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ABDOMEN - THE MAGIC BOX (November, 2003)

Abdomen – the Magic Box!
Abdominal discomfort, fullness or tightness or audibly noisy or pains of varying intensity are some of the commonest problems posed by patients to their doctors. The pain may be excruciating and almost unbearable and the victim shouts or jumps or writhes in pain. There may be nausea or actual vomiting or diarrhoea or difficulty or burning sensation while passing urine or mild to severe fever, sometimes with frightening chills and shivering. Sometimes the victim feels cold and sweats profusely and may even be not fully in his/her senses! Often one is at a loss to know if there is something serious and life threatening and the patient is rushed to the doctor. Even the doctor is often at a loss to detect/diagnose correctly what the patient is suffering from. But, by a careful and detailed evaluation, an experienced doctor can often come to a somewhat correct diagnosis. And it is almost always possible to differentiate between a serious and life threatening condition and a less serious and less urgent condition.

Serious and emergency situations:
The “intensity” of pain as expressed by the patient is partly due to the disease condition and partly the patient’s response to the pain stimulus. Hence severe pain does not necessarily mean serious disease. The experienced doctor is often able to decide on the severity of the underlying condition and start immediate treatment measures. A quick examination of the patient and assessment of “Vital Signs” like pulse rate and rhythm, blood pressure, respiratory rate and type, temperature, colour and feel of the skin and tongue will give valuable clues. In emergency situations the doctor should quickly try and restore the vital signs by administering pain killers, I.V fluids, oxygen administration and other measures to give relief and restore and maintain the vital functions pending proper diagnosis and precise and targeted treatment. Various laboratory tests, x-rays and scans as indicated, will help in properly and correctly detecting the causative disease/disorder. The large number of organs and parts inside the abdomen, around it and above it too may be the cause of the emergency situation. Even a “heart attack” (myocardial infarction) can present as severe abdominal pain.

A doctor who makes a complete, thorough, detailed and systematic examination is more likely to be able to correctly find out/diagnose the disease and hence will be able to treat and cure the disease. A mere bookish knowledge, however extensive, is no substitute to detailed clinical evaluation.

More diagnoses are missed,
By not taking the look,
Than by not knowing,
What is in the Book!

These golden words should be remembered and followed by every good doctor!

More on some of the abdominal problems and their management in general will be in our future newsletters.

Be healthy, be happy and be contented!

 

Dr. M.Mohan Rao, MBBS,MS,FICS,MCH,

M.D. & Chief Surgeon, Dr. U Mohan Rau Memorial Hospital.
E-mail: mmr@mohanraohospital.com

 

 

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Updated on 01.11.2003.
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