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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Laparoscopy is useful in the management of a wide range of benign conditions. In the elective situation, it may be chosen to evaluate hepatobiliary disorders, abdominal masses, or chronic pain, and is an ideal way to sample tissue. Under the emergency setting, it is another tool for the assessment of trauma patients and may be of value in those patients with abdominal pain, mesenteric ischemia, fever of unknown origin, or gastrointestinal hemorrhage. It is important for the surgeon to be familiar with the technique, correctly prepare the patient, and be aware of the risks and limitations of this diagnostic modality.
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PMID:Diagnostic laparoscopy in nonmalignant disease. 138 95

Non-specific abdominal pain (NSAP) may have a detectable psychological component that could be used to predict outcome. To test this hypothesis, 131 patients aged 14-40 years admitted with acute abdominal pain were assessed using the General Health Questionnaire (GHQ) and Hospital Anxiety and Depression (HAD) scale, and a structured interview. Of 61 patients with NSAP, more had a psychosocial problem identified by the admitting registrar (P < 0.01) and marginally more had high questionnaire scores. The risk of having NSAP was high if an abnormality on interview accompanied high questionnaire scores (relative risk 1.93 (95 per cent confidence interval (c.i.) 1.35-2.77)) or if prodromal pain had lasted > 7 days (relative risk 2.13 (95 per cent c.i. 1.55-2.92)). After 2 years, patients with continuing pain had higher HAD and Spielberger Anxiety Trait scores (both P < 0.02); NSAP was associated with persisting pain (relative risk 2.22 (95 per cent c.i. 1.10-4.48)). Psychosocial factors are implicated in NSAP and in chronic pain, but the sensitivity and specificity of questionnaire assessment are too low to be useful in diagnosis.
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PMID:Psychological screening for non-specific abdominal pain. 148 44

We report data on abdominal pain and depression from a survey of Hispanic Americans by the United States National Center for Health Statistics. The point prevalence rates of chronic abdominal pain were 4.6% in Mexican Americans and 5.8% in Cuban Americans in a total of 4175 subjects. The rate was 8.3% among 1323 Puerto Ricans. In 53% the abdominal pain came in waves. Using the Depression scale of the Center for Epidemiologic Studies (CES-D), 18.7% of Mexican and Cuban Americans with pain were found to be depressed to an extent likely to require intervention, and 40.8% of Puerto Ricans were so affected. The Diagnostic Interview Schedule (DIS) gave more conservative figures for major depression in terms of DSM-III, viz., 6.8% for Mexican and Cuban Americans with chronic pain, and 12.6% for Puerto Ricans with chronic pain. Logistic regression analyses demonstrated links between depression and female sex, the single state, low education and income, and chronic abdominal pain. The most consistent relationships for depression were with chronic pain, female sex and the single state. The results confirm the strong relationships between chronic pain, mood and female gender, and other socio-demographic variables.
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PMID:Chronic abdominal pain and depression. Epidemiologic findings in the United States. Hispanic Health and Nutrition Examination Survey. 159 84

Four cases of torsion of the gall-bladder are reported. The clinical features closely mimic those of acute cholecystitis. Although conservative management was initially instituted, close monitoring of our patients led to appropriate surgical intervention. Review of the literature suggests that torsion is uncommon. Four surgical registrars at busy district general hospitals seeing four cases in one year suggests that it is under-reported. Acute torsion can develop after a period of recurrent abdominal pain--retrospectively diagnosed as 'chronic torsion'. A prospective study using currently available imaging procedures to assess gall-bladder mobility, itself associated with torsion, could reveal whether this leads to chronic pain.
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PMID:Torsion of the gall-bladder: rare, unrecognized or under-reported? 187 46

Chronic pain status and health care utilization were assessed in a probability sample of 1016 adult HMO enrollees, and among 242 HMO enrollees seeking treatment for Temporomandibular Disorder (TMD) pain. Likelihood of health care contact for a painful symptom: Among persons reporting back pain, headache, chest pain, abdominal pain or temporomandibular pain in the prior six months, we evaluated whether (1) pain characteristics (severity, persistence, recency of onset), and (2) psychological distress were associated with the likelihood of recent use of health care for each pain symptom. Severity, persistence, and recency of onset of pain were generally associated with recent health care contact for a pain symptom. Females with a pain symptom were no more likely than males to report recent health care contact for the symptom after controlling for pain characteristics. The presence of psychological distress did not increase the likelihood of health care contact for individual pain symptoms. However, psychologically distressed persons were more likely to report pain at multiple anatomical sites and to report recent health care contact for one or more of the five pain symptoms (as a group). Chronic pain status and total use of ambulatory health care: Total number of health care visits (irrespective of reason for visit) was measured by automated data. Chronic pain status (summarized across all five anatomical sites) showed a modest correlation with the volume of health care use. Persons with recurrent pain and severe-persistent pain with no pain-related disability days used ambulatory care at rates close to population means. Persons with severe-persistent pain and seven or more pain related disability days used health care at rates substantially above population means. There was a statistically significant association between the volume of health care use and chronic pain after controlling for age, sex, self-rated health status, and psychological distress.
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PMID:Chronic pain and use of ambulatory health care. 201 51

