Abdominal pain. It’s a catchall, and incredibly common, complaint, and it’s the single most common reason people go to the ER in the US, with nearly 10 million visits a year, according to the CDC. But that’s not the main reason it’s such a pain for ER doctors. Abdominal pain is, it turns out, caused by a wide range of potential problems, which makes it especially hard to diagnose.
Even ER Docs Can't Always Diagnose
In 2011, one doctor wrote for Time that a dozen patients with abdominal pain were once in his ER at one time: “A few had potentially life-threatening causes for their pain, others had nothing but gas. One ended up in the operating room, three were admitted overnight and the other eight went home. A quarter of them received a CT scan. And, perhaps most alarmingly, nearly half of the belly-pain patients that day—including those who got what we call the million-dollar workup (blood tests and multiple imaging tests)—left the ER without a definitive diagnosis.”
'The Challenge Is to Differentiate'
We sat down with Dr. Mark Friedman, First Stop Health’s chief medical officer and a veteran emergency room physician, and he says that bellyaches are indeed a bit of a black box for physicians, with an extensive range of potential causes. Even the more benign ones—flu, food poisoning, gas, constipation, gallstones—sound unpleasant enough, while the alternatives—bowel obstruction, pancreatitis, leaking aortic aneurysm, a ruptured ectopic pregnancy)—are downright catastrophic.
“The challenge is to differentiate,” Dr. Friedman says. “Do I just have a bellyache, or acute appendicitis and I need to go to the operating room?” Signaling one reason why abdominal pain is the largest cause of ER visits, he adds: “I’d rather be wrong 20 times in sending people to the ER than to be wrong once in not sending.”
Keep Calm and Call FSH
The CDC estimates that nearly one in five of all ER visits for abdominal pain are due to "serious diagnoses." That’s a significant portion, but keep in mind that more than 83% are not serious, so don’t panic.
If you’ve got stomach pain, Dr. Friedman urges, don’t use Dr. Google. Call First Stop Health immediately to describe your symptoms in as much detail as possible, and from there you’ll get medical advice on whether the pain warrants a trip to the ER for more testing.