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Relieve Abdominal Pain – 1. Offer non-pharmacological interventions. Non-pharmacological therapy plays a significant role in the treatment of abdominal pain. It is a practical, cost-effective approach to reducing the dosage of analgesic drugs required. It decreases the side effects and reduces drug dependence and healthcare costs.

• Proton pump inhibitors or antacids reduce or neutralize stomach acid
• Antispasmodics relieve spasming due to irritable bowel syndrome
• Loperamide stops diarrhea
• Bismuth-containing products coat the stomach to reduce nausea, indigestion, and diarrhea
• Stool softeners and laxatives relieve constipation
• Antiemetics relieve nausea and vomiting
• Simethicone helps the body pass gas easier
• Opioid analgesics relieve severe abdominal pain

3. Rest the bowel. Giving the digestive system a rest from ingesting anything by mouth is known as bowel rest. Sometimes, bowel rest involves refraining from all oral intake. The diet is usually advanced as tolerated, from clear liquids to bland foods, before returning to a normal diet.

Bowel rest allows the intestines to recover from an infection, disease, trauma, or injury.4. Insert a nasogastric tube. This is a common intervention for patients with bowel obstruction as it allows the stomach to decompress.5. Ensure proper hydration. Constipation can occur due to insufficient water to move waste through the intestines.

Abdominal pain, bloating, and stomach cramps may result. Dehydration involves more than just a deficiency in water consumption. The body lacks the proper electrolyte balance when dehydrated.6. Warm the GI tract. Warm fluid consumption stimulates the digestive system and helps speed the elimination process by causing the intestines to contract.7.

• Consider natural remedies.
• Peppermint, chamomile, and ginger are the three natural remedies most frequently used to alleviate abdominal pain.
• They reduce GI upset and symptoms like nausea.8.
• Avoid triggers.
• Limit the consumption of alcohol, coffee, caffeinated tea, and spicy food because these are gastric irritants and can exacerbate abdominal pain.9.

Encourage the BRAT diet. Encourage the BRAT diet for vomiting, diarrhea, and GI upset. Begin with clear liquids when the patient can eat again, then move on to bland foods like bananas, rice, applesauce, or toast. None of these foods have salt or spices, which can further irritate the stomach, and they are low in fiber making stools firmer.10.

1. Promote ambulation.
2. Ambulation increases blood flow.
3. It helps wounds and injuries heal more quickly (especially post-abdominal surgery).
4. Movement promotes peristalsis and improves overall abdominal muscle tone and strength.11.
5. Treat the underlying cause.
6. Abdominal pain can encompass discomfort from the esophagus to the pelvis.

Most patients only require symptom relief, and many instances of abdominal pain will resolve without lasting effects. If abdominal pain is persistent or recurrent, this warrants further investigation. Mild to moderate causes of abdominal pain may include conditions like:

• Irritable bowel syndrome
• Gastroenteritis (stomach flu)
• Constipation
• Poor diet choices/gastric irritants
• Acid reflux

More serious causes of abdominal pain include:

• Appendicitis
• Cholecystitis
• Pancreatitis
• Peritonitis
• Ruptured spleen
• Hernias
• Endometriosis
• Cancer
• Bowel obstruction
• Gallstones
• Kidney stones
• Pelvic inflammatory disease
• Crohn’s disease/ulcerative colitis

12. Teach the patient about pain management. Adequate information about pain management ensures the proper use of pain relievers as well as abstaining from foods or triggers that cause abdominal pain.

How do nurses assess abdominal pain?

Department: Topics in Progressive Care Marjaana Mehta is an adult nurse practitioner in adult medical oncology at Hackensack (N.J.) University Medical Center. Assessing your patient’s abdomen can provide critical information about his internal organs. Figure. Inspection

