Abdominal Pain

Abdominal pain in athletes

Abdominal pain can result from direct impact or trauma to the stomach. Or it could be gastrointestinal related with abdominal cramps, nausea, diarrhea, and vomiting. Here we outline the injuries and conditions which cause stomach pain.

Is your pain sudden onset/acute or gradual onset?

Sudden onset/acute

Gradual onset/chronic

Acute abdominal pain

The following are all possible injuries or complications which can be caused by a direct impact or trauma to the abdomen.

Winded (Solar Plexus Syndrome)

Being winded refers to what happens when you are subjected to a sudden forceful impact to the abdomen which causes breathing difficulties.

  • Being ‘winded’ is a common term used to describe Solar plexis syndrome.
  • The symptoms usually pass in 10-15 minutes as the diaphragm relaxes and recovers from the blow.

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Abdominal muscle strain

An abdominal strain is a tear or rupture of part of the abdominal muscles, usually at the point where it attaches to the pelvis.

  • Immediate severe pain in the abdominal muscles is a sign of a rupture.
  • Pain is worse when the muscles contract.
  • The strain can be caused by participation in sports such as pole vault, gymnastics, and rowing that use the whole body.
Cold therapy

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Bruised bladder

Bruised Bladder

A bruised bladder, also known as a contusion, is caused by a direct impact or trauma to the lower abdomen. Symptoms include:

  • Sudden pain in the lower stomach area.
  • Tenderness in the abdomen.
  • Nausea.
  • Blood in the urine.

Medical attention will be needed to judge and monitor the extent of the damage.

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Bruised Liver (Contusion)

A bruised liver or a liver contusion occurs after a direct impact on the torso, resulting in bleeding within the organ. Car accidents are the most common cause of this injury. The pain will be severe and immediate, and there may be a referred pain in the right shoulder. Medical attention will be needed immediately to assess and monitor the damage.

Symptoms of a Bruised Liver: Sudden pain on impact. Pain and tenderness in the upper right of the abdomen. Referred pain in the right shoulder. Nausea. In severe injuries when a lot of blood is lost, the patient could develop shock and possibly lose consciousness. Severe injuries could actually be a laceration (tear) of the liver.

Treatment of a liver contusion: Seek medical attention immediately. Your doctor will examine you and may perform an ultrasound or CT scan to assess the damage. If the injury is just a contusion with no tearing then close observation is recommended for several days.

Blood tests will be repeated daily to check for blood loss. The CT scan or ultrasound may also be repeated after a few days to check the liver is healing and that there has been no bleeding. Contusions tend to be relatively mild injuries that heal within a week or so.

Bruised Kidney (contusion)

A bruised kidney (or kidney contusion) occurs following a direct impact on the lower back area. This is most commonly from car accidents, although may also result from a fall or a physical attack, such as being kicked in the back. The impact will cause immediate pain which will need to be medically examined straight away and monitored over a few days.

Symptoms of a kidney contusion may include instant pain in the lower back area, usually on one side, nausea, vomiting, blood in the urine, and muscle spasms in the back.

If you suspect a kidney contusion seek medical attention immediately. A doctor will examine the patient and may request An X-ray to check for associated injuries such as fractured ribs. Other tests such as MRI or CT scans may also be ordered to check for internal bleeding. In cases of a simple kidney contusion, the patient is usually monitored closely for a few days. The kidney will usually heal on its own without further complications within a week or so.

Kidney laceration

A kidney laceration (or rupture) occurs following a blunt impact to the lower back region, whether it’s a fall or a physical attack. The extent of the injury can vary considerably and mild damage may not demonstrate many symptoms. Whether the damage is mild or severe, it is important to continually assess for deterioration in the condition.

Symptoms can vary and mild damage may initially show no symptoms. Usually, the abdomen will be painful on palpation. Blood in the urine. Nausea or vomiting. Changes in blood pressure and pulse. Shock may lead to unconsciousness.

