Abdominal pain can be triggered by a number of factors. Sometimes, it's mild enough to be overlooked while at others, the pain can be debilitating. Most abdominal problems start with the same symptoms and hence the cause of this pain can be a little difficult to pin point. In many cases, the location of the pain can help understand the factors that are triggering it.

Generalized pain can be simply be triggered by indigestion. On the other hand, it could also be a symptom of a number of illnesses like irritable bowel syndrome, appendicitis, viral gastroenteritis and intestinal obstructions etc. However, the former are more common. This type of pain resolves itself without medical intervention.

In other cases, abdominal pain can be localized to the upper or lower abdomen on the right or left side or in the centre of the abdomen. This sort of pain is usually sporadic and comes and goes with great intensity. In most cases, this sort of pain is a symptom of a serious problem and should not be ignored. One of the most common examples of localized abdominal pain is the pain caused by appendicitis in its later stages. Severe pain that is located just above the centre of the belly button could be a sign of pancreatitis. A burning sensation and severe cramps in the center of the stomach could point towards stomach ulcers that could cause perforations if left untreated. Other causes for this type of pain include endometriosis, ovarian cysts, angina, kidney infections and a spleen infection.

Mild stomach pain whether localized or general can be relieved using home remedies and does not often require medication. However, if the pain is severe or if it comes on suddenly, you must immediately consult a doctor. Another reason to consult a doctor is if the pain persists for more than 24 hours. If the pain is accompanied by black or bloody stools or vomiting and nausea, do not ignore it. Black stools are often an indicator of the presence of blood in the digestive tract. Abdominal pain that worsens with movement or is tender to touch is also something that should be shown to a doctor. Other reasons to consult a doctor are abdominal pain with persistent vomiting following meals and unexplained weight loss and a loss of appetite.

The bottom line is, that when it comes to abdominal pain, it's better to consult a doctor and be told that there's nothing to worry about rather than self medicate and wait for it to worsen.

Abdominal Pain & When To Consult A Doctor

Types of abdominal and pelvic surgical incision

At the time of a surgical procedure, while making an incision a doctor has to take care of a number of factors before making an incision. Considering a number of factors, different types of incisions have come into fore, such as 

Midline Incision: It s the commonest incision and is done along the linea alba (fibrous structure running through the mid of the abdomen). These are preferred, especially in diagnostic laparotomy as it permits a wide access to the abdomen.
Pfannenstiel Incision: It is transverse in nature, extending from the umbilicus to the pubic-symphysis. It is generally employed for abdominal hysterectomy of benign nature and caesarean section.
Chevron Incision: It is an incision under the rib-cage and is done on the abdomen. It starts from beneath the ribs on the right abdomen and extends till the other mid axillary line. Thus, the entire abdominal width is incised for proper reach into the liver. The incision can be up to 2 feet.
Kustner Incision: It is transverse in nature and extends from the symphysis pubis till the iliac spine (anterior). This type of incision takes time to perform. A Pfannenstiel incision offers more exposure than a Kustner incision.
Lanz Incision: It is a variation of the more common mcburney-incision (also known as Gridiron s incision). It is generally used for open appendectomies. There are quite a few variations for this type of an incision.
Gridiron s incision: It is done for appendectomies. It is an oblique short incision which is done in the lower right quadrant in the abdomen.
Kocher s Incision: It is oblique in nature, extending from the abdominal upper right quadrant and is generally used for performing an open cholecystectomy. Gallbladder, biliary tract and certain liver operations can be suited for a Kocher s incision. This however is different from the same named incision used for the thyroid gland surgery.
Cherney Incision: It is transverse in nature. It allows a great range of exposure for the pelvic sidewall. It is less painful than a midline incision. It allows for the greatest pelvic exposure and hence is a widely preferred and practiced incision.

8 Types Abdominal and Pelvic Surgical Incisions

The outcome and the procedure of an abdominal laparoscopic surgery vary among patients. The extent of the surgery, the length of the procedure, the surgeon, the hospital nursing staff, and a number of other factors vary with each patient.

Moreover, the recovery or the healing time also varies among patients. What applies to one patient may not apply to another. Generally speaking, surgeons will tell you that it takes only a few days to recover from a laparoscopic surgery, but this is not true to specific cases as in many cases, the recovery time has been longer than expected. So, a laparoscopic surgery is subjective to the health of the patient and the extent of the procedure; however, there are some tips that may prove to be helpful for you to deal with a laparoscopic surgery and to improve your healing process.

Here are some useful tips that you can follow before the surgical procedure.

After you have consulted your doctor and made up your mind on the procedure, then it will be useful to watch some surgery videos and read about the procedure to prepare yourself mentally. The videos can be gory and hence discretion must be maintained.
You can read blogs by patients who have undergone laparoscopic surgery to get a better understanding of the procedure and its implications.
Eight hours prior to the procedure, do not drink or eat anything.
Ask someone to accompany you on the day of the procedure.
Make sure that you fix a pre-op appointment with the surgeon to clear any doubts about the surgery, anesthesia or any such concern.
You can shave the part of your body where the surgery will be performed by yourself or be prepared for someone else to do the same at the hospital.
Prepare your hospital bag with the necessary items and inform the person accompanying you about the items in your bag.
Here are some useful tips that you can follow after the surgery.