Picture your patient’s abdomen in four quadrants. Standing at his right side, look at the abdomen from the side and from above, from the xiphoid process to the symphysis pubis, to determine whether it’s flat, scaphoid, rounded, or protuberant. If it’s protuberant, ask whether this is normal for him. If it isn’t, you’ll assess for distension or ascites during percussion and palpation. Next, assess for any visible mass, bulging, or asymmetry. Look for unusual coloring, scars, striae, lesions, petechiae, ecchymoses, spider angiomas, and suspicious-looking moles. Inspect the umbilicus and note any hernias. Look for pulsations. You won’t see any on most patients, but in a thin patient you may see pulsation of the aorta in his epigastric area and possibly peristaltic waves. Figure. Auscultation Place the diaphragm of your stethoscope lightly over the right lower quadrant and listen for bowel sounds. If you don’t hear any, continue listening for 5 minutes within that quadrant. Then, listen to the right upper quadrant, the left upper quadrant, and the left lower quadrant.
1. Describe bowel sounds as absent, normoactive, hypoactive, or hyperactive.
2. Absent bowel sounds may indicate ileus or peritonitis.
3. Hyperactive bowel sounds may occur with an early intestinal obstruction or gastrointestinal hypermotility.
4. With the bell of your stethoscope, listen over the aorta, as shown, and the renal, iliac, and femoral arteries.

If the patient has hypertension, you may hear a bruit—a vascular sound similar to a heart murmur—caused by turbulent blood flow through a narrowed artery. Occasionally, you may hear a bruit limited to systole in the epigastric region of a healthy person. Figure. Percussion Lightly percuss all four quadrants of your patient’s abdomen. You’ll hear dull sounds over solid structures (such as the liver) and fluid-filled structures (such as a full bladder). Air-filled areas (such as the stomach) produce tympany. Dullness is a normal finding over the liver, but a large, dull area elsewhere may indicate a tumor or mass. Figure. Palpation Place the palmar aspect of the fingers on your dominant hand flat and together on your patient’s abdomen. Using a light, gentle, dipping motion, palpate for abnormalities, such as muscle guarding, rigidity, or superficial masses. Palpate clockwise, lifting your fingers as you move from one location to another.

After light palpation of the entire abdomen, place your nondominant hand on your dominant hand to perform deeper palpation (1½ to 2 inches ). However, avoid deep palpation if your patient may have a problem such as splenomegaly, appendicitis, or aneurysm or if palpation is painful for any reason. To palpate the liver, place your left hand under your patient, parallel to and supporting the right 11th and 12th ribs and your right hand lateral to the rectus muscle with your fingertips below the liver border (as identified by dullness during percussion).

As shown, press gently in and up as your patient takes a deep breath. Figure Another approach is to stand by his right shoulder, hook the fingers of both hands (side by side) below the liver border, press in and up toward the costal margin, and ask him to inhale. You may be able to feel the soft, smooth, sharp edge of the liver descending during inspiration. The liver is considered enlarged if the edge extends more than 1.2 inch (3 cm) below the right costal margin. Document your assessment findings in the medical record.

What to ask a patient with abdominal pain?

Taking a patient history – In her book ” Every Patient Tells a Story,” Dr. Lisa Sanders discusses the idea that patients spend a significant amount of time crafting the narrative of their illness and the events leading up to their symptom onset, Sanders states that there is value in asking a question while taking a patient’s history and actually listening to the answer.

In addition to being on faculty at the Yale Medical School, Sanders was a technical advisor for the TV show “House, M.D.” and is an experienced diagnostician. All too often, medical providers ask something of the patient and immediately start thinking about the next question. If you stop and listen, the patient will tell you what is wrong.

After understanding where the pain is located, begin by asking the patient about the quality of the pain and its severity. Has the location moved? Has the pain increased in severity? Use the OPQRST questions, In cases of abdominal pain, the history of the event is especially valuable.

In addition to simply understanding what the patient was doing when the pain began, also try to determine if there is anything which makes the pain better or worse. Sometimes pain is positional or can occur after eating or immediately upon waking in the morning. Each of these questions about the pain allows you to narrow down the list of potential diagnoses.

For abdominal pain, be sure to ask about bowel and urinary habits. Understanding when a patient’s body is not acting in a way that is consistent with what is “normal” (for him or her) can provide clues about a possible disease, For female patients of child-bearing age, it is also important to obtain specifics of her sexual and menstrual history.

In patients who might be pregnant a presenting symptom of abdominal pain should generate a “must not miss” diagnosis of ruptured ectopic pregnancy which is a potentially life-threatening condition. Be sure to ask these questions in an environment that respects the patient’s privacy. In many states even minor patients have a protected right to access “sensitive services” which are those related to sexual and reproductive health.

Be sure to understand and follow your local laws.

What management is usually given to patients with acute abdominal pain?

