OVERVIEW
Abdominal pain can be referred to as the pain or discomfort that is felt in the part of the trunk below the ribs and above the pelvis.
It occurs due to the discomfort in organs within the abdomen or organs adjacent to the belly. It is commonly called as Stomach ache.
The organs that are located in the abdominal area includes
Stomach, Small intestine, Kidney, Gallbladder, Liver, Pancreas, Spleen, Adrenal glands, Duodenum, Ileum, Jejunum, Umbilicus, Cecum, Appendix, Colon, Female reproductive organs and Urinary bladder

CAUSES
The probable causes of Stomach ache are diagnosed on the basis of its onset, characteristics of pain, physical examination, and lab investigations if required.
Common Causes are-
• Overeating
• Due to any inflammation, distention of any underlying organ, or due to loss of the blood supply to an organ.
• Any Viral, bacterial, or parasitic infections that affect the stomach and intestines may also cause significant abdominal pain. However, in irritable bowel syndrome (IBS) the discomfort is caused by contraction of the intestinal muscles or hypersensitivity to normal intestinal activities.
• Infections in the throat, intestines, and blood can cause bacteria to enter the digestive tract which results in stomach upset and abdominal pain. These infections may also cause indigestion, such as diarrhoea or constipation.
• Cramps associated with menstruation are also a potential source of lower abdominal ache, but more commonly these are referred to as pelvic pain.
• Other common causes of abdominal pain include diseases like constipation, diarrhoea, gastroenteritis, acid reflux (when stomach contents leak backward into the oesophagus, causing heartburn and other symptoms), vomiting and stress
• Major diseases that affect the digestive system can also cause chronic abdominal discomfort and pain. The most common are:
Gastroesophageal reflux disease (GERD)
Crohn’s disease (an inflammatory bowel disease)
Lactose intolerance (the inability to digest lactose, the sugar found in milk and milk products)
Some other causes also include organ rupture or near-rupture (such as a burst appendix, or appendicitis), gallbladder stones (known as gallstones), kidney stones etc.

TESTS FOR STOMACH PAIN

Physical examination
• Palpation in the different quadrants helps to locate if any tenderness.
• The presence of a mass within the abdomen may be suggestive of Tumour, Enlarged organ or an abscess
• Sounds will be prominent from the intestines, which occur when there is an obstruction.
• The presence of thick blood stain in the stool may signify an intestinal problem such as an ulcer, colon cancer, colitis, or ischemia.

Laboratory tests
• Laboratory tests such as the complete blood count (CBC), liver enzymes, pancreatic enzymes (amylase and lipase), pregnancy test and urine analysis also helps to rule out the reason for abdominal pain.
• Plain X-rays and other radiographic studies like USG, CT, MRI also helps in diagnosing the fundamental causes of stomach ache.

SYMPTOMS
• Severe abdominal tenderness which lasts for more than 24hrs.
• Persistent Nausea, Vomiting or Diarrhoea
• Burning sensation in the Stomach
• Loss of Appetite
• Sometimes stomach pain may be associated with fever and chills.

RISK FACTOR
Conditions that weakens the immunity like diabetes, organ transplant, chemotherapy, AIDS, or sickle cell anaemia increase chances of abdominal pains. Other potential risk factors for stomach pain are abdominal surgery or old age.

DIET
• Vegetables: green beans, broccoli, asparagus, cauliflower, leafy greens, potatoes, and cucumbers, white pumpkins, bitter gourd, matured ash gourd, leafy vegetables.
• Fruits: Non citrus fruits including melons, bananas, apples, and pears. Gooseberry, dry grapes, black grapes, sweet lime, pomegranate, fig, dry fig,
• Grains: Wheat, old rice, barley, green gram, horse gram, jowar
• Spices: Coriander, Ginger, Garlic, Pepper, Asafoetida, Turmeric
• Take adequate amount of fluids like pomegranate juice, lemon juice, Amla juice, sweet lime juice, water processed with (puffed rice).
• Include ghee in regular diet