How to Get Patients to Describe Abdominal Pain

Pains in general are difficult to describe, but the description of abdominal pain is very important. The quality or character of abdominal pain can be very useful to you as you try to interpret such pain and you should explore the character as far as you can.

There are many ways to describe the quality of pain in the abdomen. Patients often use descriptive terms voluntarily but some patients will not volunteer descriptions. It is useful to ask first, “What is the pain like?” The answer to this question may be quite specific like “a sharp pain,” or the patient may refuse to answer, saying “just a pain.” In either case you should press for a further description and it is always fruitful to do so. Do this by offering terms or descriptions from which the patient can choose. Ask, “Does the pain feel hot, burning, like a knife, like something sharp, like something moving around, like something squeezing, like something too big, or like a cramp?” Offered such choices, most patients will select one of these terms and you then can explore the description further. Sometimes after considering such a set of these terms, a patient will refuse them all. Pains in the abdomen can be classified usefully in three categories: bright pains, dull pains, and undifferentiated pains. These three categories have different implications. In this chapter we use “dull” to mean “not sharp” rather than “mild”: we use dull to refer to the character rather than to the severity of pain.

Ex.3. Read the text. Speak on the tests used for assessment of gastric patient. What data are revealed by each of them?

Observe how the patient looks and note appropriateness of behavior. Visual examination should check the skin, size, and shape of the abdomen, abdominal scars, excessive skin folds.

Auscultation provides helpful clues to GI abnormalities.

Palpating the abdomen helps to detect tenderness, muscle tone and abdominal masses.

Percussion helps detect air, fluid and solid matter in the abdomen.

After physical assessment, several tests can identify GI malfunction. A barium or gastrografin swallow is used primarily to examine the esophagus. The barium outlines stomach walls and delineates ulcer craters and defects.

A stool specimen is useful to detect suspected GI bleeding, infection or malabsorption.

In esophagogastroduodenoscopy, insertion of a fiber-optic scope allows direct visual inspection of the esophagus, stomach and duodenum. These structures are examined for tumors, inflammation, hernias, polyps, ulcers and obstruction.

Colonoscopy is used for inspection of descending, transverse, and ascending colon. This test helps visualize tumors, polyps, hemorrhoids, or ulcers. Gastric analysis examines gastric secretions for the presence of high levels of gastric mucosa and the amount of acid produced.

Ex.4. Read the text “Common digestive disorders”. Find in it the sentences with Complex subject and translate them. Answer the questions.

1. What principle serves as the basis for classification of gastric disorders in this text?

2. What functions are affected?

a) in mouth pathology

b) in diseases of esophagus

c) in disorders of stomach and duodenum

d) in large intestine pathology

3. What symptoms are produced by each dysfunction?