How is acute abdominal pain treated? – Treatment depends on the cause of your abdominal pain. You may need any of the following:

• Medicines may be given to decrease pain, treat an infection, and manage your symptoms, such as constipation.
• Surgery may be needed to treat a serious cause of abdominal pain. Examples include surgery to treat appendicitis or a blockage in your bowels.

What are the 4 steps abdominal assessment?

Function – The abdominal examination is performed with the patient lying supine. The examiner should begin by giving their formal introduction and then approach the patient and perform the examination from the right side of the patient. The initial steps are described as follows:

1. Wash hands thoroughly with soap and water. An alcohol-based sanitizer can also be used. The examiner needs to ensure that their hands are dry and warm before starting the examination.
2. Identify the patient.
3. Briefly explain the reason for and the steps of the examination and take consent from the patient.
4. Inquire if the patient has any pain.
5. Position the patient. The patient is initially positioned at 45 degrees for comfort, but a supine position is necessary to palpate the abdomen. Keeping a pillow under the patient’s head or knees can be considered.
6. The ideal exposure is from the nipples to the knees, but this is sometimes not practically possible. During most clinical examinations, the exposure is from the nipples to the lower abdomen.

General Inspection Begin with the general inspection of the patient and then proceed to the abdominal area. This should be performed at the foot end of the bed. The general inspection can give multiple clues regarding the patient’s diagnosis; for example, yellowish discoloration of the skin (jaundice) indicates a possible hepatic abnormality.

It is important to note any medical equipment for monitoring and/or treatment attached to the patient or present in the bed space. These may include catheters, pulse oximeter, oxygen mask and tubing, nasogastric tube, central lines, and total parenteral nutrition lines. Examination of the Hands and Arms The hands should be examined for the presence of pallor and jaundice.

The outstretched hands are observed for the presence of tremors. A flapping tremor (asterixis) indicates hepatic encephalopathy and may be present in cirrhosis. A non-specific tremor may also indicate alcohol withdrawal. The radial pulse should be examined, and the blood pressure should be recorded.

The hands and arms should be examined for evidence of intravenous drug use, which may be present as injection site marks. The presence of an arteriovenous fistula indicates renal replacement therapy and should be inspected and palpated. Examination of the Face and Neck The examination should begin by asking the patient to look straight ahead.

The eyes should be examined for scleral icterus and conjunctival pallor. Additional findings may be present; for example, a Kayser-Fleischer ring, a brownish-green ring at the periphery of the cornea may be seen in patients of Wilson’s disease due to excess copper being deposited at the Descemet’s membrane.

The ring can be best viewed under a slit-lamp. Peri-orbital plaques due to lipid deposition called xanthelasmas may be present in chronic cholestasis. Angular cheilitis, inflammatory lesions around the corner of the mouth indicate iron or vitamin deficiency which may be due to malabsorption. The oral cavity should be examined in detail.

The presence of oral ulcers may indicate Crohn’s disease or celiac disease. A pale, smooth, and shiny tongue indicate iron deficiency, and a beefy, red tongue is seen in vitamin B-12 and folate deficiency. The smell of the patient’s breath is itself indicative of different disorders, for example, fetor hepaticus, a distinctive smell indicating liver disorder, or a fruity breath, pointing towards ketonemia.

1. The examiner should stand behind the patient to examine the neck.
2. It is important to palpate for lymphadenopathy in the neck and the supraclavicular region.
3. The presence of the Virchow’s node may indicate the possibility of gastric or breast cancer.
4. The abdominal examination consists of four basic components: inspection, palpation, percussion, and auscultation.

Four Examination Components Inspection of the Abdomen It is important to begin with the general examination of the abdomen with the patient in a completely supine position. The presence of any of the following signs may indicate specific disorders. Distension of the abdomen could be present due to small bowel obstruction, masses, tumors, cancer, hepatomegaly, splenomegaly, constipation, abdominal aortic aneurysm, and pregnancy.

1. The presence of any abnormal masses may indicate umbilical hernia, ventral wall hernia, femoral hernia, or inguinal hernia, depending on the location.
2. The patient may be asked to cough, which results in raised intraabdominal pressure, causing the hernia to become more prominent.
3. A patch of ecchymosis may be visible on any part of the abdomen on inspection and usually indicates internal hemorrhage.

