Chronic abdominal pain

April, 2020 Abdominal &pelvic pain treatment

Injury and dysfunction in each sections can cause pain.One of the best early ways to diagnose pain is to pay attention to the signs and symptoms. Abdominal pain is one of the most common causes of patient referral to a physician. The most common abdominal pain can be as follows:

Referral pain

These pains originate from the outside of the abdomen, so that an organ outside the abdominal area causes nerve stimulation to the abdomen. It is like lower lung problems or heart problems that are exacerbated by activity and can be felt in the abdomen. These pains are referal.

Pain from medical disorders

Pains such as severe, persistent pain, accompanied by fever and jaundice, spread to the back and waist or groin, along with gastrointestinal bleeding are problems that should be promptly reviewed by an internist or  if necessary by a surgeon.

Chronic abdominal pain

Chronic pain, which has undergone thorough internal, gastrointestinal, renal, etc. examinations and despite all the remedies, is still a nuisance in the field of specialist pain specialists, including:

Neuropathic Pain :

These pains are caused by nerve cells called neuropathy and can be seen in cases such as shingles,skin incisions, in the use of drugs such as chemotherapy.

After surgery incisinal Pain :

Abdominal, groin, and sub-abdominal pain after abdominal wall surgery, eg, umbilical hernia repair, can cause more than 50% chronic pain in the abdominal incision and abdomen so that one-fourth of these patients They cannot perform their daily activities because of severe pain.

Cancer Pain :

Abdominal organs cancers can cause chronic, overwhelming pain that causes restlessness and helplessness and requires intervention.

Diagnosis of abdominal pain

History and physical examination are very important.

Imaging Tests : Imaging tests provide physicians with complete information about anatomic problems including:

X-ray : To check gross anatomic problems.

Computed tomography : CT scans can be used for more information.

MRI : Used to examine tissues and organs in the abdomen

Treatment of chronic abdominal pain

Interventional pain procedures :

Interventional procedures are performed by a pain specialist under the guidance of X-ray (fluoroscopy) or ultrasound in the operating room.

Diagnostic and therapeutic injections in abdominal pain :

  1. Splanchnic Block : Splanchnic nerve block (Visceral) is an effective way to relieve chronic pain in the upper abdomen, often due to cancer or pancreatic inflammation. The splenic nerve is located on both sides of the spine and transmits the pain message from the abdominal organs to the brain.
  2. Celiac plexus block : A number of nerves coming out of the spinal cord connect to the anterior of the spine and below the diaphragm, forming the celiac plexus. Other nerves come out of this neural network and innervate the abdominal viscera. Nerve blocking is said to prevent the passage of a nerve message (including pain messages) by injecting anesthetic substances around the nerve and can be used to manage abdominal pain. As a diagnostic method, the block of this plexus helps to find the major source of pain and nerve transmission..
  3. TAP Block : The nerve block is said to block the passage of a nerve message using anesthetic substances. The transverse abdominal plane nerve block is used for therapeutic and diagnostic purposes. This block is used to treat abdominal wall pain caused by surgical incision, etcz

Selective nerves Block :

The diagnostic and therapeutic block of peripheral nerve fibers (such as ilioinguinal or iliohypogastric) under local anesthetic or radiofrequency guided ultrasound is highly successful and curative.

 

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