Abdominal pain in adults under 40 years of age

In adults under the age of forty, acute abdominal pain usually indicates a serious illness. Appensicitis (appendix inflammation is the most common). Below I describe a number of serious conditions that are associated with acute abdominal pain.

Perforation of an ulcer in the stomach or duodenum

From the age of twenty-five, an ulcer in the stomach or duodenum is increasingly common. This can sometimes break and the gastric juice then flows into the free abdominal cavity. Medications such as painkillers (e.g. Ibuprufen), blood thinners and corticosteroids can play a role in this.
In half of the cases, a perforation can occur without any prior complaints of an ulcer. If an ulcer bursts, you suddenly have very severe and persistent pain in the upper abdomen. The heartburn and pain spread throughout the abdomen. The more there is movement, the more pain there is. Patients who have a perforation prefer to lie as still as possible. The abdomen feels rock hard, no longer moves and is retracted. Patients are often very anxious, ill and look pale. People with a perforation must be quickly referred to the hospital where the operation will usually be performed.

Intestinal blockage due to a cord or adhesion.

If you have ever had abdominal surgery in the past, you run the risk of developing stitches and adhesions that run like cables through the abdominal cavity. Sometimes such a cord can become tight over a piece of intestine, which can cause a blockage of the intestine.
It causes attacks of severe cramping pain in the abdomen. People who suffer from this also have a need for exercise. They seem to have to move to make the pain somewhat bearable. The abdomen begins to swell, and there are no more gases or stools. The patient often also vomits. Someone with an intestinal blockage must be referred to the hospital.

Acute abdominal pain in women under forty years of age.

Sometimes ovulation can cause severe lower abdominal pain in women. Inflammation of the female genital organs (PID = pelvic inflammatory disease) can also cause increasing lower abdominal pain. There is often a fever and the patient feels very ill. There is a strong vaginal discharge. It can occur after childbirth, miscarriage, uterine surgery or sexually transmitted diseases. The GP can usually make a diagnosis himself through internal examination. Treatment is usually done at home with antibiotics.

Acute abdominal pain in pregnant women.

In the first half of pregnancy, an extrauterine pregnancy can cause severe abdominal pain. The abdominal pain is severe and on one side of the abdomen. If this is suspected, the woman should be referred to a gynecologist.
In the second half of pregnancy, a detachment of the placenta can also cause sudden severe lower abdominal pain that does not go away. The abdomen is rock hard and the baby is in mortal danger. Here too, the woman must be sent in urgently.
Upper abdominal pain in the second half of pregnancy may indicate HELPP syndrome. The HELPP syndrome is a complication of high blood pressure and protein loss in the urine during pregnancy. It often starts with pain and a burning sensation in the upper abdomen, which feels like a belt has been tightened. This feeling is because the liver is swelling. Nausea, vomiting and headache may also occur. A pregnant woman with these complaints must be seen quickly by a GP. If blood tests also show that the red blood cells are being broken down, the platelets are reduced and there are signs of liver cell damage, the pregnant woman must be immediately sent to a gynecologist.

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