腹痛Abdominal Pain(1)

Abdominal pain definition and facts 腹痛的定义和事实

• Abdominal (belly) pain is pain or discomfort that is felt in the part of the trunk below the ribs and above the pelvis. 腹痛是指肋骨下方和骨盆上方的躯干部分感到的疼痛或不适。
• It comes from organs within the abdomen or organs adjacent to the belly.

它来自于腹部的器官或邻近腹部的器官。

• It is caused by inflammation, distention of an organ, or by loss of the blood supply to an organ.

它是由炎症、器官膨胀或器官供血不足引起的。

• In irritable bowel syndrome (IBS) it may be caused by contraction of the intestinal muscles or hyper-sensitivity to normal intestinal activities. 在肠易激综合症(IBS)中，它可能是由肠道肌肉收缩或对正常肠道活动过度敏感引起的。
• Symptoms associated with it may include:相关症状包括:
• Bloating 腹胀
• Belching 反酸；打噎
• Gas (flatus, farting) 气体(排气、放屁)
• Indigestion 消化不良
• Discomfort in the upper left or right; middle; or lower left or right abdomen

左上腹或右上腹不适;中腹部不适;或左下腹部或右下腹部不适

• Constipation 便秘
• Diarrhea 腹泻
• GERD (gastro-esophageal reflux disease) 胃食管反流病(GERD)
• Heartburn 胃灼热
• Chest discomfort 胸部不适
• Pelvic discomfort 盆腔不适

• The cause of abdominal pain is diagnosed on the basis of its characteristics, the physical examination, and testing. Occasionally, surgery is necessary for diagnosis.

腹痛的病因是根据其特征、体格检查和检测来诊断的。有时，手术是必要的诊断。

• The medical diagnosis of the cause is challenging because the characteristics may be atypical, tests are not always abnormal, diseases causing pain may mimic each other, and the characteristics of the pain may change over time.

医疗诊断的原因是具有挑战性的，因为特征可能是非典型的，测试并不总是异常的，引起疼痛的疾病可能类似，疼痛的特征可能随着时间的推移而改变。

• Medical treatment depends upon the patient' s history of disease or other health conditions that may be the cause. 医疗治疗取决于患者的疾病史或其他可能导致疾病的健康状况。

What is abdominal pain? 什么是腹痛?

      Abdominal pain is felt in the abdomen. The abdomen is an anatomical area that is bounded by the lower margin of the ribs and diaphragm above, the pelvic bone (pubic ramus) below, and the flanks on each side. Although pain can arise from the tissues of the abdominal wall that surround the abdominal cavity.(such as the skin and muscles), the term abdominal pain generally is used to describe discomfort originating from organs within the abdominal cavity. Organs of the abdomen include the stomach, small intestine, colon, liver, gallbladder, spleen, and pancreas.

      腹部有痛感。腹部是一个解剖学上的区域，它的边界是上面的肋骨和隔膜的下缘，下面是骨盆骨(耻骨支)，以及两侧的侧翼。虽然疼痛可能来自腹腔周围的腹壁组织(如皮肤和肌肉)，但术语腹痛通常用于描述由腹腔内器官引起的不适。腹部器官包括胃、小肠、结肠、肝脏、胆囊、脾脏和胰腺。

      Technically, the lowermost portion of the area described previously, is the pelvis, which contains the urinary bladder and rectum, as well as the prostate gland in men, and the uterus, Fallopian tubes, and ovaries in women. Often, it can be dificult to know if lower abdominal pain is coming from the lower abdomen or pelvis (pelvic pain).

      从技术上讲，上述区域的最下面部分是骨盆，其中包括男性的膀胱和直肠，以及前列腺，女性的子宫、输卵管和卵巢。通常，很难知道下腹部疼痛是来自下腹部还是骨盆（骨盆疼痛）。

      Occasionally, pain may be felt in the belly even though it is arising from organs that are close to, but not within, the abdominal cavity, for example, conditions of the lower lungs, the kidneys, and the uterus or ovaries. On the other hand, it also is possible for pain from organs within the belly to be felt outside of the it. For example, the pain of pancreatic inflammation may be felt in the back. These latter types of pain are described as "referred” because it does not originate in the location that it is felt. Rather, the cause is located away from where it is felt (i.e., it is referred to a different area).

