When Does Abdominal Pain Require Surgery?

January 6, 2020

We all get aches and pains in the abdomen for a multitude of reasons. Usually, this discomfort goes away rapidly or we can pinpoint the cause based on recent events. However, there is a fine line between benign abdominal pain and serious signs that may require surgery or other medical intervention. Unfortunately, for some, not knowing went to go to the doctor leads to an urgent or emergency situation that makes treatment more difficult. But how do you know when abdominal pain may lead to surgery? To understand that, it is important to discuss the different kinds of abdominal pain including location.

Abdominal Aches and Pains that May Or May Not Require Surgery

A sharp pain in the upper abdomen at the base of the rib cage could signal gas pain. If you’ve eaten a particularly large, fiber full or unhealthy meal in the past day or so, this could simply be your gut bacteria working overtime to process the food. This pain does not usually linger for more than a few minutes to half an hour and the pain may migrate as the gas bubble does. You will certainly feel relief once the gas is expelled.

General stomach malaise along with nausea and vomiting may indicate food poisoning. It is usually hard to pinpoint exactly what food caused the poisoning as it can occur immediately after a meal or several hours after eating something. While food poisoning is extremely uncomfortable, is not typically life-threatening. However, if you are unable to keep down any liquids at all, visit your doctor or urgent care facility to make sure you do not experience severe dehydration.

An infection, either within the abdominal cavity or in any of the organs of the abdomen can cause serious discomfort for long periods of time. While infection may not necessarily lead to surgery (though it could) it is definitely something that needs to be evaluated by your doctor. Serious infections of the pancreas, called pancreatitis, the gallbladder, called cholecystitis, or the liver, called hepatitis, can all lead to follow-on conditions and must be treated rapidly.

If you have worked out your core abdominal muscles significantly in the past day or two, you may feel a great deal of tightness, deep aching and even pain. This will be especially strong if you do not regularly workout your core. Most patients are pretty adept at determining when pain is muscular, but the previous days’ events are usually the telltale sign of muscle strain.

The Most Common Abdominal Pains Requiring Surgery

Gallbladder pain is often experienced in the upper right quadrant of the abdomen under the rib cage. This pain can radiate around to the back as well. Gallbladder pain is usually caused by an inflammation of the gallbladder, which in turn is most likely caused by the presence of symptomatic gallstones. Symptomatic gallbladder disease will appear within 1 to 4 hours after eating a large and/or high-fat or high sugar meal. The symptoms are usually severe – pain, nausea and vomiting are very common. Once you experience your first gallbladder attack, they usually become more frequent and more painful on until you have your gallbladder removed in a procedure known as a cholecystectomy.

Pain in the lower right quadrant of the abdomen that becomes more severe after pushing down and letting go can signal an inflammation of the appendix. This is known as appendicitis. Appendicitis must be treated immediately, before the appendix bursts and releases infective matter into the abdomen.

Hernias, protrusions of abdominal organs through a hole in the protective fascia of the abdomen may also cause pain. However, hernias can also be asymptomatic. We typically only treat hernias when they become symptomatic and impede the patient’s lifestyle. A bulge anywhere in your abdomen that cannot be pushed back in or does not slide back into the abdomen when lying down may mean incarceration and requires immediate care. If the herniated contents become trapped and blood flow is reduced or cut off, this is an emergency situation known as strangulation. An immediate visit to the emergency room is necessary to avoid serious complications or even death. Hernias can only be repaired with surgery.

Pain in the lower left quadrant of the abdomen can signal a condition known as diverticulitis. As we age, it is more common to have small out pouches in the colon known as diverticula. When these pouches become infected, it is known as diverticulitis. This is a painful condition that, in mild cases, can be managed with antibiotics and lifestyle change. Severe cases may require a colectomy – the removal of part of the large intestine.

Pain in the center or upper left quadrant of the abdomen may suggest an issue involving the pancreas. Having any suspected pancreas issues evaluated immediately is important because not only is pancreatitis (infection in the pancreas) very dangerous, but pancreatic cancer is one of the most aggressive forms of malignancy.

So, with all that said what do you do?

These are just a few of the multitude of abdominal conditions that can cause aches and pains.

Our bodies and minds have a remarkable way of letting us know when something is truly wrong. But we cannot always rely on our intuition to decide if we should or shouldn’t go to a doctor. If you have any doubts about the provenance of your abdominal pain or if you know you have an abdominal condition, but have not yet had it examined, we suggest that you visit your primary care physician, urgent care or general surgery specialist as soon as possible. If you’re experiencing serious pain, do not delay in seeking emergency care. Many abdominal conditions can quickly become a serious problem with potential long-term consequences.

Preventing an emergency situation is always better than hoping it will go away, so if you believe that you have a hernia, gallbladder or other abdominal issue, but you do not believe that it warrants a doctor’s visit, please rethink that decision. Your doctor will be able to give you a definitive diagnosis and let you know if it simply can be watched or if medical treatment or surgery is the best course of action.

We encourage you to schedule a consultation with one of our surgeons to learn more about any abdominal condition you may be suffering from and to fully understand your options for treating it.

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Advanced Surgical Associates is one of the first exclusively surgical groups practicing in Union County New Jersey. And that is just the first of many firsts for ASA. For over 40 years, we have pioneered breakthrough surgical patient care in North Jersey in both general and weight loss surgery. ASA also offers gastric bypass, gastric sleeve and gastric banding to those suffering from obesity in New Jersey.
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