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Abdominal Pain, Long-term

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Ongoing or recurrent abdominal pain, also called chronic pain, may be dif f icult t o diagnose,
causing f rust rat ion f or bot h you and your doct or. Do your sympt oms f it one of t he diagnoses
described in t his chart ?
SYMPT OMS

DIAGNOSIS

SELF-CARE

Begin Here

1. Does your pain get

worse af t er you eat a
big meal?

Go to Question 10.*
No

Yes

2. Do you f eel pressure

in your upper abdomen
t hat get s worse when
you bend over or lie
down at night ?

Your problem may be a

HIATAL HERNIA.

See your doct or. Eat

smaller meals,
especially at night .
Don't lie down right
af t er you eat . Use 2 or
3 pillows, or a f oam
wedge, or raise t he
head of your bed t o
prevent discomf ort .

Your pain may be f rom

GAST RIT IS, an ULCER
or HEART BURN; all are
irrit at ions of t he
st omach and

Eat smaller meals and

use an over-t hecount er ant acid. If
ant acids don't help, see
your doct or.

Yes

No

3. Is t he pain relieved
by ant acids?
Yes

Generated from

esophagus.
No

4. Does t he pain st art in

your upper middle or
upper right abdomen,
and is it brought on by
greasy or f at t y f oods?

Yes

Your pain may be a sign

of GALLST ONES or
CHOLECYST IT IS
(inf ect ion of t he
gallbladder).

See your doct or.

Your pain may be f rom

IRRITABLE BOWEL
SYNDROME, also
known as SPAST IC
COLON.

Try a diet high in soluble

FIBER f or 2 weeks.
Takew st eps t o reduce
your st ress and t o
exercise regularly. If you
don't get bet t er, check
wit h your doct or.

You may have

CROHN'S DISEASE or
ULCERAT IVE COLIT IS,
inf lammat ory diseases
of t he colon or large
int est ine.

See your doct or. T hese

disorders are t reat able.

You may have

DIVERT ICULIT IS, an
inf ect ion of small
pocket s in t he colon.

Any inf ect ion of t he

abdomen can be
serious. CALL YOUR
DOCT OR RIGHT AWAY.

Bright red, bloody

st ools may be caused
by a bleeding
HEMORRHOID or a
bleeding POLYP, but
t hey can also be a sign
of a more serious
problem such as
CANCER of t he colon.

See your doct or.

No

5. Does your pain get

worse when you're
under st ress or do you
alt ernat e bet ween
loose and hard bowel
movement s?

Yes

No

6. Do you have sof t or

diarrhea-like bowel
movement s many
t imes t hroughout t he
day and mucus or blood
in your st ools?

Yes

No

7. Do you have
recurrent bout s of pain
in t he lower lef t side of
your abdomen along
wit h f ever?

Yes

No

8. Do you have bright

red blood in or on your
bowel movement s?

Yes

No

Generated from

9. Has it been a f ew
days or longer since
you last had a bowel
movement and do you
have t o st rain when you
have a bowel
movement ?

Your discomf ort is

probably f rom
CONST IPAT ION.

Use a simple bulkf orming laxat ive and be

sure t o add lot s of
FIBER and f luids t o
your diet . If t he
const ipat ion persist s,
call your doct or.

Unint ent ional weight

loss can be a sign of a
serious condit ion such
as CANCER.

See your doct or.

You may have VIRAL

HEPAT IT IS a serious
inf ect ion of t he liver.

See your doct or.

You may have

MONONUCLEOSIS
("MONO") or a similar
VIRAL INFECT ION.

See your doct or.

Treat ment of mono
includes rest , drinking
plent y of f luids and
t aking medicine t o t reat
t he sympt oms.

Your problem may be

MALABSORPT ION, an
inabilit y t o absorb
some f oods, or
LACT OSE
INT OLERANCE or
WHEAT
INT OLERANCE
(CELIAC DISEASE).

Avoid t he f oods and

beverages t hat cause
your sympt oms. People
who have lact ose
int olerance can use
lact ose enzyme t ablet s
or drops t o help t hem
digest f oods t hat
cont ain lact ose.

Your pancreas may not

be producing enough
enzymes f or proper

Call your doct or. He or

she may ask f or a
sample of your bowel

Yes

No

*10. Has your appet it e

decreased, and have
you lost 10 t o 15
pounds over t he past
f ew mont hs wit hout
t rying?

Yes

No

11. Do your skin or eyes

have a yellow color, or
is your urine dark?

Yes

No

12. Have you had f ever,

sore t hroat or ext reme
t iredness?
Yes

No

13. Do you have

abdominal bloat ing and
discomf ort made worse
by milk or wheat
product s?
Yes

No

14. Are your bowel

movement s yellow and
greasy, and do t hey

Generated from

f loat in t he t oilet ?
Yes

digest ion. T his

condit ion is called
PANCREAT IC
INSUFFICIENCY.

movement s t o conf irm

pancreat ic insuf f iciency.

You might have a

parasit ic inf ect ion
called GIARDIASIS.
Ot her BOWEL
INFECT IONS or
MALABSORPT ION may
also cause t hese
sympt oms.

See your doct or. To

prevent parasit ic
inf ect ions, don't drink
unt reat ed wat er f rom
lakes or st reams, and
wash f ruit s and
veget ables t horoughly
bef ore eat ing t hem.

No

15. Do you have excess

gas t hat is very f oulsmelling and occasional
loose bowel
movement s?

No

For more inf ormat ion,

please t alk t o your
doct or. If you t hink your
problem is serious, call
right away.
This tool has been reviewed by doctors and is for general educational purposes only. It is not a
substitute for medical advice. The information in this tool should not be relied upon to make
decisions about your health. Always consult your family doctor with questions about your
individual condition(s) and/or circumstances. Source: American Academy of Family Physicians.
Family Health & Medical Guide. Dallas: Word Publishing; 1996.
See complet e list of chart s.
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