      有时，腹部可能会感到疼痛，即使疼痛是由接近腹腔但不在腹腔内的器官引起的，例如下肺、肾脏、子宫或卵巢的状况。另一方面，也有可能感觉到来自腹部器官的疼痛。例如，胰脏发炎的疼痛可以在背部感觉到。后一种类型的疼痛被称为“牵涉痛 ”，因为它不是起源于感觉到的部位。相反，病因位于感觉不到的地方（即，它指的是一个不同的区域）。

What causes abdominal pain? 什么引起腹痛?

      Abdominal pain is caused by inflammation of an organ (for example, appendicitis, diverticulitis, colitis), by stretching or distention of an organ (for example, obstruction of the intestine, blockage of a bile duct by gallstones, swelling of the liver with hepatitis), or by loss of the supply of blood to an organ (for example, ischemic colitis).

      腹痛是由器官的炎症（例如阑尾炎、憩室炎、结肠炎）、器官的伸展或扩张（例如，肠梗阻、胆结石阻塞胆管、肝炎引起的肝肿胀）或器官供血不足（例如，缺血性结肠炎）引起的。

      To complicate matters, however, abdominal pain also can occur without inflammation, distention or loss of blood supply. An important example of the latter is the irritable bowel syndrome (IBS). It is not clear what causes the belly pain in IBS, but it is believed to be due either to abnormal contractions of the intestinal muscles (for example, spasm) or abnormally sensitive nerves within the intestines that give rise to painful sensations inappropriately (visceral hyper-sensitivity). This often is referred to as functional pain because no recognizable specific abnormality to account for the cause of the pain has been found - at least not yet.

      然而，更为复杂的是，腹痛也可以在没有炎症、扩张或血供丧失的情况下发生。后者的一个重要例子是肠易激综合征（IBS）。目前尚不清楚是什么引起了IBS的腹痛，但人们认为这可能是由于肠肌肉的异常收缩（例如痉挛）或肠内异常敏感的神经导致不适当的疼痛感觉（内脏超敏感）。这通常被称为功能性疼痛，因为还没有发现可识别的特殊异常来解释疼痛的原因——至少目前还没有。

What's Causing Your Abdominal Pain?你的腹痛是怎么引起的?

Signs, symptoms, locations, types, and severity of abdominal pain

      Doctors will ask you a variety of questions about your belly pain in order to help find the possible causes of it, for example: 医生会问你各种关于你肚子痛的问题，以帮助找到可能的原因，例如:

How did the pain begin? 疼痛是怎么开始的?

      If it comes on suddenly, this may suggest a problem with an organ within the belly; for example, the interruption of the supply of blood to the colon (ischemia) or obstruction of the bile duct by a gallstone (biliary colic). 如果突然发病，这可能意味着肚子里的某个器官出了问题;例如，结肠供血中断(缺血)或胆道阻塞(胆绞痛)。

Where is the pain located? 疼痛部位在哪里?

• Appendicitis typically causes discomfort in the middle of the abdomen, and then moves to the right lower abdomen, the usual location of the appendix. 阑尾炎通常在腹部中部引起不适，然后转移到右下腹部，这是阑尾的通常位置。
• Diverticulitis typically causes discomfort in the left lower abdomen where most colonic diverticulum are located. 憩室炎通常会导致结肠憩室所在的左下腹部的不适。
• Discomfort from the gallbladder (biliary colic or cholecystitis) typically is felt in the middle, upper abdomen or the right upper abdomen near where the gallbladder is located. 胆囊的不适(胆道绞痛或胆囊炎)通常在中、上腹部或右上腹部胆囊附近感到。

What is the type and pattern of the pain? 疼痛的类型和模式是什么?

• Is it severe, crampy, steady; or does it wax and wane? Obstruction of the intestine initially causes waves of crampy pain due to contractions of the intestinal muscles and distention of the intestine. True cramp-like pain suggests vigorous contractions of the intestines. 是严重的，痉挛的，稳定的，还是起起落落的？肠梗阻最初由于肠肌肉收缩和肠扩张而引起阵痛。真正的痉挛样疼痛意味着肠的剧烈收缩。
• Obstruction of the bile ducts by gallstones typically causes steady (constant) upper belly pain that lasts between 30 minutes and several hours. 胆结石阻塞胆管通常会导致持续30分钟到几个小时的上腹部疼痛。
• Acute pancreatitis typically causes severe, unrelenting, steady pain in the upper abdomen and upper back.

