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What Causes Abdominal Pain,bloating And Distension?
Question: 39 YO male, generally good health. I normally have gas pains from time to time, lasting 20-30 min. Bloated feeling in upper abdomen which is relieved by lying down and massaging area. I've had multiple abdominal surgeries and have scar tissue and mesh in abdomen. Same today except I've had these pains all day (not too severe) and have only passed gas once or twice. How can I get rid of this? I've tried Simethicone gel caps and Naproxen (Alleve), heating pad, light exercise, but still the dull sharp cramps. Is it normal for it to last for the day? It's a Sunday and I do not feel like going to the ER.I should clarify that the pains today are the same as I've been getting for the past 6 years, just they're not going away as easily, and the usual methods of lying down on my back, massaging the area, and taking GasX aren't working as well. As I write this it is slowly improving, but still pains in the upper abdomen that are sort of moving around and gurgling. What makes me nervous is not the pains themselves but the fact that they're lasting most of the day.
Brief answer....abdominal adhesions seem to be the cause for your chronic abdominal symptoms
Detailed answer....
Hello,
Thanks for the query.
It appears that multiple surgeries have lead to the development of adhesions in abdomen resulting in chronic abdominal off and on symptoms of abdominal pain,bloating,distension etc.
Multiple abdominal surgeries are the most common cause for adhesions however inflammatory conditions like cholecystitis,appendicitis,peritonitis,some foreign objects in abdomen can also result in adhesions.
These adhesions result in intertwining of intestines resulting in obstruction of intestinal movement.Generally this obstruction is short lived and gets all right of it's own but sometimes it can result in severe obstruction,which may necessitate surgery.
I would advise you to undergo abdominal ultrasound and CT abdomen for diagnosing other conditions since adhesions can't be detected by any investigations.
If all the investigations are found to be normal,then laparoscopic exploration remains the best tool to diagnose and even correct this condition by cutting the bands of adhesions.
However this adhesions cutting surgery in itself can result in more adhesions.
In general laparoscopic adhesions band cutting is reserved for severe conditions or intestinal obstructions.
Treatment is done conservatively by taking medications,taking rest,massaging,regular exercises,taking plenty of water etc.
The problem generally gets resolved soon but sometimes can take little longer as it is happening to you now.
In case your problem doesn't subside by toninght,you can think of going to ER tomorrow.
I wish you consult a gastroenterologist surgeon and get evaluated yourself.
I hope it helps,however you may revert to me for any further query.
Best of luck
Thanks
Detailed answer....
Hello,
Thanks for the query.
It appears that multiple surgeries have lead to the development of adhesions in abdomen resulting in chronic abdominal off and on symptoms of abdominal pain,bloating,distension etc.
Multiple abdominal surgeries are the most common cause for adhesions however inflammatory conditions like cholecystitis,appendicitis,peritonitis,some foreign objects in abdomen can also result in adhesions.
These adhesions result in intertwining of intestines resulting in obstruction of intestinal movement.Generally this obstruction is short lived and gets all right of it's own but sometimes it can result in severe obstruction,which may necessitate surgery.
I would advise you to undergo abdominal ultrasound and CT abdomen for diagnosing other conditions since adhesions can't be detected by any investigations.
If all the investigations are found to be normal,then laparoscopic exploration remains the best tool to diagnose and even correct this condition by cutting the bands of adhesions.
However this adhesions cutting surgery in itself can result in more adhesions.
In general laparoscopic adhesions band cutting is reserved for severe conditions or intestinal obstructions.
Treatment is done conservatively by taking medications,taking rest,massaging,regular exercises,taking plenty of water etc.
The problem generally gets resolved soon but sometimes can take little longer as it is happening to you now.
In case your problem doesn't subside by toninght,you can think of going to ER tomorrow.
I wish you consult a gastroenterologist surgeon and get evaluated yourself.
I hope it helps,however you may revert to me for any further query.
Best of luck
Thanks
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your honest and detailed reply. Do you think the pain is resulting directly from the adhesions or that the adhesions cause temporary obstruction which leads to the trapped gas?
It's the next day now and the pains have partly subsided. As you said, surgery I think is a last resort. I also think that obstruction is not likely because I have been able to have normal bowel movements, just unable to flatulate. My appetite was a little less yesterday but I think that was just anxiety. My main suspicion was gas since most of the day I was unable to pass flatula at all, and I was scared mainly because this type of thing (bloating, gas pain) usually resolves in minutes, whereas yesterday it took most of the day. But it feels a little better today, I still have some abdominal areas sore to the touch but hopefully that's just from the pressing and massage I did yesterday.
It's the next day now and the pains have partly subsided. As you said, surgery I think is a last resort. I also think that obstruction is not likely because I have been able to have normal bowel movements, just unable to flatulate. My appetite was a little less yesterday but I think that was just anxiety. My main suspicion was gas since most of the day I was unable to pass flatula at all, and I was scared mainly because this type of thing (bloating, gas pain) usually resolves in minutes, whereas yesterday it took most of the day. But it feels a little better today, I still have some abdominal areas sore to the touch but hopefully that's just from the pressing and massage I did yesterday.
Hello,
Adhesions in themselves don't cause any pain.In fact adhesions result in temporary and partial intestinal obstructions which result in pain and trapped gases.Since adhesions are caused by surgery and a further surgery to cut adhesions can result in more adhesions,surgery is considered only if either the obstruction is complete or if there are repeated episodes of pain and trapped gases.
Sporadic and occasional episodes are treated only conservatively.
Thanks
Adhesions in themselves don't cause any pain.In fact adhesions result in temporary and partial intestinal obstructions which result in pain and trapped gases.Since adhesions are caused by surgery and a further surgery to cut adhesions can result in more adhesions,surgery is considered only if either the obstruction is complete or if there are repeated episodes of pain and trapped gases.
Sporadic and occasional episodes are treated only conservatively.
Thanks
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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