Ankylosing Spondylitis
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Colic Attacks

Abdominal pain is traditionally described by its chronicity (acute or chronic), its progression over time, its nature (sharp, dull, colicky), its distribution (by various methods, such as abdominal quadrant (left upper quadrant, left lower quadrant, right upper quadrant, right lower quadrant)) or other methods that divide the abdomen into nine sections), and by characterization of the factors that make it worse, or alleviate it.


Parietal peritoneal inflammation

  • due to infection: inflamed or suppurative appendix in appendicitis, pelvic inflammatory disease
  • due to chemical irritation: perforated gastric or peptic ulcer; pancreatitis, Mittelschmerz, ruptured ectopic pregnancy
  • miscellaneous (familial Mediterranean fever)
  • inflammation of bowel wall Crohn's disease, ulcerative colitis, microscopic colitis, diverticulitis, gastroenteritis
  • autoimmune: sarcoidosis, vasculitis
  • mechanical obstruction of hollow viscera such as the small intestine, the appendix associated with appendicitis, the large intestine (e.g. by intussusception), the biliary tree (e.g. by gallstones), or the ureter (e.g. by urinary calculi)
  • vascular disturbances (leading to ischemia): embolism, thrombosis, vascular rupture, torsional occlusion (volvulus), sickle cell anemia, left renal vein entrapment, superior mesenteric artery syndrome (nutcracker syndrome)
  • abdominal wall injury/disruption: mesenteric traction, muscle trauma, muscular infection, abdominal cutaneous nerve entrapment syndrome (ACNES), also known as intercostal neuralgia; diverticulosis (rare)
  • digestive: lactose intolerance, Celiac sprue
  • distention of visceral surfaces such as the hepatic or renal capsule
  • referred pain from the thorax (pneumonia, coronary occlusion), the spine (radiculitis secondary to arthritis), genitals (testicular torsion)
  • metabolic disturbance: lead poisoning, Black widow spider bite, uremia, diabetic ketoacidosis, porphyria, C1-esterase inhibitor deficiency, adrenal insufficiency.
  • neurogenic pain: tabes dorsalis, herpes zoster, Lyme disease (Lyme radiculitis or Bannwarth syndrome)
  • functional pain, Irritable Bowel Syndrome (affecting up to 20% of the population, IBS is the most common cause of recurrent,intermittent abdominal pain)
  • reproductive organs (in women): mittelschmerz, torsion of the ovary, ectopic pregnancy,
  • pelvic inflammatory disease
  • endometriosis
  • Post-surgical adhesions
  • Diarrhea
  • meningitis
  • menstruation
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