Clinical evaluation of abdominal pain in adults

Abdominal pain is a common presentation to the acute medical unit and outpatient department. The patient may have poorly localized pain and, given the wide differential diagnosis, a comprehensive history and examination are essential. Linking this with the pathophysiology and anatomical location of abdominal pain is key to establishing a valid differential diagnosis. The immediate aim is to identify potentially life-threatening acute abdominal conditions that require resuscitation, prompt investigation and early surgical assessment/intervention. For conditions that are not life threatening, defining timely and pertinent investigations is essential for appropriate intervention and management.Functional gastrointestinal disorders are common and important to recognize, as this diagnosis will lead to different, and often multi-disciplinary, management of these complex conditions. Within this article, we provide a summary of the different types of abdominal pain and their pathophysiology, linked to key questions within the history and important physical findings in the examination that provide clues to the aetiology. This includes a comprehensive list of common causes of pain in differing anatomical locations and a summary of useful investigations.