Chronic Abdominal Pain

Over the years, so many years, I have seen many patients, mostly women, sometimes very   young, with Chronic Abdominal pain. As a health provider I feel especially lacking in my offerings. I take heart though, in the knowledge that no-one else is much good at helping people with this problem. I see people to help them to adjust and manage their condition and to find ways for them to find joy despite this. As a caveat, this very complex issue is managed by very highly qualified specialists. My conversation on this topic is not a substitute for expert advice from appropriate Doctors and Specialists.

People have difficulty adjusting to a long line of treatment options that don't work or fail to reach expectations. We work with an acute care Specialist drive health model which is not likely to be effective for a chronic illness.

Chronic Abdominal Pain is a broad description for pain between the bottom of the ribs and the pelvis. It may be due to various medical conditions; menorrhagia, Crohne's, IBS, Adhesions, GI issues, GORD, Pancreatitis, Ulcers, Iron deficiency anaemia, urological issues and many other conditions.

Women affected by Chronic Abdominal Pain are often diagnosed and treated with the most invasive surgical strategies including hysterectomy, oblation, and mesh. Often with no result in terms of pain.

I don't know the statistic for Australia. Around the world its 2.8% with around 1% unexplained. I believe this has increased in recent years.

What is causing this is really unknown. It has been noticed that people who have experienced high doses of antibiotics are over represented in the Abdominal Pain group. There are immune disruptions and gastro dysfunction as well as iron deficiencies, and of course Endometriosis.

I would suggest there is likely to be another factor that is responsible and the clinical observations are not the cause but the symptoms.

Whatever the cause and label, the best treatment on offer is targeting psychological and physical well-being within a multidisciplinary team. Communication needs to be open, transparent and involve the patient at every turn. Rather than invasive treatments and a specialist focus, I would suggest Relaxation, Nutrition, Medication Management, and Exercise supervised by a team of appropriately qualified health professionals.

Written by Dr Mike Shelley