Everyone can suffer from pain in the stomach, at one time or the other and we usually ignore it. But when the pain is sudden and severe abdominal pain then it is termed as acute pain and this should not be ignored.

Often the following can be expected with acute pain:

Acute abdomen pain is usually synonymous with rapid onset of the symptoms which might indicate life threatening intra-abdominal pathology.
Pain is just a feature and not necessary that it is present at all times. An acute abdomen which is pain free usually occurs in children and women who are in their third trimester of pregnancy.
The differential diagnosis is difficult and wide especially in primary care. This is because the different organs within their peritoneal cavity might have different areas of referred pains.
Abdominal pain usually happens to be in the top three symptoms when patients present their state in the emergency and accident departments. But only few of these have acute abdominal pain.
Management of the abdominal pain should be the primary focus and an assessment should be done to reach the differential diagnosis so that care can be given accordingly.
The clinical evaluation regarding abdomen pain can change quickly. Any diagnosis which had been made can change and both doctor and patient should not be hesitant and seek other treatment.
Conditions which might cause acute abdomen pain are:

Meckel's diverticulitis or Acute appendicitis
Acute cholecystitis
Ectopic pregnancy
Acute pancreatitis.
Peptic ulcer disease
Diverticulitis.
Intestinal obstruction, including paralytic ileus (adynamic obstruction)
Pelvic inflammatory disease.
Gastrointestinal (GI) haemorrhage
Gastroenteritis.
Acute intestinal ischaemia/infarction or vasculitis.
Acute urinary retention
Renal colic or renal tract pain
Testicular torsion
Abdominal aortic aneurysm
Non surgical diseases like pericarditis, sickle cell crisis, acute intermittent porphyria, HIV-associated lymphadenopathy, bowel disease, typhoid, opiate withdrawal, enteritis, pneumonia, myocardial infarction and hepatitis.
Rare causes might include thromboemboli, phytobezoar, and phytobezoar
Diagnosis of abdominal pains:

Patients can be ordered to get their blood tests done. Also if need be then imaging can also be referred to them.
Following tests can be done to rule out the condition causing the abdominal pain:
Blood Tests: these include FBC, LFTs, glucose, amylase, clotting, calcium and arterial blood gas for pancreatitis
Crossmatch or group and save
Pregnancy test in women of childbearing age
Blood cultures
Peritoneal lavage in case of an abdominal trauma
Urine analysis
X ray of the abdomen, ultrasound, CT scan
ECG and cardiac enzymes
Laparoscopy should be a routine procedure

Don't Ignore the Acute Abdominal Pain

The human body s ability to manage the fats consumed and the way the liver functions to handle this in the overall metabolism setting are dependent on choline. Choline, which is present mostly in the form of Vitamin B12, is available in plenty in most of the foods consumed by people regularly. The issue arises when the body system fails to absorb choline nutrient from the food consumed. There are also cases where the dietary intake does not possess adequate choline in it.

Natural Difficulty in Absorbing Choline
There are certain conditions in which the system finds it difficult to absorb choline though the diet may contain the nutrient. People who have just undergone a by-pass surgery or those who have had a kidney transplant done or if there is already a liver problem like cirrhosis face this issue. There are other reasons also which can lead to choline deficiency, such as the prolonged intake of anti-convulsant drugs and so on.

How to Detect or What are the Symptoms?
Some apparent symptoms can lead the GP to ask for more tests to establish that the person does have choline deficiency. In normal person, even high blood pressure could be caused due to choline deficiency. Then in many cases, a blood test for any other condition might reveal very low levels of VLDL (Very Low-Density Lipoprotein). This substance in the blood is used by the liver to transport fats and naturally, if VLDL is below a certain threshold the person is bound to be suffering from choline deficiency. High level of cholesterol is another symptom. It has to be understood that choline is also essential for the human brain to be functioning at its active best. Deficiency of choline can lead to an early setting in of dementia. Of course, any patient with liver and kidney related condition reaching the doctor will be checked for choline deficiency since these are closely related.

Where to Get Choline from?
The next obvious question is which foods can get you choline easily and you won t suffer from a deficiency. As mentioned there are plenty of food items of daily consumption which have choline in them. The most frequently recommended are the yolk of the egg. Pastured eggs are recommended and though even one egg can give some 115mgms of choline, you can make a couple of eggs a part of your daily breakfast menu. The other suggestion is raw liver as in beef liver which is quite rich in choline. Those who consume only vegetarian foods can always eat a lot of green vegetables like cauliflower, cabbage and also nuts and legumes (soaked) and milk and yoghurt are all good for choline intake.

Choline is an essential nutrient in the human body and is critical to the growth and development of cognitive functions and its deficiency can lead to many serious conditions, including liver impairment and brain disorders. There are plenty of foods rich in choline and should be consumed regularly.


Choline Deficiency - Signs You Are Suffering From It + Sources Of Choline!! 

