Abdomen / Stomach

Anatomy

The human abdomen (from the Latin word meaning "belly") is the part of the body between the pelvis and the thorax. Anatomically, the abdomen stretches from the thorax at the thoracic diaphragm to the pelvis at the pelvic brim. The pelvic brim stretches from the lumbosacral angle (the intervertebral disk between L5 and S1) to the pubic symphysis and is the edge of the pelvic inlet. The space above this inlet and under the thoracic diaphragm is termed the abdominal cavity. The boundary of the abdominal cavity is the abdominal wall in the front and the peritoneal surface at the rear.

Functionally, the human abdomen is where most of the alimentary tract is placed and so most of the absorption and digestion of food occurs here. The alimentary tract in the abdomen consists of the lower esophagus, the stomach, the duodenum, the jejunum, ileum, the cecum and the appendix, the ascending, transverse and descending colons, the sigmoid colon and the rectum. Other vital organs inside the abdomen include the liver, the kidneys, the pancreas and the spleen. The abdominal wall is split into the posterior (back), lateral (sides) and anterior (front) walls.


Abdominal Organs

The abdomen contains most of the tubelike organs of the digestive tract, as well as several solid organs. Hollow abdominal organs include the stomach, the small intestine, and the colon with its attached appendix. Organs such as the liver, its attached gallbladder, and the pancreas function in close association with the digestive tract and communicate with it via ducts. The spleen, kidneys, and adrenal glands also lie within the abdomen, along with many blood vessels including the aorta and inferior vena cava. Anatomists may consider the urinary bladder, uterus, fallopian tubes, and ovaries as either abdominal organs or as pelvic organs. Finally, the abdomen contains an extensive membrane called the peritoneum. A fold of peritoneum may completely cover certain organs, whereas it may cover only one side of organs that usually lie closer to the abdominal wall. Anatomists call the latter type of organs retroperitoneal.





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Understanding & Treating Abdominal Pain

Just about everybody at one point or another will experience abdominal pain. Most of the causes of abdominal pain are not serious and can be readily diagnosed and treated. However, pain can also be a sign of a serious illness. It is important to be able to recognize symptoms that are severe and know when to call a doctor.

What Are the Most Common Causes of Abdominal Pain?

Whether it is a mild stomach ache, sharp pain or stomach cramps, abdominal pain has numerous causes. These include:

  • Indigestion
  • Constipation
  • Stomach "flu"
  • Menstrual cramps
  • Food poisoning
  • Food allergies
  • Gas
  • Lactose intolerance
  • Ulcers
  • Pelvic inflammatory disease
  • Hernia
  • Gallstones
  • Kidney stones
  • Endometriosis
  • Crohn's disease
  • Urinary tract infection
  • Gastroesophageal reflux disease (GERD)

What Symptoms of Abdominal Pain Are Cause for Concern?

If your abdominal pain is severe or if it is accompanied by any of the following symptoms, contact your doctor as soon as possible:

  • Fever
  • Inability to keep food down for several days
  • Inability to pass stool, especially if you are also vomiting
  • Vomiting blood
  • Bloody stools
  • Difficulty breathing
  • Painful or unusually frequent urination
  • The pain occurs during pregnancy
  • The abdomen is tender to the touch
  • The pain is the result of an injury to the abdomen in the previous days
  • The pain lasts for several days

These symptoms can be an indication of an internal problem that requires treatment as soon as possible.

How Is the Cause of Abdominal Pain Determined?

Because there are so many potential causes of abdominal pain, your doctor will perform a thorough physical examination, discuss with you the type of symptoms you are experiencing, and ask you several related questions about the pain you are feeling. These questions may include:

  • What type of pain are you experiencing? Is the pain throughout your abdomen or is it confined to a particular area?
  • Where in your abdomen does the pain seem to be located?
  • What type of pain are you experiencing? Is it stabbing and severe? Is it a dull ache?
  • When does the pain occur? Always? More often in the morning or at night? If the pain comes and goes, about how long does it last each time? Does it occur after eating certain types of foods or after drinking alcohol? During menstruation?
  • How long have you had this pain?
  • Does the pain also radiate in your lower back, shoulder, groin or buttocks?
  • Are you currently taking any medications or herbal supplements?
  • Are you pregnant?
  • Does any activity such as eating or lying on one side relieve the pain?
  • Have you been injured recently?

Once an initial evaluation has been completed, your doctor may have you undergo some tests to help him or her diagnose your pain. These may include stool or urine tests, barium swallows or enemas, an endoscopy, x-ray, ultrasound, or CT scan.

How Is Abdominal Pain Treated?

Treating abdominal pain depends on its cause. This can range from medications for inflammation, GERD or ulcers, to antibiotics for infections, to changes in personal behavior for abdominal pain caused by certain foods or beverages. In some cases such as appendicitis and hernia, surgery is necessary.

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