Category Archives: Gastrointestinal

Stomach Ache

What happens when you have a stomach ache? 

— When you have a stomach ache, you have pain or discomfort in your belly. Sometimes that’s the only symptom you have. Other times, you can have other symptoms such as:

Burning in your chest known as heartburn

Burping

Bloating (feeling as though your belly is filled with air)

Feeling full too quickly when you start eating

Should I see a doctor or nurse about my stomach ache? — Most people do not need to see a doctor or nurse for a stomach ache. But you should see your doctor or nurse if:

You have bloody bowel movements, diarrhea, or vomiting

Your pain is severe and lasts more than an hour or comes and goes for more than 24 hours

You cannot eat or drink for hours

You have a fever higher than 102°F (39°C)

You lose a lot of weight without trying to, or lose interest in food

What causes stomach aches? 

— In some cases, stomach aches are caused by a specific problem, such as a stomach ulcer (a sore on the inside of the stomach) or a condition called “diverticulitis,” in which small pouches in your large intestine get infected. But in some cases, doctors and nurses do not know what causes stomach aches or the other symptoms that happen with them. Even so, doctors and nurses can usually treat the symptoms of stomach ache.

What treatments help with stomach symptoms? 

— If your symptoms are caused by a specific problem, such as an ulcer, treatments for that problem will likely relieve your symptoms. But if your doctor or nurse does not know what is causing your pain, he or she might recommend medicines that reduce the amount of acid in your stomach. These medicines often relieve stomach ache and the symptoms that come with it. Some of these medicines are available without a prescription.

Can I do anything on my own to prevent stomach ache? — Yes, the foods you eat and the way you eat them can have a big effect on whether or not you feel pain.

To lower your chances of getting a stomach ache:

Avoid fatty foods, such as red meat, butter, fried foods, and cheese

Eat a bunch of small meals each day, rather than two or three big meals

Stay away from foods that seem to make your symptoms worse

Avoid taking over-the-counter medicines that seem to make your symptoms worse – Examples include aspirin or ibuprofen (sample brand names: Advil, Motrin).

Some people – especially kids – sometimes get a stomach ache after drinking milk or eating cheese, ice cream, or other foods that have milk in them. They have a problem called “lactose intolerance,” which means that they cannot fully break down foods that have milk in them. People with lactose intolerance can avoid problems caused by milk if they take a medicine called lactase. Lactase (sample brand name: Lactaid), helps your body break down milk. Some foods come with it already added. If your stomach ache seems to be related to constipation, meaning that you do not have enough bowel movements, you might need more fiber or a medicine called a laxative. (Laxatives are medicines that increase the number of bowel movements you have.) Taking in a lot of fiber helps to increase the number of bowel movements you have. You can get more fiber by:

Eating plenty of fruits, vegetables, and whole grains

Taking fiber pills, powders, or wafers

Is a stomach ache the same for children as it is for adults? — In general, yes. Children get stomach aches for the same reasons that adults do. As with adults, doctors and nurses often do not know what causes stomach pain in children. But in children, stomach pain is often triggered by stress or anxiety. For them, it’s especially important to pay attention to psychological or emotional problems that might be making pain worse.

     

Appendicitis

What is the appendix? — The appendix is a long, thin pouch that is shaped like a finger. It hangs down from the large intestine, which is also called the colon (figure 1).

What is appendicitis? — Appendicitis is the term doctors use when the appendix gets infected and swells. When that happens, the appendix can sometimes burst. A burst appendix can be serious, because it can cause a bad infection.

Appendicitis can happen in children and adults. When it happens in children, it is more likely to affect older children and teens than babies or younger children.

What are the symptoms of appendicitis? — Symptoms can be different, depending on a child’s age. The most common symptoms are:

Belly pain – In older children and teens, belly pain is usually the first symptom. The pain might start around the belly button and then move to the right side of the lower belly. Children can also have belly pain that gets worse with coughing or hopping.

Vomiting

Fever – Fever often starts after 1 to 2 days.

Loss of appetite

Should my child see a doctor or nurse? — Yes. Call your child’s doctor or nurse if your child has the symptoms listed above. If your child does have appendicitis, it’s important to get treatment as soon as possible.

Will my child need tests? — Maybe. Your child’s doctor or nurse will first ask about the symptoms and do an exam. The doctor or nurse might be able to tell if your child has appendicitis without doing any tests.

If the doctor or nurse can’t tell for sure if your child has appendicitis, he or she might do one or more of the following tests:

Blood tests

Urine tests

An imaging test such as an ultrasound or CT scan – Imaging tests create pictures of the inside of the body.

No test can say for sure if a child has appendicitis. But the doctor or nurse can use the test results, symptoms, and exam to figure out how likely it is that your child has appendicitis.

How is appendicitis treated? — The main treatment for appendicitis is surgery to remove the appendix. This surgery can be done in 2 ways:

Open surgery – During open surgery, the doctor makes a cut in the belly near the appendix. Then he or she removes the appendix through that opening.

Laparoscopic surgery – During laparoscopic surgery, the doctor makes a few cuts in the belly that are much smaller than cuts for open surgery. He or she puts long, thin tools into the belly through these openings. One of the tools has a camera (called a “laparoscope”) on the end, which sends pictures to a TV screen. The doctor can look at the image on the screen to know where to cut and what to remove. Then he or she uses the tools to do the surgery.

