Abdominal pain is a frequent reason for consultation with a gastroenterologist. This is a common symptom with a diverse etiology. There are numerous causes of abdominal pain which includes conditions such as irritable bowel syndrome, ulcer disease, inflammatory bowel disease, intestinal ischemia, gallstones, pancreatitis, diverticulitis etc.
Evaluation starts with a careful history and physical examination followed by appropriate investigations tailored to perceived etiology of patient’s symptoms. This may include imaging such as ultrasound, computed tomography scans, MRI as well as endoscopic evaluation with upper endoscopy and/or colonoscopy in Redding or in some cases endoscopic ultrasound.
After ruling out any underlying serious cause with appropriate investigations depending on patient presentation and/or presence or absence of ’red flag’ signs such as anemia, weight loss, rectal bleeding, a diagnosis of irritable bowel syndrome and/or functional abdominal pain syndrome is ascertained. Overall from a population standpoint, these are frequent causes of abdominal pain and require targeted treatment. Irritable bowel syndrome and functional abdominal pain syndrome frequently overlap in the leading cause is visceral hypersensitivity in which there is excessive sensitivity to normal physiologic signals arising from the gastrointestinal tract. Another proposed mechanism is abnormal contractility of the gut and abnormal brain-gut axis communication.
Treatment for irritable bowel syndrome/functional abdominal pain syndrome may involve taking medications called neuromodulators which help reset the abnormal brain-gut axis in these patients. Some patients may also require non-medicine approaches to management such as gut directed hypnosis, cognitive behavioral therapy, relaxation techniques.