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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 cramps?

__ 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 from it.

__ 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.

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 The best advice I can give you is: if you think it's an emergency, it probably is. 

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