If your child’s appendix has burst, the doctor will do surgery to remove the appendix. During the surgery, he or she will also clean out the area in the belly around the appendix to wash away the material that spilled out of the burst appendix. This surgery can be more complicated than the surgery that is done if the appendix has not burst. If it has been more than a few days since your child’s appendix burst, your child might not have surgery right away. That’s because the body sometimes forms a wall inside the belly, to block off the area that became infected when the appendix burst. In cases like these, the doctor will first treat your child with antibiotics and watch him or her. He or she might take the appendix out once the antibiotics have made your child feel better, or stick a needle in the walled-off area to drain the infected fluid. This treatment is usually done at the same time as an imaging test, so that the doctor can see where to put the needle. After the doctor treats the infection, he or she might recommend that your child have surgery later on.

Appendicitis in Children

What is the appendix? — The appendix is a long, thin pouch that is shaped like a finger. It hangs down from the large intestine, which is also called the colon (figure 1).

What is appendicitis? — Appendicitis is the term doctors use when the appendix gets infected and swells. When that happens, the appendix can sometimes burst. A burst appendix can be serious, because it can cause a bad infection.

Appendicitis can happen in children and adults. When it happens in children, it is more likely to affect older children and teens than babies or younger children.

What are the symptoms of appendicitis? — Symptoms can be different, depending on a child’s age. The most common symptoms are:

Belly pain – In older children and teens, belly pain is usually the first symptom. The pain might start around the belly button and then move to the right side of the lower belly. Children can also have belly pain that gets worse with coughing or hopping.

Vomiting

Fever – Fever often starts after 1 to 2 days.

Loss of appetite

Should my child see a doctor or nurse? — Yes. Call your child’s doctor or nurse if your child has the symptoms listed above. If your child does have appendicitis, it’s important to get treatment as soon as possible.

Will my child need tests? — Maybe. Your child’s doctor or nurse will first ask about the symptoms and do an exam. The doctor or nurse might be able to tell if your child has appendicitis without doing any tests.

If the doctor or nurse can’t tell for sure if your child has appendicitis, he or she might do one or more of the following tests:

Blood tests

Urine tests

An imaging test such as an ultrasound or CT scan – Imaging tests create pictures of the inside of the body.

No test can say for sure if a child has appendicitis. But the doctor or nurse can use the test results, symptoms, and exam to figure out how likely it is that your child has appendicitis.

How is appendicitis treated? — The main treatment for appendicitis is surgery to remove the appendix. This surgery can be done in 2 ways:

Open surgery – During open surgery, the doctor makes a cut in the belly near the appendix. Then he or she removes the appendix through that opening.

Laparoscopic surgery – During laparoscopic surgery, the doctor makes a few cuts in the belly that are much smaller than cuts for open surgery. He or she puts long, thin tools into the belly through these openings. One of the tools has a camera (called a “laparoscope”) on the end, which sends pictures to a TV screen. The doctor can look at the image on the screen to know where to cut and what to remove. Then he or she uses the tools to do the surgery.

If your child’s appendix has burst, the doctor will do surgery to remove the appendix. During the surgery, he or she will also clean out the area in the belly around the appendix to wash away the material that spilled out of the burst appendix. This surgery can be more complicated than the surgery that is done if the appendix has not burst. If it has been more than a few days since your child’s appendix burst, your child might not have surgery right away. That’s because the body sometimes forms a wall inside the belly, to block off the area that became infected when the appendix burst. In cases like these, the doctor will first treat your child with antibiotics and watch him or her. He or she might take the appendix out once the antibiotics have made your child feel better, or stick a needle in the walled-off area to drain the infected fluid. This treatment is usually done at the same time as an imaging test, so that the doctor can see where to put the needle. After the doctor treats the infection, he or she might recommend that your child have surgery later on.

Abdominal Pain – inside the mind of a doctor

Abdominal pain is very scary,  there are a few diagnosis that we are very concerned about.   Like when someone shows up with appendicitis,  because there is potential for many bad illnesses. For example: appendicitis,  diverticulitis, a bowel obstruction,  abdominal aortic aneurysm, a spontaneous rupture of the bowel, etc.   There are many diagnoses that are potentially very serious and severe, some of them potentially surgical diseases  that we as physicians are going to worry about when we see someone with abdominal pain. So I am going to take you inside the mind of an emergency medicine doctor,  and how we try to figure out the cause of the abdominal pain. When I mention of specific diagnosis, I suggest she go to www.patienteducation.Video and search and find that specific diagnosis  and view the specific video on that subject.   Not all  these videos are made by me,  others are by other physicians, and other websites to better educate you better. First we going to ask the patient about the ‘character’ of the pain and help define it better. We are going to start  with the location of the pain. Where is it located? We divide the abdomen into 4 quadrants: RUQ – right upper quadrant LUQ – left upper quadrant RLQ – right lower quadrant LLQ – left lower quadrant That is going to help us zone in  the underlying structures of that particular quadrant.  For example, in the RUQ you have the liver and gallbladder, also the kidney posteriorly and part of the duodenum (bowel).  On the LUQ you will find not much there, you have kidney, bowel, and the spleen.  On the LLQ you will find diverticula, bowel (which can cause colitis) if you are female then also ovaries, fallopian tubes, and uterus. And finally on the RLQ there is the appendix, but also other diseases like mesenteric adenitis, kidney stones, of course female related problems.         screen-shot-2016-07-20-at-9-31-52-am Dr. Carlo Oller Board Certified Emergency Physician Please visit my website, www.DrER.tv make sure you subscribe, comment, and share! That is the best way to show your support.