FAQ’s on Abdominal Pain Treatment in Las Vegas

Abdominal pain affects every person at some point during life. However, for some people, pain of the abdomen can last longer than three months (chronic). Chronic abdominal pain (CAP) is often disruptive and disabling, especially when it is frequent and severe.

Is chronic abdominal pain a common problem?

Abdominal pain is considered chronic when it persists for more than three months. It can be continuous (all the time) or intermittent (come and go). CAP affects about two percent of the adult population, and is more common in women.

What are the causes of chronic abdominal pain?

Common causes of chronic abdominal pain include:

  • Diverticulitis – This disorder involves inflammation of the small sacs in the large intestine lining.
  • Chronic pancreatitis – With this condition, the pancreas and biliary tree are inflamed and painful.
  • Inflammatory bowel disease – Conditions in this category include Crohn’s disease and ulcerative colitis.
  • Gastroesophageal reflux disease (GERD) – The stomach overproduces acid, which irritates the esophageal lining.
  • Irritable bowel syndrome (IBS) – This common condition causes abdominal pain, cramping, and bouts of diarrhea and/or constipation.
  • Gastritis – When the stomach lining remains inflamed for several months, it is known as gastritis.
  • Ovarian cysts – Accumulation of fluid-filled cysts on the ovaries can lead to pain.
  • Uterine fibroids – These benign growths of the uterus cause cramping and bleeding.
  • Endometriosis – With this chronic condition, uterine lining tissue grows outside the uterus, causing pain.

Who is at risk for chronic abdominal pain?

Certain people are more prone to CAP than others. While chronic pain of the abdomen can occur without a cause, it is also associated with:

  • Divorce
  • Abuse
  • Death of a loved one
  • Injury to the abdomen
  • Abdominal surgery
  • Trauma to the abdomen

How is chronic abdominal pain diagnosed?

The doctor first attempts to diagnose the cause of the abdominal pain. He/she will ask questions about your pain, take a medical history, and perform a physical examination. Diagnostic tests are used to uncover the cause of CAP or to rule out serious disorders. These include computed tomography (CT) scans, ultrasounds, x-rays, and laboratory tests.

What is the treatment for chronic abdominal pain?

Treatment focuses on the underlying cause of the abdominal pain. The goal of treatment is to alleviate associated symptoms and discomfort. Options for treatment are:

  • Superior hypogastric plexus block – The superior hypogastric plexus is a bundle of nerves that supply the abdominal cavity and organs. To perform the block, the doctor numbs the skin of the back, and inserts a small needle near the nerves using x-ray guidance. A long-acting anesthetic is instilled onto the nerves. Research studies show a 72-78% efficacy rate with this block, and results are reported to last for up to six months.
  • Celiac plexus block – The celiac plexus is a mass of nerves that supply several abdominal organs and structures. Using x-ray guidance, the doctor inserts a needle through the back and positions it near the nerves. An anesthetic is injected onto the nerves. A recent clinical report found this block to have a 90% success rate.
  • Neurolysis – If a block shows to be effective, the doctor can inject a neurolytic agent onto the nerves, or use radiofrequency energy to destroy a portion of the nerve root. As with the block procedures, the needle is positioned using x-ray guidance. In a clinical pilot study, researchers found neurolysis to be 90% effective.
  • Patient controlled analgesia (PCA) pump – For long-term chronic abdominal pain, the doctor may recommend a PCA pump. This device allows for strong pain relievers to be delivered intravenously to control the pain. The patient can administer the medication as necessary.

Resources

Eisenberg E, Carr DB, & Chalmers TC (1995). Neurolytic celiac plexus block for treatment of cancer pain: a meta-analysis. Anesthesia Analgesia, 80:290-295.

McGreevy K, Hurley RW, Erdek MA, Aner MM, Li S, & Cohen SP (2013).The effectiveness of repeat celiac plexus neurolysis for pancreatic cancer: a pilot study. Pain Practice,13:89–95.

Plancarte R, de Leon-Casasola OA, El-Helealy M, et al.(1997). Neurolytic superior hypogastric plexus block for chronic pelvic pain associated with cancer. Regional Anesthesia, 22:562-568.

Rosenberg SK, Tewari R, Boswell MV, et al. (1998). Superior hypogastric plexus block successfully treats severe penile pain after transurethral resection of the prostate. Regional Anesthesia Pain Medicine, 23:618-620.