauma. Closely associated with driver-side impact in a vehicle collision, spleen rupture is a very deadly condition. Although splenic pain can be felt in the Upper Left Abdomen, "referred pain", pain felt somewhere other than where it is being caused, often can be felt in the left shoulder, shoulder blade, or collar bone areas.

Stomach pain causing severe Left Upper Abdominal Pain can be caused by gas, hunger or cramping, but a serious concern would be an ulcer, whether bleeding or not. These are generally found by upper endoscopy which should be considered for anyone who experiences recurring upper abdominal pain.

Upper Right Abdominal Pain

Upper Right Abdominal Pain is generally linked to three organs, the Liver, the Gallbladder, and the Stomach. Although pain can come from blockages or bleeds in the small or large intestine, one of those three is usually the culprit.

The liver, a large organ that occupies the upper right abdomen but can also reach into the upper left abdomen and into the thorax behind your right lower ribs. Pain from the liver can be from injury but it can also be from infection to the liver, which is called Hepatitis. We all associate Hepatitis with a disease transmitted by sex, blood transfusions, or dirty needles, but it can be caused by any medical problem with the liver, including cirrhosis and other causes.

Gallbladder pain can be caused by stones and/or infection. The pain usually occurs when the bile duct that travels from the Gallbladder to the small intestine is blocked due to swelling or a stone. Pain can be more prevalent after eating a greasy meal, and is more common with slightly overweight females who are over forty years old.

Stomach pain in the right upper abdominal area is often due to stomach and/or duodenal ulcers (ulcers occurring in the first section of the small intestine).

Right Side Lower Abdominal Pain

One of the most commonly thought of pains in the abdomen is Right Side Lower Abdomen pain. Generally, this pain is associated with appendicitis or appendix rupture, but other organs can cause Right Lower Abdominal pain. Some of the possible causes of right lower abdomen pain are:

• Appendicitis
• Small or Large Intestine Bleed or Blockage
• A passing Kidney stone in the Ureter or Bladder
• Pain associated with female reproductive organs (Ovaries, Uterus, Cervix)
• Blood in the abdominal cavity
• Blood clot in the area

Although, as I said, Appendicitis is associated with pain in the Right Lower Quadrant, it generally begins in the umbilicus (belly button) area, due to how our abdominal sensory nerves develop while we are in the womb, then it moves over to an area between the belly button and the top front of the hip bone. One aspect of abdominal pain that is indicative of appendicitis or appendix rupture is pain when releasing pressure on the right lower abdomen.

Kidney stone pain in the ureter is usually associated with side (flank) and back pain. It can be accompanied by fever and even blood in your urine.

Diffuse Abdominal Pain

Diffuse abdominal pain, or pain that is spread all over the abdomen and not in one specific spot, can be just as painful and just as deadly as other types of abdominal pain. Peritonitis, inflammation and infection of the lining of the abdomen, can be caused by:

• Blood in the abdominal cavity
• lack of oxygen due to a blood clot
• infection spreading from a specific organ to all of the abdominal organs
• pain from one of the other causes that is felt all over the abdomen rather than in their normal spot

Bleeding from either injury or medical problems, such as aneurysm, can be very deadly due to the amount of blood that can be lost in the abdominal cavity and the size of the blood vessels that run through the abdomen. AAA, or abdominal aortic aneurysm, is the swelling and even ripping of the descending aorta. Symptoms can also include numbness or paralysis to one or both legs, weakness, profuse sweating, cold skin, and feeling of impending doom. If you have any of these symptoms call 911 immediately.

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Do You Need Gallbladder Removal?

More and more often today, people are having issues with their Gallbladder. Many people experience pain, usually from Gall Stones, and often they end up having their Gallbladder removed via surgery. In fact, more than half a million people have their Gallbladder removed each year, due to a Gallbladder stone problem or other problems.