The ‘Grey Turner sign,’ the ecchymosis of the flank and groin seen in hemorrhagic pancreatitis, and the ‘Cullen’s sign,’ is a periumbilical ecchymosis from retroperitoneal hemorrhage or intra-abdominal hemorrhage. The presence of scars may be due to surgical or traumatic injuries (gunshot wounds or stab wounds), and pink-purple striae may indicate Cushing’s syndrome.

1. Vein dilation may be present that indicates portal hypertension or vena cava obstruction.
2. Caput Medusa’ that are distended veins flowing away from the umbilicus, have a 90% specificity in detecting hepatic cirrhosis.
3. Sinuses and fistulae, if present, usually occur as a result of deep infection or an infection of a surgical tract.

If a stoma is identified, various features should be noted to identify the type of stoma. These include the size and appearance of the stoma and the contents of the stoma bag. Auscultation of the Abdomen The last step of the abdominal examination is auscultation with a stethoscope.

The diaphragm of the stethoscope should be placed on the right side of the umbilicus to listen to the bowel sounds, and their rate should be calculated after listening for at least two minutes. Normal bowel sounds are low-pitched and gurgling, and the rate is normally 2 to 5/min. Absent bowel sounds may indicate paralytic ileus, and hyperactive rushes (borborygmi) are usually present in small bowel obstruction and sometimes might be auscultated in lactose intolerance.

The diaphragm should be placed above the umbilicus to listen for an aortic bruit and then moved 2 cm above and lateral to the umbilicus to listen for a renal bruit. The presence of the former indicates an abdominal aortic aneurysm, and the latter indicates renal artery atherosclerosis.

• These clinical findings must be correlated with the remaining physical examination and history to formulate a preliminary diagnosis.
• If there is a clinical suspicion of delayed gastric emptying, a maneuver that is sometimes uncomfortable for the patient may be performed; the examiner should place the stethoscope on the abdomen and hold the patient at the hips and shake him from side to side.

If splashing sounds, called the ‘succussion splash,’ are audible, the test is positive. Percussion of the Abdomen A proper technique of percussion is necessary to gain maximum information regarding abdominal pathology. While percussing, it is important to appreciate tympany over air-filled structures such as the stomach and dullness to percussion, which may be present due to an underlying mass or organomegaly (for example, hepatomegaly or splenomegaly).

• To appreciate splenic enlargement, the percussion of the Castell’s point (the most inferior interspace on the left anterior axillary line) as the patient takes a deep inspiration may be helpful.
• A percussion note that changes from tympanitic to dull as the patient takes a deep breath suggests splenomegaly, with an 82% sensitivity and an 83% specificity.

Splenomegaly occurs in trauma with hematoma formation, portal hypertension, hematologic malignancies, infection such as HIV and Ebstein-Barr virus, and splenic infarct. Percussion is necessary to assess the size of the liver, percussion downward from the lung to the liver, and then the bowel; the examiner may be able to demonstrate the change in percussion notes from resonant to dull and then tympanitic.

Shifting dullness, present in ascites, should be demonstrated by percussing from the midline to the flank till the note changes from dull to resonant and then having the patient roll over on their side towards the examiner and wait for ten seconds. This allows any fluid, if present, to move downwards.

The percussion should then be repeated, moving in the same direction. If the percussion note changes to resonant, shifting dullness are positive. With the patient sitting up, the right and left costal-vertebral angles can be percussed to determine if there is any renal tenderness as in pyelonephritis.

• The patient is in a supine position, with the head relaxed and the arms on the side of the body. This is necessary to relax the abdominal wall muscles completely.
• The patient has mentioned if he is experiencing any pain in the abdominal area and has located the point of maximal pain.

The ideal position for abdominal examination is to sit or kneel on the right side of the patient with the hand and forearm in the same horizontal plane as the patient’s abdomen. There are three stages of palpation that include superficial or light palpation, deep palpation, and organ palpation and should be performed in the same order.

Maneuvers specific to certain diseases are also a part of abdominal palpation. The examiner should begin with superficial or light palpation from the area furthest from the point of maximal pain and move systematically through the nine regions of the abdomen. If no pain is present, any starting point can be chosen.

Several sources mention that the abdomen should first gently be examined with the fingertips. Crepitus, a crunching sensation, if present, indicates the presence of air in the subcutaneous tissue. Any irregularity in the abdominal wall may also be noted, which may be due to a hernia or a lipoma.