In general, fatty liver is considered synonymous with alcoholic liver disease. However, in reality it is not so. Fatty liver just indicates the presence of fat in the liver. It may or may not be harmful for the patient. Fatty liver is harmful only when it starts to damage the liver cells. Simple fatty liver does not cause inflammation, but when it starts doing so, it does not remain a simple fatty liver anymore.

Types of Fatty Liver Disease

There are two types of Fatty liver disease: Alcohol Related Fatty Liver Disease and Non-alcoholic Fatty Liver Disease.

Alcohol Related Fatty Liver Disease

Fatty liver does not always beget symptoms, although the liver may be enlarged. One may also feel discomfort or pain in the upper right quadrant of the abdomen. However, one can prevent alcoholic liver disease, since fatty liver owing to alcohol consumption usually gets better after stopping alcohol abuse. However, if a person doesn t do that, ALD can progress to more serious stages, like alcoholic hepatitis and alcoholic cirrhosis.

Alcoholic Cirrhosis
Alcoholic Cirrhosis occurs when there is formation of scar tissue in the liver. It can cause symptoms like bleeding, confusion, changes in mood and enlargement of spleen. Scar tissue formation can even lead to fatal liver failure.

Alcoholic Hepatitis
Alcoholic Hepatitis occurs when there is a swelling of the liver. It can precipitate nausea, fever, abdominal pain, vomiting, jaundice etc.

Non-Alcoholic Fatty Liver Disease

This is of two types: Simple Fatty Liver and Non-alcoholic Steatohepatitis.

Simple fatty liver just indicates the presence of fat in the liver without inflammation. On the other hand, Non-alcoholic steatohepatitis is a much worse form of fatty liver. This indicates that there is fat as well as inflammation in the liver. Even some of the liver cells may have become damaged. It can cause the following problems:

Formation of scar tissue in the liver, called fibrosis.

Severe fibrosis can lead to cirrhosis in advanced stages. Cirrhosis can lead to liver failure

Liver cancer

Causes of Fatty Liver

In alcoholic fatty liver disease, the prime cause is consuming too much alcohol. Alcohol may precipitate fatty liver by promoting obesity, malnourishment and even chronic hepatitis.

For non-alcoholic fatty liver disease there may be a number of factors:

Obesity

Insulin resistance

High levels of LDL cholesterol or low levels of HDL cholesterol

Diabetes

Conditions that may precipitate Type 2 diabetes 

High blood pressure

High blood sugar

Symptoms of Fatty Liver

There is hardly any symptom of fatty liver disease. At most, one can feel pain or tiredness in the right upper quadrant of the abdomen. However, if fatty liver has advanced to cirrhosis, fibrosis or hepatitis, there can be a number of symptoms. Some of these symptoms are:

Swollen abdomen

Enlarged blood vessels under the skin

Abnormal breast size in men

Redness in palms

Yellowing of skin and eyes.

Treatment

For alcoholic fatty liver disease, the best treatment is cessation of drinking when the fatty liver has still not progressed to more serious forms. For non-alcoholic fatty diseases, weight loss is an effective treatment. If there is Cirrhosis or Liver Failure, liver transplant is the only option.

As the treatment may vary from patient to patient, it is important that one should always consult a doctor before going for any option.

Fatty Liver - Types & Treatment Of It!

Sometimes, when it comes to problems in the abdominal area, an ultrasound is not clear enough for a diagnosis. In such cases, an Endoscopic Retrograde Cholangiopancreatography (ERCP) may be performed. This procedure gives the doctor a clear view of the duodenum, bile duct, pancreatic ducts, gallbladder and papilla of Vater.

This procedure is usually performed under intravenous sedation without general anesthesia. This procedure involves the use of a duodenoscope, which can be described as a thin, long, flexible tube with a camera at one end. It also has a fiber optic bundle that transmits lights to the camera and a chip to transmit video images to a TV screen.

This is inserted through the patient s mouth and sent down the throat through the food pipe to the stomach and duodenum while the patient is lying on his or her back. The air pipe is left undisturbed so as to not interfere with the patient s breathing. Since the patient is not under general anesthesia, he or she can move and turn according to the doctor s needs. The papilla of Vater is a small nipple like structure with an opening to the bile duct and pancreatic duct. Once this has been identified, a small plastic catheter is passed through the duodenoscope into the bile duct or pancreatic duct through the papilla. Dye is then injected into the area and X-rays are taken of the bile ducts and pancreatic duct. In cases where a biopsy is needed, other instruments can also be passed through the endoscope. Plastic or metal stents can also be passed through this to relieve obstructions in the bile ducts and pancreatic ducts.

ERCP can be used to diagnose and treat a number of conditions in the liver, bile ducts, gall bladder, pancreas and papilla of Vater. These include:

  Blockage of the bile duct by gallstones, cancer, scars, tumors or compression from adjacent organs.

  Jaundice due to an obstructed bile duct. This can also cause light stools and dark urine.

  Persistent upper abdominal pain

  Unexplained weight loss and loss of appetite

  Diagnosing a Dysfunctioning Sphincter of Oddi within the Papilla of Vater

ERCP can also be used to confirm pancreatic cancer and cancer of the bile duct. Once the diagnosis is confirmed, the doctors can customize treatment according to the patient s needs.

