Abdominal Pain: Just Gas Or An Emergency?
Diagnosis and Evaluation:
How do you know if you have emergency abdominal pain? The bottom line is that
if you think you do, contact your physician sooner rather than later.
Your symptomatic and long term treatment may be much more successful if begun
early. You can get other clues from the questions below.
Take Dr. Donnica's Decisionnaire™. These are the specific
questions your doctor or the emergency room physician will probably ask you
in addition to all the general questions about your health, past medical history,
family history, and what drugs/medicines you take (prescription and over the
counter). Try to answer as many of these questions as you can.
__ When was the first day of your last period? This is the first question
you will be asked. You will also be asked if this was a "normal" period: was
the flow heavy or light? Was it on time, early or late? If you might be pregnant
or are trying to get pregnant, say so right away.
__ What are you using for contraception? Be honest if you are not using
regular contraception. Your physician may also ask frank questions about your
partner(s) and other high risk behaviors: these questions are not meant to
embarrass or offend you, but are intended to help make a proper diagnosis and
select the appropriate medical tests.
__ Severity: On a scale of 1 to 10, how bad is the pain? If you've
given birth, how does it compare to labor pain? How does it compare to menstrual
__ Location: Where is the pain now? Where was it when it began? Think
of dividing your belly into four sections, or "quadrants". Different conditions
are usually characterized by the location of their pain in the right upper quadrant,
the right lower quadrant, the left upper quadrant, or the left lower quadrant.
Other pain is "diffuse", meaning it's all over your belly, whereas other pains
localize in the upper half of the abdomen or the lower half.
__ Referral: Does the pain go to another location? For example, does
it start somewhere specific and then radiate elsewhere?
__ Quality: Is the pain sharp, dull (like a toothache), "boring" (e.g.
like a bull's horn going through you), burning, crampy, or just overwhelming?
If you've had this type of pain before, how is it different this time?
__ Timing/Duration: How long have you had the pain? Is this the first
time you've had this particular type of pain or have you had it before? When?
Under what circumstances? What happened that time? Does it wake you from sleep?
Do you get it every month? Does it come/go with your period? Does it occur
after eating, drinking alcohol, or exercising? If so, how much alcohol do you
drink (regularly or sporadically)? Describe your diet, especially spicy or
fatty foods. Do you binge eat or make yourself vomit?
__ What makes it better/what makes it worse? This includes movement,
positions, exercise, sex, foods, medicines (prescription and over the counter),
bowel movements or passing gas, vomiting, etc. Give this some thought-the answers
to these simple questions can actually lead you to the operating room or away
__ What other symptoms do you have in addition to the pain? This includes
everything that's just not normal for you: increased/decreased appetite, fever,
chills, changes in your bowel or bladder habits (constipation, diarrhea, increased
or decreased urination, burning with urination), blood coming from anywhere
(stool, urine, vagina, nose), pain elsewhere in your body, dizziness, or fainting.