Deep palpation should be performed in the same position of the hand and forearm relative to the patient’s abdomen but with the application of firm and steady pressure. It is important to press slowly as pressing too fast may trap a gas pocket within the intestinal lumen and distend the wall resulting in false-positive tenderness.

During palpation, tenderness should be noted, which may present as guarding. This may be a voluntary process, in which the patient voluntarily tightens the abdominal muscles to protect a deeper inflamed structure, or an involuntary process, where the intra-abdominal pathology has progressed to cause rigidity of the abdominal muscles.

1. Engaging the patient in conversation may help differentiate between voluntary and involuntary guarding, as the former disappears when the patient’s attention is diverted.
2. Tenderness in any of the nine regions of the abdomen may indicate an inflammation of the organs underneath.
3. Examination of the different areas of the abdomen may indicate separate disease processes.

Tenderness of the epigastrium may be due to gastritis or early acute cholecystitis from visceral nerve irritation. Other signs that may be appreciated include the presence of a pulsatile mass from an abdominal aortic aneurysm or abdominal wall defects, seen in muscle diastasis.

Left lower quadrant tenderness may be a presenting sign of diverticulitis in the elderly. A mass, if present, could be due to a tumor of the colon, a left ovarian cyst, or ectopic pregnancy. In the elderly, constipation leading to impacted feces may also present with a mass palpated in the left lower quadrant.

In the right lower quadrant, tenderness over McBurney’s point implies possible appendicitis, inflammation of the ileocolic area that may be due to Crohn disease, or an infection with bacteria that have a predilection for the ileocecal area such as Bacillus cereus and Yersinia enterocolitica.

• Rovsing’s sign: While standing on the patient’s right side, gradually perform deep palpation of the left lower quadrant. Increased pain on the right suggests right-sided peritoneal irritation.
• Psoas sign: Place your hand just above the patient’s right knee and ask the patient to push up against your hand. This results in contraction of the psoas muscle, which causes pain if there is an underlying inflamed appendix.
• Obturator sign: This is performed by flexing the patient’s right thigh at the hip with the knee flexed and rotating internally. Increased pain at the right lower quadrant suggests inflammation of the internal obturator muscle from overlying appendicitis or an abscess.

The examiner should palpate the periumbilical area for any defect, mass, or umbilical hernia. The patient can be asked to cough or bear down to feel for any protruding mass. The inguinal and the suprapubic area should not be missed. If an inguinal or a femoral hernia is present, a detailed examination should be done.

• A mass palpated in the suprapubic area may be due to a uterine pathology such as uterine fibroids or uterine cancer in females or bladder mass or distension in both males and females.
• The next step is to proceed to palpation of the abdominal organs.
• To palpate the liver, the examiner must place the palpating hand below the right lower rib margin and have the patient exhale and then inhale.

With mild pressure, the liver margin may be felt under the hand as a gentle wave. It is important to feel for any nodularity or tenderness. For palpation of the gallbladder, it is recommended that the examiner gently place the palpating hand below the right lower rib margin at the midclavicular line and ask the patient to exhale as much as possible.

As the patient exhales, the palpating hand should slowly be pushed in deeper, and the patient should then be asked to inhale. The sudden cessation of inspiration due to pain characterizes a positive ‘Murphy sign’ seen in acute cholecystitis. To start palpating the spleen, the hand should be placed in the right lower quadrant and moved toward the splenic flexure.

When the hand reaches the left lower rib margin, the patient should be asked to exhale and take a deep breath in. With mild pressure, the spleen may be felt under the hand as a firm mass if splenomegaly is present. There are multiple causes of splenomegaly and must be correlated with the patient’s history and other physical findings.

• A two-handed technique with the patient in the supine position is used to palpate the kidneys.
• To palpate the right kidney, place the left hand underneath the patient’s back, pushing the kidney forward and the right hand below the right lower rib margin between the midclavicular and anterior axillary lines, gently pushing down.

This technique is called ‘balloting.’ To palpate the left kidney, the examiner should lean onto the patient with the left hand placed around the flank into the patient’s loin and place the right hand on the abdomen below the left lower rib margin between the mid-clavicular line and the anterior axillary line.

