What You Should Know About Abdominal Tenderness

Many disorders that cause abdominal tenderness are medical emergencies. Seek emergency medical help if you have abdominal tenderness, especially if you also have a fever. Untreated abdominal tenderness can be life-threatening. Some

• Appendicitis can result in a ruptured appendix and peritonitis (inflammation of the inner lining of the abdomen).
• An ectopic pregnancy can cause severe blood loss, which can be fatal.
• A twisted fallopian tube or pelvic inflammatory disease (PID) can cause pelvic scarring and infertility.
• Infections in the digestive tract (diverticulitis) can be fatal.

Abdominal tenderness is generally a sign of inflammation or other acute processes in one or more organs. The organs are located around the tender area. Acute processes mean sudden pressure caused by something. For example, twisted or blocked organs can cause point tenderness.

Some common causes of abdominal 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 (IBD); or infection
• Meckel’s diverticulum: a remnant of the umbilical cord that creates a small bulge on the small intestine which can cause bleeding or intestinal obstruction later in life (occurs in about 2 percent of the general population)
• diverticulitis: inflammation of the inner lining of the intestines

Common causes for women include:

• 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
• pelvic inflammatory disease (PID): 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 linked with some sort of inflammation. Inflammation causes swelling, which creates pressure inside the abdomen and results in tenderness.

Symptoms that go along with abdominal tenderness are:

• loss of appetite
• bloating
• nausea
• vomiting
• abdominal pain
• constipation
• diarrhea
• pale stools
• distended abdomen
• jaundice
• fainting
• missed periods
• fever

What to expect from the doctor

Your doctor will take a complete medical history and perform a physical examination. They’ll want to know about all the symptoms you have and when they started. Your doctor will also want to know what makes your symptoms feel better or worse.

Parts of the abdomen

Your doctor can examine the area by touch. The region where there’s pain may indicate an issue with certain organs. For example:

• right upper quadrant: liver and gallbladder
• left upper quadrant: stomach and duodenum
• right lower quadrant: appendix
• left lower quadrant: final segment of colon or digestive tract

The most well-known type of point tenderness is McBurney point. It is located in the right lower quadrant, in the area of your appendix. Point tenderness over McBurney point means your appendix is very inflamed. At this point, your appendix is at risk of rupturing.

Problems with pelvic organs, including the ovaries and fallopian tubes, can also cause right or left lower quadrant tenderness.

Tests

You may need to take the following tests to help determine the cause of abdominal point tenderness:

• abdominal X-ray: a noninvasive test that uses X-rays to examine your abdominal organs, which can help find cysts and 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
• complete blood count (CBC): 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 test: a blood test that is positive when inflammation is present
• serum progesterone test: a blood test for pregnancy, which is more sensitive than a urine pregnancy test, 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

Treatment for abdominal tenderness depends on the underlying cause. Avoid taking aspirin, ibuprofen, or naproxen for more than 1 to 2 weeks, as this increases your risk for stomach ulcers and gastrointestinal bleeding. It may also worsen your condition.

Surgery

For appendicitis, you may get medicine and fluids through a port in a vein in your hand or arm (intravenous antibiotics). You may also have an appendectomy. This is the surgical removal of the appendix through your abdomen.

You may need surgery to remove part of the colon if it’s obstructed.

Hernias, a twisted fallopian tube, and ectopic pregnancies may also need surgery to correct such structural irregularities.

Your doctor may perform a laparoscopic examination if you are very ill and tests don’t show which organ is causing abdominal point tenderness. 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 through a small incision in the skin. It allows doctors to see which organ inside your abdomen or pelvis is causing the problem.

Other treatments

Nausea, vomiting, and diarrhea can cause severe dehydration and low blood pressure. If you’ve been experiencing vomiting and diarrhea, you may also get fluids and electrolytes intravenously.

Your doctor will introduce these fluids through a vein in your arm or hand. These fluids help 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.

Home remedies

Once you’ve addressed the main cause of your abdominal tenderness, you can help ease any other symptoms with some simple home treatments.

The following tips can help reduce the inflammation:

• 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. Be cautious when taking ibuprofen since it can increase the risk of stomach bleeds if taken for too many days in a row.
• Practice relaxation techniques, such as yoga, meditation, and deep breathing. Stress can worsen inflammation and tenderness.

Seeing your doctor for regular checkups is the best method of prevention. Some causes can’t be prevented, but you can help your body fight off infections. Here are a few tips:

• Eat a balanced, healthy diet.
• Eat smaller meals throughout the day.
• Get at least 7 to 8 hours of sleep a night.
• Exercise at least 30 minutes a day.
• Drink water frequently.

Practice sex using barrier methods (such as condoms) to decrease your risk for pelvic inflammatory diseases.