Keep yourself active after the procedure to enhance the healing process and to relieve any flatulence.
Stick to comfortable clothing and preferably loose clothes.
Avoid taking a bath for a week or as advised by your surgeon.
To avoid constipation and to stay hydrated drink at least 2-3 liters of water a day.
Hold a pillow against your stomach to lessen the pain while sneezing or coughing.
Don t get up straight from your bed. Roll sideways and use the support of your arm to stand up.
Avoid driving for at least 2 weeks.
Go for regular check-ups with your surgeon or doctor to ensure that the incisions are healing properly.

Tips To Deal With Abdominal Laparoscopy!

Ulcerative Colitis is a chronic inflammatory disease that affects the lining of the intestine and the rectum. It is located just above the anus. Patients suffering from ulcerative colitis tend to have small ulcers in their rectum and the colon. These eventually flare up leading to diarrhea, bloody stools, anemia and abdominal pain. The inflammation starts from the rectum and eventually, spreads to the colon. Ulcerative Colitis tends to flare up and remit in an alternate phase. The remission can last from few weeks to few years.

Methods adopted to diagnose Ulcerative Colitis-
Ulcerative Colitis is very similar to an inflammatory bowel disease known as Crohn s disease. The only differentiating factor is the fact that, ulcerative colitis affects the colon whereas, Crohn s disease affects the digestive system and the small intestine. A doctor might prescribe certain tests such as the colonoscopy, blood tests, CT scan, pill camera, stool sample tests etc.

Why is surgery necessary to treat Ulcerative Colitis?
An estimated 40 percent of all Ulcerative Colitis patients need to undergo surgery to recover completely. The reason surgery becomes necessary to treat ulcerative colitis are the following:

Drug therapy and medication become ineffective.
Without undergoing surgery, the condition might increase the risk of developing cancer.
The colon has the risk of getting ruptured if surgery is not performed on time.
There could be excessive bleeding.
Toxic megacolon might set in.
Types of surgery available to treat Ulcerative Colitis
A procedure where the entire colon is removed is known as the colectomy. In case both the colons are removed, the procedure is termed as proctocolectomy. In this procedure, an external pouch needed to be attached to the stoma that collects the stools. There is another method known as pouch surgery. 

Pelvic pouch or ileal pouch is also termed as IPAA. This procedure doesn t involve permanent stoma. In this procedure, both the colon and the rectum are eradicated from the body. The small intestine is then used to form a J-shaped pouch, that serves as the new rectum. The pouch is then connected to the anus. The whole procedure is done via two surgeries.

What are the surgical complications of this procedure?

There could be an excessive bowel movement.
There are instances where an inflammation of the pouch is observed. This condition is known as pouchitis.
There could be a situation of intestinal blockage from adhesion due to surgery.
There could be pouch failure that can happen inside within 5 few years. This is observed in 4 out of 100 patients who are treated. In this case, the patient should go for a permanent ileectomy.

Ulcerative Colitis - What You Need To Know?

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

As soon as one is released from hospital after going through an abdominal surgery, the patient must make a checklist and an early recovery strategy before leaving home. Do follow the following tips and recover soon.

    Do make prior arrangements for a safe and comfortable journey back to home. Ensure that you have made transportation arrangements to go home safely. Use your own car or book any cab or take any friend s help. Place a cushion over your abdomen to keep it safe from jerks.
    Do go for post-surgery checkup. Book an appointment with your surgeon post-surgery. This would ensure that surgery did not cause any side-effect.
    Understand the schedule for taking medicines. Usually the patients are given painkillers. If you think you are not getting relief from it then ask your surgeon to prescribe you an alternative. Patients are likely to suffer from constipation post an abdominal surgery. If that happens, intake more fibrous food, fluids and indulge in light physical activities. Patients can also ask for cheaper alternative medicines.
    Check for certain signs and symptoms and take adequate steps:
        Take adequate sleep. There are chances that you may feel dizzy and fatigue, therefore one must observe change in sleep patterns. Have patience. Things will become normal in due course of time.
        You will also be subjected to little pain from the incision. Take your medicines as directed in order to get an early relief from pain.
        Draining of yellow color liquid from the incision in little quantities post the surgery is normal. If the drainage continues even after 7 to 14 days with redness around incision, it is a clear symptom of infection. Consult your surgeon immediately for the cure.
        Removal of urinary catheter from the bladder may cause minor difficulties during urination. Situation will become normal in few days. If discomfort persists, consult your surgeon.
    Identify the following dangerous symptoms and call your doctor right away.
        Persistent vomiting or nausea
        Incapability to digest food or fluids
        Swelling in leg
        Abnormal body temperature
        Infection at the surgical site
    Maintain a healthy and supervised lifestyle post surgery.
        It will take few days to return to your normal routine life. So have patience until then.
        Go for morning and evening walks. Avoid heavy exercises as such activities may cause physical strain.
    Take care of your surgical incision
        Surgical incision should be regularly cleaned or washed gently. Try to keep the surgical site dry until the stitches are removed.
        After 5-7 days of surgery, the stitches would be removed by the surgeon. Avoid putting ointment on the stitches until then. It will take few weeks for the scars to fade.

Under proper care and supervision, the patient will soon recover post an abdominal surgery and will be able to get their life back on track.

Tips to Recover from an Abdominal Surgery

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