It is usually caused by impacts to the abdomen, especially the lower back area. Falls, car accidents, and physical attacks are the most common causes.

To confirm the diagnosis of a kidney laceration and the extent of the damage a patient may undergo:

  • A CT scan to view the kidneys.
  • An Aortogram. This is where a special dye is injected into the main artery (the aorta). X-rays are then taken of the area as the blood containing the dye travels through the kidneys. A leak can be seen clearly here.

Treatment depends on the extent of the damage. Minor lacerations may only require observation to check that the kidney is still functioning efficiently. In more serious cases, surgery may be required. The aim of surgery is to stop bleeding and to preserve the kidney tissues and function.

Bruised Spleen (Contusion)

A bruised spleen (or spleen contusion) is bruising to the spleen which occurs after a direct impact to the upper left abdomen. It may occur after a fall or a car accident. It is not as severe an injury as a spleen laceration (or rupture). Symptoms include immediate pain on the left side of the body and nausea, but a worsening of the person’s condition can signify something more severe.

Symptoms of a bruised spleen include instant pain on impact. Pain is located on the left side of the abdomen. Pain may also be referred to the left shoulder or arm. Nausea. Tenderness in the area. Watch out for more severe symptoms such as changes in blood pressure, heart rate, confusion, and loss of consciousness which indicate a more serious injury.

Treatment: Seek medical attention immediately. A doctor will carry out an examination and may require further investigations such as ultrasound or CT scans to determine the extent of the injury and if there is any internal bleeding (see ruptured spleen). Most spleen contusions will heal successfully on their own, provided there are no other complications. Rest and observation should be undertaken and a hospital stay is usually advised so you can be closely monitored. Bleeding from the spleen may not be picked up initially so further tests are usually carried out after a day or two to confirm that it is just a contusion.

Ruptured Spleen (Laceration)

A ruptured spleen may occur following a direct blow to the left side of the stomach or back. This will often be from road accidents, contact sports, or physical fights. The impact tears the lining of the spleen and the tissues inside which can make the abdomen painful. Medical help will be needed as it causes internal bleeding.

Symptoms of pain and tenderness in the upper abdomen and nausea. Pain is sometimes referred to as the left shoulder. If bleeding is rapid, symptoms of shock develop quickly. These include light-headedness, blurred vision, confusion, loss of consciousness,

Treatment: Medical attention should be sought immediately as internal bleeding can be fatal. The patient will be put on a drip to maintain circulation to the organs. A blood transfusion may be given to replace lost blood. Surgery is required to stop the bleeding. Usually, the entire spleen will be removed in an operation called a splenectomy.

Occasionally, when the tear is only small, the surgeon may be able to fix the tear. If the spleen is removed, it is important that the patient has an injection to vaccinate them against pneumococcal infection as the spleen plays a large role in protecting the body against infection, especially from pneumococcal bacteria.

Gradual onset abdominal pain

Gradual onset or chronic abdominal pain is anything not caused by direct trauma or impact.

Gastrointestinal symptoms & abdominal pain

Gastrointestinal abdominal pain involves the stomach and intestines. Problems during exercise, especially high-intensity exercise are common. The specific symptoms may include:

  • Heartburn
  • Belching
  • Abdominal cramps
  • Nausea
  • Diarrhea
  • Vomiting
  • An urge to defecate.

There are a number of causes including Peptic ulcer, peritonitis, or simply a virus or infection.

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Kidney stones & abdominal pain

Kidney stones are small hard lumps that develop within the kidneys. They can develop from the waste products which are filtered through the kidneys forming crystalized masses. Symptoms usually include:

  • Severe pain in the back or side of the abdomen.
  • Pain is occasionally also felt in the groin.
  • Symptoms may last from a few minutes to several hours and may be constant or intermittent.
  • Nausea
  • Burning sensation on going to the toilet
  • Blood in the urine, cloudy urine and an urge to urinate more regularly are also symptoms.

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