Information on the prevalence of pain in the general population has relevance for the allocation of health services and for understanding of chronic pain. In 1986 a sample of 1498 adults were interviewed using the Diagnostic Interview Schedule. Questions on pain were taken from the somatisation section of the interview schedule. These responses were used to determine the lifetime prevalence of pain in the urban population of New Zealand. The majority of subjects reported more than one life disrupting experience of pain. Pain was most common in the joints, back, head and abdomen. Women reported more pain than men. In general the prevalence of pain increased with age, however this was not true for headaches and abdominal pain. Most subjects related their pain symptoms to a physical cause.
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PMID:Epidemiology of pain in New Zealand. 205 97

The irritable bowel syndrome is above all a syndrome of intestinal pain. Although the intestinal disorders described in this syndrome have prompted several studies focused on intestinal motility, little has been learned from these studies increasing our knowledge on the pathophysiology of this syndrome. The demonstration of colonic hypermotility or various and slightly significant modification in small intestinal motility do not add much to our knowledge. For one, why are clinical signs such as abdominal pain, bowel movement disorders, and abdominal distension, and most likely other motor disorders, found in numerous normal subjects (14 to 30 percent of the normal population) who do not seed medical advice for intestinal signs which are, one must admit, not very alarming? Are patients who complain of functional digestive tract disorders, constantly seeking medical advice and heavy medication consumers, mentally ill (emotional patients, hypochondriacs, depressive, hysterics), are they just under great stress, or do they indeed have chronic pain pathology? A number of studies show clearly that the last hypothesis is most likely true: patients with the irritable bowel syndrome (i.e. hypersensitive bowel) have a chronic pain pathology because their threshold perception of pain is lower than in the normal population. The threshold tolerance to distension of the pelvic colon is lower in these patients than in asymptomatic patients. The gastric transmural potential is lower in patients complaining of functional intestinal disorders, and it is known that a fragile mucosa is highly sensitive to normally innocuous stimuli.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The hypersensitive bowel]. 221 Jan 81

Pain patients' retrospective reports of pain are important to physicians and other health professionals in helping to decide on future treatment plans. Unfortunately patients' memory of pain can be inaccurate and subject to overestimation. This study examined variables which influenced accuracy of remembering pain in 93 chronic pain patients. The patients were initially evaluated by a physician and completed a comprehensive pain questionnaire and an SCL-90. All patients were asked to monitor their pain intensity every hour for 1 week. At the end of this period each patient was asked to estimate their average pain intensity ratings for 4 times during the day for the previous week. These estimations were compared with the actual mean pain ratings. Results showed that most patients tended to overestimate their pain intensity levels. Cervical and low back pain patients were found to be more accurate than headache and abdominal pain patients in remembering their pain. Patients who reported more emotional distress, who had conflicts at home, who were less active and who relied on medication tended to be the most inaccurate in remembering their pain.
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PMID:The influence of physical and psychosocial factors on accuracy of memory for pain in chronic pain patients. 275 10

To determine the prevalence and nature of pain in multiple sclerosis, we evaluated by questionnaire, interview, and chart review 159 patients residing in Middlesex County and followed in the MS Clinic at University Hospital, London, Ontario, Canada. Eighty-eight patients (55%) had either an acute or chronic pain syndrome at some time during their disease. Fifteen patients (9%) with acute pain syndromes had episodes of paroxysmal tic-like pain diagnosed in seven as trigeminal neuralgia. Chronic pain syndromes, present for a mean duration of 4.9 years, occurred in 76 patients (48%) and included dysesthetic extremity pain (29%), back pain (14%), painful leg spasms (13%), and abdominal pain (2%). MS patients with pain were similar to the pain-free group in mean age of onset (34.0 versus 31.9 years), average duration of disease (13.3 versus 12.1 years), spinal cord involvement (97% for each group), and mean rating on Kurtzke Disability Status Scale (4.2 versus 3.5). They differed in sex ratio with a higher female-to-male ratio in the pain group (3:1 versus 1.4:1). Chronic pain is a common feature of well-established MS and is usually associated with a myelopathy. Therapy must be individualized for each specific pain syndrome.
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PMID:Pain syndromes in multiple sclerosis. 273 10

We report a case of a latissimus dorsi muscle strain that presented as a recurrence of chronic abdominal pain. One explanation of the referral of acute pain to a site of chronic pain is the convergence-projection theory, which hypothesizes that pain signals of visceral and somatic origin converge at some point in the sensory pathway. Upon reaching the cortex, these signals are interpreted as coming from the afferents which have previously excited this pathway. In this case an extensive gastrointestinal diagnostic evaluation was pursued unsuccessfully before the latissimus dorsi muscle strain was diagnosed. Outpatient therapy of spray and stretch combined with a home stretching program produced a prompt and persistent resolution of the symptoms.
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PMID:Acute somatic pain can refer to sites of chronic abdominal pain. 276 98


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