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Common Causes for Severe Stomach Pain
Interviewer: Dr. Scott Youngquist with the Ìð¹ÏÊÓƵ of Utah Hospital, are you ready for ER or Not?
Dr. Youngquist: I'm ready.
Interviewer: All right. Here we go. Here's the situation. You wake up and you can't stand up straight because your stomach hurts so much. ER or not?
Dr. Youngquist: In most cases, ER.
Interviewer: Really?
Dr. Youngquist: Yes. The reason is that there could be some very bad things causing that abdominal pain. So, in some way, it depends. If this is a chronic issue, obviously, it may not require any treatment in the emergency department at all, and some people unfortunately suffer from abdominal pain on a daily basis. But I'm going to assume this is new, you've never had this before, and you woke up with abdominal pain so severe that you couldn't stand up. So what could it be?
Appendicitis
If you're a young and otherwise healthy person, the most likely cause is appendicitis. And, usually, if you've got appendicitis, you've started with some mild abdominal pain; it's often located around the belly button and then tends to migrate to the right lower quadrant of your abdomen and gets severe over time. It can perforate if it's not treated surgically and cause a large intra-abdominal infection or sepsis, or even death from infection.
Interviewer: It's nasty because it releases all that nasty stuff into your body that it would normally contain in the appendix.
Dr. Youngquist: Absolutely. People don't feel well when they've got it. They feel sick all over, and it's all coming from their appendix.
Gallbladder Disease
Now, the other things that can cause this, particularly in middle-aged older people, are gallbladder disease. So you could have a gallstone that is obstructing the common bile duct or even causing perforation or infection of the gallbladder. And that also requires emergency treatment sometimes, and removal of the gallbladder or at least antibiotics.
When It's Time to Go to the Emergency Room
Interviewer: Got you. I'd be afraid that I was just a little bloated or gassy or had some sort of a weird cramp.
Dr. Youngquist: It could be, but that should resolve in a matter of minutes, seconds to minutes.
Interviewer: Okay.
Dr. Youngquist: It shouldn't last hours.
Interviewer: Okay.
Dr. Youngquist: So if you want to wait a little bit and see if it goes away that's probably fine. But if it's lasting for minutes/hours, then you need to come in and see somebody about it.
Is it really an emergency?
ER OR NOT?