Endoscopic Retrograde Cholangiopancreatography - Procedure and Results

Peptic Ulcers are sores that develop in the lining of a stomach, small intestine or lower oesophagus. They usually crop as a result of inflammation caused by bacteria and also due to erosion from stomach acids. Peptic Ulcers affecting the stomach are also known as gastric ulcer, one in the duodenum is called a duodenal ulcer and an ulcer occurring in the oesophagus is called an oesophageal cancer. 

Talking about the causes, symptoms, tests and exams related to it and treatment options for peptic ulcers. Let s go ahead and take a look at them one by one:

There are certain symptoms for peptic ulcers and one of the most common ones being, indigestion-like pain in the abdomen. 
The pain tends to occur anywhere in the region between the belly button and breastbone and the duration can be brief or may even last for hours. 
A change in appetite could be noticed, wherein you may not feel like having anything
Feeling of uneasiness which can have an effect as if you are going to vomit.
You tend to lose weight for no apparent reason.Stools with dark red blood.
Causes Of Peptic Ulcers

Peptic ulcers can be caused as a result of different factors, which lead to the breakdown of lining of the stomach, oesophagus and small intestine. The causes are as follows:

Helicobacter pylori: It is a type of bacteria which causes stomach infection and inflammation. Helicobacter pylori produces urease, which is an enzyme that neutralizes stomach acid by making it less acidic. In order to compensate this, the stomach goes on to produce more acid which leads to irritation of the stomach lining. The bacterium makes the stomach s defense system weak and causes inflammation.
Overdose of drugs: If you are in the habit of using aspirin or ibuprofen along with other anti-inflammatory drugs on a regular basis, then you increase the chances of suffering from ulcer.
Smoking: Smoking leads to an increase in the production of stomach acids and that tends to reduce bicarbonate production. People who smoke are at risk of developing duodenal ulcers.
Increased Alcohol Consumption: When you have too much alcohol, then you are at a risk of developing all sorts of problems. Alcohol is basically a toxin which can damage almost every organ of the body. Digestive system can get hampered a lot through alcohol. Alcohol irritates the stomach lining, which leads to an increased risk of developing ulcer.
Treatment Of A Peptic Ulcer

Treatment would depend upon the underlying cause of ulcer. Your doctor would most probably suggest you to do an endoscopy and if the test shows that there is H.pylori infection, a combination of medicines would be prescribed. Medications would ideally continue for two weeks. There will be antibiotics to kill infections and Proton Pump Inhibitors (PPI) for reducing stomach acid. If the doctor feels that ulcer has not been caused as a result of H.pylori infection, then you might be asked to take over-the-counter medicines like Prilosec or Prevacid for close to eight weeks, which would not only reduce stomach acid but also heal your ulcer.

Peptic Ulcers - Common Causes Behind Them!

Irritable bowel syndrome is a disorder, which generally affects the colon (large intestine). It usually show symptoms like abdominal pain, cramping, bloating, diarrhea, gas and constipation. IBS is a long term condition. It can result in sudden mood swings, depression and thus, holds you back from living your life to the fullest. IBS can be controlled by managing lifestyle, stress and managing your diet. Medication and counseling could also be required to manage IBS.

Symptoms of IBS:
1. Immense cramping and pain.
2. A feeling that your belly is bloated all the time
3. Severe gas
4. Alternating and sudden bouts of constipation and diarrhea.
5. Presence of mucus in the feces.

Whenever you experience such kind of symptoms, it is always advisable that you must consult a doctor, so that it doesn't lead to a serious condition.

When should you consult a doctor for IBS?
IBS is not a chronic disorder and can be controlled by home remedies. It may also require medical treatment if the symptoms become acute and persist for too long. If you experience certain symptoms like rectal bleeding, weight loss and heavy abdominal pain that might increase at night, you may be at a risk for colon cancer. If such symptoms persist, you should visit a doctor as soon as possible.

Causes of IBS:

Foods: Most people are susceptible to IBS if they consume foods like spices, fats, fruits, cabbage, beans, broccoli, cauliflower, carbonated beverage, milk or alcohol. These foods irritate the lining of the stomach and trigger IBS. However, the trigger may vary from person to person.
Stress: Signs and symptoms of IBS can also increase if you are very stressed out. Stress makes your muscles too worked up and this may result in IBS. However, you should know that stress aggravates or triggers the symptoms but doesn't cause IBS.
Hormones: Women are more likely to develop IBS. Fluctuations in the hormonal cycle can trigger IBS. This usually occurs around or during menstruation.
Other illnesses - Sometimes illness such as gastroenteritis (infectious diarrhea) or bacterial overgrowth in the intestines can trigger symptoms of IBS.
Age: You will be more likely to develop IBS if you are 45 years of age or above.
Hereditary: People having a family history of IBS are more susceptible to develop IBS.
Mental problems: Depression, personality disorder, anxiety and a history of sexual abuse can also trigger symptoms of IBS.

Irritable Bowel Syndrome - Can Severe Gas be a Sign of it

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