What causes abdominal tenderness? 16 possible conditions
Point tenderness in your abdomen is pain that occurs when your abdomen is pressed in a specific area. It’s also known as abdominal tenderness. Point tenderness is often a sign that something is wrong with one or more organs in the area being pressed. All... Read more
Point tenderness in your abdomen is pain that occurs when your abdomen is pressed in a specific area. It’s also known as abdominal tenderness. Point tenderness is often a sign that something is wrong with one or more organs in the area being pressed. All disorders that cause abdominal point tenderness are medical emergencies. Always seek emergency medical help if you have abdominal tenderness.
Doctors divide the area of the abdomen into four quadrants:
- right upper quadrant (liver and gallbladder)
- left upper quadrant (stomach and duodenum)
- right lower quadrant (appendix)
- left lower quadrant (sigmoid colon)
Problems with pelvic organs can also cause right or left lower quadrant tenderness. These organs include the ovaries and fallopian tubes. The most well known type of point tenderness is McBurney’s point. McBurney’s point is located in the right lower quadrant, in the area of your appendix. Point tenderness over McBurney’s point tells the doctor that your appendix is very inflamed. At this point, you are at risk for rupturing.
Common causes of abdominal point tenderness
Point tenderness is generally a sign of inflammation or other acute processes in one or more organs, located in the same area as the tenderness. Twisted or blocked organs, such as your fallopian tubes or colon, can also cause point tenderness.
Some common causes of abdominal point tenderness are:
- appendicitis: swelling of the appendix, a small pouch attached to the large intestines, which usually occurs when the appendix becomes blocked by feces traveling through the intestines
- abdominal abscess: a pocket of infected fluid and pus inside the belly, caused by a burst appendix, intestine, or ovary, inflammatory bowel disease, or infection
- Meckel’s diverticulum: a remnant of the umbilical cord that creates a small bulge on the small intestine and that can cause bleeding or intestinal obstruction later in life (occurs in about 2 percent of the U.S. population)
- inguinal hernia: a condition that occurs when part of the membrane lining the abdominal cavity or intestines bursts through a weak spot in the abdominal muscle
- twisted fallopian tube: a rare condition in which one or both fallopian tubes twist on the tissues that surround them
- ruptured ovarian cyst: sometimes cysts form on the ovaries where follicles form and these cysts may burst
- ruptured ectopic pregnancy: a life-threatening pregnancy condition in which the fetus begins to form outside the uterus, and the sac of fluid holding the fetus bursts
- diverticulitis: inflammation of the inner lining of the intestines
- pelvic inflammatory disease: an infection of a woman’s reproductive organs, often the complication of several kinds of STDs, such as chlamydia and gonorrhea
These conditions are all associated with some sort of inflammation. This creates pressure inside the abdomen, resulting in tenderness.
Symptoms that go along with abdominal point tenderness are:
- loss of appetite
- abdominal pain
- pale stools
- distended abdomen
- missed periods
What to expect from the doctor
Your doctor will take a complete medical history and perform a physical examination. Your doctor will want to know about all of the symptoms you have and when they started. Your doctor will also want to know what makes your symptoms feel better and what makes them worse.
Some of the tests that will help pinpoint the cause of abdominal point tenderness are:
- complete blood count: a blood test that helps assess your general health (an elevated white blood cell count tells the doctor that inflammation is present, indicating infection or disease)
- C-reactive protein: a blood test that is positive when inflammation is present
- serum pregnancy test: a blood test for pregnancy that is more sensitive than a urine pregnancy test, which can help determine if you are experiencing ectopic pregnancy
- abdominal or pelvic ultrasound: a noninvasive test that uses sound waves to make images of abdominal and pelvic organs, which can help locate hernias, cysts, or ectopic pregnancies
- abdominal X-ray: a noninvasive test that uses X-rays to examine your abdominal organs, which can help find cysts other abdominal irregularities
- abdominal computed tomography (CT) scan: a noninvasive test that uses X-rays to make high resolution images of your abdominal organs to locate structural abnormalities
The treatment of abdominal point tenderness depends upon the underlying cause. Options for treatment of appendicitis include intravenous antibiotics — giving medicine and fluids through a port in a vein in your hand or arm — and surgical removal of the appendix through your abdomen (called an appendectomy). Colon obstruction may require that a part of the colon be removed with surgery. Hernias, twisted fallopian tube, and ectopic pregnancy may also require surgery to correct such structural irregularities.
