Abdominal Pain: Is It a Gastrointestinal or Muscle Issue?

Abdominal issues?

Doctor, recently when I tighten my abdomen, I feel a dull pain just above my navel, slightly below the rib cage.
It also hurts when I lean forward while sitting, and I experience pain when lying down and tightening my abdomen, but there is no pain when I am standing.
Could this be a problem with my stomach or an issue with my rectus abdominis?

A Cai, 20~29 year old female. Ask Date: 2020/08/09

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, a 23-year-old male is experiencing abdominal pain, specifically in the left upper quadrant, which worsens when leaning forward while sitting.
There is a sensation of pressure that causes pain.
If this occurs frequently, it is advisable to consult a gastroenterologist to check for any gastrointestinal issues.
Wishing you peace and good health! Sincerely, Dr.
Ming-Hui Lin, Attending Physician, Department of Gastroenterology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2020/08/09

More Info

Understanding abdominal pain can be quite complex, as it may stem from various sources, including gastrointestinal issues, muscular problems, or even referred pain from other areas of the body. Based on your description, the pain you experience when contracting your abdominal muscles or leaning forward could suggest a few possibilities.

Firstly, the location of your pain—just below the rib cage and to the left—could indicate a potential issue with the gastrointestinal tract. This area corresponds to the stomach and the upper part of the colon. Conditions such as gastritis, peptic ulcers, or even gastroesophageal reflux disease (GERD) could manifest as pain in this region, especially when the abdominal muscles are engaged. If the pain is related to eating or is accompanied by other symptoms like nausea, bloating, or changes in bowel habits, it would be prudent to consider a gastrointestinal evaluation.

On the other hand, if the pain is primarily felt during specific movements, such as contracting your abdominal muscles or leaning forward, it could be related to the abdominal muscles themselves. Strain or tension in the abdominal muscles, particularly the rectus abdominis (the "six-pack" muscle), can lead to localized pain. This is especially true if you have recently increased your physical activity or changed your exercise routine, as you mentioned doing sit-ups previously. Muscle strain can cause discomfort that is exacerbated by certain movements, and it may not be present when you are standing still or at rest.

Additionally, it’s important to consider the possibility of referred pain. Sometimes, issues in the spine or even the diaphragm can manifest as abdominal pain. For example, a herniated disc or muscle strain in the lower back could potentially cause discomfort that feels like it originates from the abdomen.

Given that your symptoms are specific to certain movements and positions, it would be advisable to monitor the pain closely. If it persists or worsens, or if you develop additional symptoms such as fever, significant changes in appetite, or gastrointestinal distress, seeking medical attention would be essential. A healthcare provider may recommend imaging studies, such as an ultrasound or CT scan, to rule out any underlying conditions.

In summary, the pain you are experiencing could be due to either gastrointestinal issues or muscular strain. It is crucial to consider the context of your symptoms, including any accompanying signs or changes in your health. If the pain continues or becomes more severe, consulting a healthcare professional for a thorough evaluation would be the best course of action. They can provide a more definitive diagnosis and appropriate treatment based on a comprehensive assessment of your symptoms and medical history.

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