急性胰腺炎通常会导致上腹部和上背部严重、持续、稳定的疼痛。

• The pain of acute appendicitis initially may start near the umbilicus, but as the inflammation progresses, it moves to the right lower abdomen. 急性阑尾炎的疼痛最初可能始于脐附近，但随着炎症的进展，疼痛会转移到右下腹部。
• The character of pain may change over time. For example, obstruction of the bile ducts sometimes progresses to inflammation of the gallbladder with or without infection (acute cholecystitis). When this happens, the characteristics change to those of inflammatory pain. 疼痛的特征可能会随着时间的推移而改变。例如，胆管阻塞有时发展为胆囊炎症伴或不伴感染(急性胆囊炎)。当这种情况发生时，这些特征转变为炎症性疼痛。

How long does the pain last? 疼痛持续多久?

• The discomfort of IBS typically waxes and wanes over months or years and may last for years or decades. IBS的不适感通常会在几个月或几年的时间里逐渐增强或减弱，可能会持续几年或几十年。
• Biliary colic lasts no more than several hours. 胆道绞痛持续时间不超过几个小时。
• The pain of pancreatitis lasts one or more days. 胰腺炎的疼痛持续1天或更长时间。
• The pain of acid-related diseases - gastroesophageal reflux disease (GERD) or duodenal ulcers - typically occurs over a period of weeks or months that is worse followed by periods of weeks or months during which it is better (periodically). 胃酸相关疾病的疼痛——胃食管反流病(GERD)或十二指肠溃疡——通常发生在数周或数月期间，然后在数周或数月期间(周期性地)好转。
• Functional pain may show this same pattern of periodicity. 功能性疼痛可能表现出相同的周期性模式。

What makes the pain worse? 什么使疼痛加剧?

• Pain due to inflammation (appendicitis, diverticulitis, cholecystitis, and pancreatitis) typically is aggravated by sneezing, coughing or any jarring motion. Individuals with inflammation prefer to lie still. 由炎症引起的疼痛(阑尾炎、憩室炎、胆囊炎和胰腺炎)通常会因打喷嚏、咳嗽或任何剧烈运动而加重。有炎症的人更喜欢躺着不动。
• What health conditions make abdominal pain worse or better? 什么健康状况会使腹痛加重或减轻?

What relieves the pain? 什么能减轻疼痛?

• The pain of IBS and constipation often is relieved temporarily by bowel movements and may be associated with changes in bowel habit. 肠易激综合征和便秘的疼痛可通过排便暂时缓解，可能与排便习惯的改变有关。
• Pain due to obstruction of the stomach or upper small intestine may be relieved temporarily by vomiting which reduces the distention that is caused by the obstruction.

胃或上小肠梗阻引起的疼痛可通过呕吐暂时缓解，从而减少梗阻引起的膨胀。

• Eating or taking antacids may temporarily relieve ulcer pain from the stomach or duodenum because both food and antacids neutralize the acid that is responsible for irritating the ulcers and causing the pain. 食用或服用抗酸剂可暂时缓解胃或十二指肠溃疡疼痛，因为食物和抗酸剂均能中和引起溃疡和疼痛的酸。
• Pain that awakens a patient from sleepis more likely to be due to non-functional causes and is more significant.

将患者从睡眠中唤醒的疼痛更可能是由于非功能性原因造成的，而且更为严重。

• Other associated symptoms that accompany abdominal pain may suggest: 伴随腹痛的其他相关症状可能表明：
• Fevers uggests inflammation or infection. 发烧可引起炎症或感染。
• Diarrhea or rectal bleeding suggests an intestinal cause. 腹泻或直肠出血可导致肠道疾病。
• Fever and diarrhea suggest inflammation of the intestines that may be infectious or non-infectious.

发烧和腹泻是指肠道可能具有传染性或非传染性的炎症。

• How is the cause of abdominal pain diagnosed? 如何诊断腹痛的原因？
• Doctors determine the cause of the pain by relying on: 医生通过以下方法确定疼痛的原因：
• Its characteristics,physical signs,and other accompanying symptoms 其特征、体征和其他伴随症状
• Findings on physical examination 体检结果
• Medical laboratory,radiological,and endoscopic testing 医学实验室、放射和内窥镜检查
• Surgery 手术