If you are very ill and tests don’t show exactly which organ is causing abdominal point tenderness, doctors may perform a laparoscopic examination. A laparoscopic examination is a surgical procedure that requires general anesthesia. It involves inserting a laparoscope (a thin tube with a light attached to it) into the abdomen. The laparoscope is inserted through a small incision in the skin. Once inside, it allows doctors to see which organ inside your abdomen or pelvis is causing the problem.
Other treatment options include intravenous fluids and electrolytes, administered through a port in a vein in your arm or hand. Nausea, vomiting, and diarrhea can cause your body to become dangerously low in water and electrolytes. Water and electrolytes (such as sodium, potassium, chloride, and bicarbonate) help to maintain your blood pressure and acid-base balance. Severe dehydration can cause dangerously low blood pressure (shock). Shock reduces blood flow to all vital organs. It can also damage your kidneys, heart, and brain. Your doctor may give you intravenous fluids and electrolytes. Both help treat dehydration and maintain your blood pressure.
Once you’ve addressed the main cause of your abdominal tenderness, you can help ease any lingering symptoms with some simple home treatments. The following tips can help reduce the inflammation associated with abdominal tenderness:
- Apply a hot water bottle or heating pad to the tender area to help ease abdominal soreness.
- Take an over-the-counter pain reliever, such as ibuprofen or acetaminophen.
- Practice relaxation techniques, such as yoga, meditation, and deep breathing, as stress can worsen inflammation and tenderness.
Long-term consequences of nontreatment
Long-term consequences for untreated abdominal point tenderness are life-threatening. Left untreated, appendicitis can result in a ruptured appendix and peritonitis (inflammation of the inner lining of the abdomen). An untreated ectopic pregnancy can cause death. This would occur as a result of severe blood loss. An untreated twisted fallopian tube or pelvic inflammatory disease can cause you to have pelvic scarring and infertility. Untreated diverticulitis can be fatal.
Because many conditions associated with abdominal tenderness worsen if left untreated, you can help prevent complications by seeing your doctor for regular check-ups. Maintaining a healthy lifestyle by eating healthfully, getting enough sleep (7 to 8 hours a night), and exercising regularly (at least 30 minutes a day) can help your body fight off potential infections that can cause problems in the abdomen. If you are sexually active, it’s important to practice safe sex to avoid contracting STDs.
- Abscess. (2016, July 19). Retrieved from http://www.nhs.uk/conditions/Abscess/Pages/Introduction.aspx
- Mayo Clinic Staff. (2014, August 20). Appendicitis. Retrieved from http://www.mayoclinic.org/diseases-conditions/appendicitis/basics/symptoms/con-20023582
- Mayo Clinic Staff. (2015, January 20). Ectopic pregnancy. Retrieved from http://www.mayoclinic.org/diseases-conditions/ectopic-pregnancy/basics/definition/con-20024262
- Mayo Clinic Staff. (2014, August 13). Ovarian cysts. Retrieved from http://www.mayoclinic.org/diseases-conditions/ovarian-cysts/basics/definition/con-20019937
- Mayo Clinic Staff. (2016, June 15). Inguinal hernia. Retrieved from http://www.mayoclinic.org/diseases-conditions/inguinal-hernia/basics/definition/con-20021456
- Meckel’s diverticulum. (2014). Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001281/
- Pelvic inflammatory disease (PID). (2016, May 23). Retrieved from http://www.cdc.gov/std/pid/stdfact-pid.htm
See a list of possible causes in order from the most common to the least.
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