Part of the problem may be that we, as a people, are more obese than in years before. On of the biggest risk factors for Gall Stones is obesity. Not unrelated, rapid weight loss diets can increase a persons risk for developing Gall Stones. For this and other reasons, females are at a higher risk of Gallbladder problems than are men. This is particularly worrisome since gallbladder symptoms in women can be masked or diminished like heart attack and other thoracic and abdominal issues. In fact, the main risk factors for Gall Stone development are obesity, female, at or over 40 years of age, and premenopausal females.

What Is The Gallbladder?

The Gallbladder is a small organ that lies just below your Liver, to the right of your stomach. It is about 3-3.5 inches long. It holds bile that is produced in the Liver and releases it into the Duodenum, the beginning of the small intestine, on the presence of partially digested fats released from the stomach. This bile then emulsifies the fats to prepare them for digestion and metabolism.

It is believed that the Gallbladder stores higher concentrations of bile when a person has a high fat diet. If that is true, it is easy to see why calcifications, or Gall Stones, form more often in those who eat more fatty foods. It is also understandable that many people who experience Gallbladder stone pain feel it worse after a fatty or greasy meal. When these Gall Stones form, a person is at risk of developing Cholecystitis, (inflamed Gallbladder), Pancreatitis (inflamation of the Pancreas) or other infections.

Signs And Symptoms Of Gallbladder Stones

Gallbladder symptoms in women, in particular, can be masked or different, just like other serious medical issues. Signs for all patients generally include severe upper abdominal pain, more specifically abdominal pain just below the rib cage, below the right breast. This pain is generally constant and in many cases can occur after eating a greasy meal or after eating in general.

Although it sits in proximity to the lower right lung, it generally does not present as lung or right chest pain, however, a Gallbladder symptom can also be mid-back pain or right shoulder pain.

The upper right abdominal pain can be accompanied by Nausea and/or Vomiting, along with sweating or diaphoresis. Also, if the condition progresses without care, a person's skin and eyes can begin to yellow and a fever can occur. These tend to be late signs of the problem.

Reasons To Have Gallbladder Removal Surgery

The two main reasons for Gallbladder removal surgery are Cholecystitis (infection of the Gallbladder), generally caused by Gall Stones in the Gallbladder or one of the ducts to the small intestine, or Gallbladder Cancer. Although Gallbladder cancer is serious and should be taken as such, Cholecystitis is both more prevalent and can cause further damage to the body and even death much more quickly than Gallbladder Cancer.

Although many people have "silent stones" that do not cause pain and generally go unnoticed, once a person begins to experience Gallbladder pain the end result is usually Gallbladder removal. The most definitive reason to have Gallbladder Removal Surgery is that if a person truly has Cholecystitis and allows it to go untreated, the infection will spread to nearby organs, including the small and large intestine. An untreated case will eventually lead to sepsis, shock, and then death. This pathway normally will not go unchanged due to the intense pain that is associated with the Cholecystitis.

Complications Of Gallbladder Removal Surgery

Here lies the definite reasons to not rush to Gallbladder Removal. Although in many cases people have true Cholecystitis and must have removal, others experience mild Gall Stone pain from "silent stones" or have digestive issues that may be related to their bile storage or production. Some of these people struggle with irritable bowels and just want some relief from never knowing when they may have to rush to the bathroom.

For those just looking for digestive relief, you may find quite the opposite from Gallbladder Removal. Especially in the short term after removal, most patients experience very irritable bowels due to unrestricted bile flow to the small intestine. Although this can be controlled somewhat by change in diet, finding the right combination of food can be difficult. Also, if this can be controlled by diet change, it is highly likely that the irritable bowels experienced before removal can be controlled by diet to the same extent.

There is also a small possibility that patients who have had Gallbladder stone issues and have their Gallbladder removed will have issues with scar tissue. When the Gallbladder is removed, the ducts to and from the Gallbladder are severed, stapled, and cauterized. In this process, scar tissue can form and can cause more digestive issues or sensitivity.

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