FAQs on Abdominal Pain Treatment in Nashville TN

Everyone experiences abdominal pain from time to time. Other terms used to describe abdominal pain are stomachache, tummy ache, gut ache, and bellyache. Abdominal pain can be mild or severe. It may be continuous or come and go. Abdominal pain can be short-lived (acute) or occur over weeks and months (chronic). According to statistics, functional abdominal pain (FAP) occurs in around 1% of the U.S. population. In addition, irritable bowel syndrome (IBS) affects around 15% of Americans.

What are the symptoms of functional abdominal pain?

The pain associated with FAP can range in intensity to mild stomach discomfort to severe pain. Abdominal pain can be related to a specific organ, such as the ovary or stomach, or it can be associated with the muscles or structural tissues of the abdomen. A few characteristics of abdominal pain are:

  • Character – Sharp, crampy, dull, twisting, or piercing.
  • Duration – Brief, long-lasting, or persistent.
  • Triggering events – Worsened or relieved by certain events, foods, drinks, or substances.

What can cause abdominal pain?

Many acute diseases cause abdominal pain, such as infections, appendicitis, and pancreatitis. In addition, pain of the abdomen can occur from chronic conditions, such as gallbladder disease, diverticulosis, and irritable bowel disease. Abdominal pain that does not arise from the abdomen can occur from shingles, pneumonia, heart attack, or pelvic infection.

How is abdominal pain treated?

The treatment of abdominal pain depends on what the doctor thinks is causing the problem. Treatment options include:

  • Pain medication – If the pain is the result of a bowel spasm, the patient may receive a muscle relaxant. In addition, opioid painkillers are used for certain patients who do not respond to other treatments.
  • Epidural block – For determining the source of pain, the doctor may do an epidural block. With this procedure, a catheter is positioned in the back under x-ray guidance (fluoroscopy). A local anesthetic (lidocaine or chlorprocaine) is injected to differentiate between visceral, somatosensory, and central pain.
  • Celiac plexus block – If the results of the epidural block reveal pain of a visceral origin, then the doctor may perform a celiac plexus block. With this block, a needle is inserted through the paraspinal area of the middle back under fluoroscopy. A local anesthetic is instilled onto the celiac plexus (nerves associated with the abdomen region). In a recent large meta-analysis of several studies, researchers found this block to be 90% effective.
  • Splanchnic nerve block – With this block, two small needles are positioned on each side of the spine, targeting the greater and lesser splanchnic nerves. Once position is verified by fluoroscopy, a local anesthetic is injected onto the nerve fibers. The block interrupts nerve transmission to the splanchnic and celiac plexus nerves without interrupting the abdominal parasympathetic nerves.
  • Superior hypogastric plexus block – Under x-ray guidance, the doctor inserts a needle though the skin and soft tissues of the back. Once positioned near the superior hypogastric plexus nerves, a small amount of local anesthetic is injected onto the nerve mass. In a recent study, this block relieved pelvic and abdominal pain in 72% of patients for up to six months.
  • Radiofrequency ablation (RFA) of nerves – If the one of the blocks is effective, the doctor may decide to perform a RFA. With this procedure, an electrode is inserted through the needle, and a small radiofrequency current is sent through the electrode into the surrounding tissues, which causes the tissue to heat.

Resources

Conwell DL, Vargo JJ, Zuccaro G, Dews TE, et al. (2001). Role of differential neuroaxial blockade in the evaluation and management of pain in chronic pancreatitis. Am J Gastroenterology, 96:431– 436

Clouse RE, Mayer EA, Azia Q, Drossman DA, et al. (2006). Functional abdominal pain. Gastroenterology, 130(5), 1492-1523.

McGreevy K, Hurley RW, Erdek MA, et al. (2013).The effectiveness of repeat celiac plexus neurolysis for pancreatic cancer: a pilot study. Pain Practice,13, 89–95.

 

Plancarte R, de Leon-Casasola OA, El-Helealy M, et al.(1997). Neurolytic superior hypogastric plexus block for chronic pelvic pain associated with cancer. Regional Anesthesia, 22, 562-568.