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Anatomy of a Stomach Ache


9:00pm   

I’ll bet it was the lasagna. Homemade, oozing rivers of hot, fresh, real imported mozzarella cheese. Could be it was that second helping. OK, maybe that third helping.

And now my stomach hurts. A lot.

Don’t look at me like that.


9:30pm   

It’s getting worse. I’ve swallowed teaspoon after teaspoon of the pink stuff, plus tablet after tablet of the fizzy stuff. Guess what? My stomach still hurts, and I hate to tell you, it’s not getting any better.


10:00pm   

Now that I think about it, it may not actually be my stomach. It’s in that same general area, but a little further down. No, not that far down. And over to the side a little.

You think maybe it's a virus? Isn’t there something going around? Weren’t they talking about this on the news last night?

Yeah, that’s got to be it.


11:00pm   

I want your expert opinion. If this were you, what would you do?

The ER?

Um, no. You must be kidding. The ER’s for really serious stuff. I walk in there with a tummy ache, and they’ll never stop laughing. I’ll be blacklisted from there the next time I have an actual emergency. No, that would be bad. I’m fine.


11:15pm   

I’m not fine. It hurts. I give up. I don’t know what’s going on. You don’t know what’s going on.

I’m not going to lie here moaning and tossing and turning any longer.

ER, here I come, ready or not. Please don’t laugh at me ...


The Many, Many Causes of “Stomach” Pain

Think about all the organs, muscles, blood vessels and tissue that are in the area we all commonly call our “stomach” (even though we know it’s a lot more than that): Your liver, spleen, diaphragm, bowels, sex organs, and more. Really, it’s at least a third of your body. An injury, infection or disease to any one of these areas can cause pain of varying degree. Most of those don’t require a trip to the emergency room. But here are a few that might:

  • Heart attack
  • Indigestion
  • Acid reflux
  • Constipation
  • Diarrhea
  • Food poisoning
  • Stomach virus
  • Ectopic pregnancy
  • Irritable bowel syndrome (IBS)
  • Inflammatory bowel disease
  • Ulcer
  • Hernia
  • Gallstones
  • Appendicitis
  • Pancreatitis
  • Lactose intolerance
  • Gluten intolerance
  • Diverticulitis
  • Muscle strain
  • Menstrual cramps
  • Endometriosis
  • Urinary tract infection
  • Thyroid problems
  • Stress
  • Hepatitis
  • Pelvic inflammatory disease
  • Ovarian cysts
  • Bowel obstruction
  • Abdominal aortic aneurysm
  • Ischemic bowel
  • Cancer

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Causes of stomach pain in kids

Kids get tummy aches, often for no apparent reason. But here are some tips on what might be causing stomach pain in kids, based on their main symptoms. Of course, you should seek a pediatrician or go to the ER to treat your child's particular concerns.

  • Nausea or lack of appetite - indigestion or a stomach virus
  • Pain over all or most of their belly - indigestion, constipation, stomach virus or gas
  • Cramping pain (often followed by diarrhea - food poisoning, gas or bloating
  • Pain localized to one area (one side or the other, above or below the belly button) - may be related to the appendix, gallbladder or a stomach ulcer
  • None of the above - if your child can only describe the pain vaguely, like "it's all over but doesn't get worse," they made be experiencing stress or anxiety

How to identify stomach pain in babies and toddlers

Stomach pain is harder to identify when children are too young to talk. Here are some things to look for:

  • Fussier than normal
  • Curling up their legs toward their belly
  • Eating poorly
  • Listless and not interested in toys
  • Diarrhea
  • Vomiting

11:30pm   

Well, here we are. Nobody’s laughing. And they sure didn’t waste any time either. One look at me, and they whisked me right into the exam room. Nothing too complicated about their questions, either.

Where does it hurt? How long has it hurt? Has this ever happened before?

I told them it was the lasagna. They made it clear I should never be too embarrassed to come in if I’m in pain – better safe than sorry!


What Will the ER Team Want to Know About Your Stomach Pain?

Here are some questions you should be prepared to answer if you head to the ER with stomach pain:

  • How did the pain begin, what were you doing?
  • Is the pain steady/constant? Or does it come and go?
  • Have you had similar pain before?
  • Is the pain in one place or does it move?
  • What makes it worse (e.g., sneezing, coughing)?
  • What makes it better (e.g., lying still, changing position, vomiting, taking antacids)?
  • What is the frequency of nausea or diarrhea, if any?
  • Did you take any medications to relieve the symptoms? What medications did you take and at what time? What was the dose of the medication?
  • Did you take anything for these symptoms? If so, what amount?
  • Do you have blood in your urine or stool?
  • Are you pregnant?

What Tests May Be Used to Evaluate Abdominal Pain?

Diagnosing the causes of stomach pain starts with the typical battery of blood tests and physical exams (including a pregnancy test and pelvic exam for women). It all depends on your symptoms and what doctors find from their exams. Testing may also include:

  • X-ray
  • Ultrasound
  • CAT scan
  • MRI
  • Endoscopy

Midnight   

These people are good – I mean seriously good – at their job. And guess what? It wasn’t the lasagna after all.

Turns out I have gallstones! Go figure. Never had those before.


1:30am   

You know the best thing about the pain meds they give you for gallstones? It makes your pain seem far away, like thinking about tax season in May. So ... yay for pain meds!

And they gave me the name of a specialist. I’ll be calling him first thing tomorrow morning. Together we’ll come up with a plan. I sure am happy I have an ER I can always go to, regardless of the emergency, even if I’m not sure it’s really an emergency.

And I’m even happier it wasn’t my Mom’s lasagna.

But I’m happiest that they have meds in the ER to make a gallstone feel like it’s happening to someone else, far, far away.

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