Enlarged or cystic kidneys may be appreciated using this technique. To estimate the size of the aorta, the patient should be asked to lie down supine and completely relax the abdominal wall muscles. A two-handed technique is preferred, with the left and right hands placed along the lower borders of the left and right costal margins, respectively, and the fingers pointing toward the umbilicus.

A generous amount of skin should be left between the two index fingers. The aorta can be palpated as a pulsatile mass, and its width can be recorded. A width greater than 2.5 cm indicates an aneurysm, and an abdominal ultrasound should be performed to investigate it further.

1. However, an enlarged aneurysm may still not be appreciated by palpation due to body habitus.
2. Digital Rectal Examination The abdominal examination ends with the digital rectal examination.
3. After explaining the procedure, taking the patient’s consent, and maintaining the patient’s privacy, the rectal examination should be performed with proper technique.

The examiner should place their lubricated, gloved finger against the patient’s rectal sphincter muscle to dilate the sphincter and slowly slide it into the rectum palpating for hemorrhoids, fissures, or foreign bodies. The prostate for size and firmness should be assessed.

How do you write an abdominal assessment?

Sample Normal Exam Documentation: – Documentation of a basic, normal abdominal exam should look something along the lines of the following: Abdomen is soft, symmetric, and non-tender without distention. There are no visible lesions or scars. The aorta is midline without bruit or visible pulsation.

What is the primary assessment for abdominal pain?

Examination – A well-performed abdominal examination provides diagnostic clues regarding most gastrointestinal and genito-urinary pathologies decreasing the need for expensive radiological investigations.14 It is important that all healthcare workers are skilled in performing a correct abdominal examination, understand significance of findings and correlate these with the history in order to formulate a diagnostic strategy and management plan.14 This review does not provide a detailed discussion on abdominal examination.

The objectives of the abdominal examination includes assessment of the patient’s general condition, including a primary assessment, localisation of intra-abdominal pain and detection of extra-abdominal cause of pain.8 The patient’s general appearance and vital signs will guide to the differential diagnosis.

Patients with peritonitis tend to lie still, whilst those with renal colic seem unable to stay still.15 Some often overlooked manoeuvres are useful in evaluating signs associated with the causes of abdominal pain. The Carnett’s sign – increased pain when a supine patient tenses the abdominal wall by lifting the head and shoulders off the examination couch is suggestive of abdominal wall pain.16, 17 Others include Murphy’s sign for cholecystitis and the psoas sign for appendicitis.18, 19 In diagnosing abdominal pain, rectal and pelvic examinations are mandatory.

How do you diagnose abdominal pain?

Referred Pain and Accompanying Symptoms – Three cerebrospinal nerves, the phrenic, obturator and genitofemoral, are of particular importance because of the characteristic referred pain carried over these pathways in certain intra-abdominal conditions.

• Irritation, stretch, or injury of the dorsal or ventral aspects of the dome of the diaphragm produces referred pain in the supraclavicular fossa (Kehr’s sign) corresponding to the sensory branches of the phrenic nerve (C3 through C5).
• Irritation of the genitofemoral nerve from such retroperitoneal inflammatory processes as retrocecal appendicitis or retroperitoneal perforation of the duodenum produces pain in the labia, testicle, or shaft of the penis on the involved side.

Irritation of the obturator nerve in the obturator fossa, usually from an incarcerated obturator hernia, produces pain along the medial aspect of the thigh to the knee (Howship–Romberg’s sign). Clearly, symptoms that accompany abdominal pain are important in making an accurate diagnosis.

What are the three red flags in abdominal pain?

Red flags that raise suspicion of serious pathology –

Hypotension.Confusion/impaired consciousness.Signs of shock.Systemically unwell/septic-looking.Signs of dehydration.Rigid abdomen.Patient lying very still or writhing.Absent or altered bowel sounds.Associated testicular pathology.Marked involuntary guarding/rebound tenderness.Tenderness to percussion.History of haematemesis/melaena or evidence of latter on examination per rectum (PR).Suspicion of a medical cause for abdominal pain.

What are the complications of abdominal pain?

Complications of Abdominal Pain In addition, many of the underlying conditions that cause abdominal pain can lead to serious complications, including the possibility of structural damage to the digestive system from infection, cancer and its treatments, and inflammatory bowel disease (IBD).

When is abdominal pain an emergency?

If the abdominal pain is severe and unrelenting, your stomach is tender to the touch, or if the pain extends to your back, you should immediately visit the closest emergency department.