Abdominal pain is a very common symptom and is associated with a wide range of ailments. The intensity of the abdominal pain too varies from it being mild stomach pain to severe unbearable acute pain. The nature of pain ranges from cramp-like pain, generalized pain all over the abdomen or sometime localized pain, which is limited to a particular region. Additionally, there may be some associated symptoms, while there are some activities that may worsen the pain.
Nevertheless, any case of abdominal pain needs thorough history taking and clinical assessment. This is all the more important when patient complains of abdominal pain when coughing. History of the pain helps to understand factors like the duration of pain or for how long the pain has lasted, acute or chronic type and other events like consumption of a heavy meal, particular food item or any other triggering factor.
Understanding other details like severity of pain, activities that worsen the pain and those that reduce the pain are equally important. Another important factor is the nature of the abdominal pain; whether the pain is dull, sharp, cramping, twisting, stabbing or piercing, etc.
What are the Causes of Abdominal Pain When Coughing?
Abdominal pain can arise from a variety of reasons. It could range from a strained muscle as a result of coughing to an involvement of a major organ. Sometimes, persistent or intense coughing can lead to excess pressure on the abdominal muscles, which may get strained. This in return, can cause increased pain in abdomen when coughing.
The other most common causes of abdominal pain include constipation, acid reflux or colon disorders. Concerns arise over acute abdominal conditions like appendicitis, gallbladder disease, peptic ulcers, other gastrointestinal infections and disorders of the female reproductive system or during pregnancy. Other causes include kidney and liver disorders, disorders of the abdominal blood vessels or any rupture, intestinal obstruction or disorders of intestinal circulation. Causes may also arise in pelvic region, respiratory and cardiovascular system, injuries or viral infections affecting the skin and nerves leading to abdominal pain.
Pain in Abdominal wall- Abdominal pain when coughing can arise due to pain or conditions in the abdominal wall. Abdominal wall pain usually results from muscle diseases, muscle trauma or strain and or nerve involvement in diseases like diabetes or herpes. Sometimes, involvement of an abdominal organ too can cause referred pain. This pain is generally of constant aching type and may begin as a sharp pain but eventually becomes dull aching type. Activities like movement, coughing, sneezing, prolonged standing, lifting heavy weights can exert excess pressure on the muscles and trigger or worsen the pain.
Pain in Hernias– A hernia results from pushing of an organ through an opening in a tissue or muscle that supports it. While hernia can occur in other areas, they are common in the abdomen, when abdominal viscera or internal organs try to push out from an opening or weak musculature in the abdominal wall. The common types are hiatal hernia (part of stomach pushes up through the diaphragm), umbilical hernia (common in babies, when part of intestine protrudes near umbilicus), incisional hernia (part of intestines may bulge through a weak abdominal tissue or incision scar after abdominal surgery).
This causes pain in abdomen especially on coughing, crying or lifting weight as these activities increase intra-abdominal pressure and causes the pushing parts to bulge. Damage caused during surgery, congenital defects of abdominal wall and chronic coughing can lead to or weakness of abdominal wall and worsen the pain.
Pain in Visceral Organs– Abdominal pain when coughing can commonly be a result of disorders of the internal organs in the abdominal cavity. The location of the pain and the associated symptoms are important to identify the organ involvement and the possible conditions. For example, pain below the breastbone may be due to indigestion, acid reflux, peptic ulcer disease, etc. Pain on the right upper side may be from gall bladder or liver disease, while pain on the left side could be originating from the spleen. Pain in right lower side can be appendicitis or colon obstruction. In women pelvic organs should be considered. In boys testicular torsion or related conditions should be evaluated.
Investigations of Abdominal Pain When Coughing
Physical examination is performed to note fever, abdominal distension, bowel sounds, abdominal pulsations, blood pressure and pulse rate. Assessment is done for tenderness in peritonitis and bulging parts in hernia on coughing. Other specific signs for abdominal conditions and infections are elicited.
Laboratory tests, X-rays, Ultrasound and CT scan help in reaching an exact diagnosis for the abdominal pain. Other investigations like Barium studies, gastrointestinal endoscopy, laparoscopy and colonoscopy may be performed as appropriate.
Treatment of Abdominal Pain When Coughing
Treatment for abdominal pain when coughing largely depends on the exact cause and specific medications to treat the cause are given. Some conditions may subside with medication or on their own over time, while for some surgical treatment may be considered. If you have been suffering from chronic and continuous coughing leading to abdominal pain, then the treatment should focus on controlling the coughing bouts as continuous coughing tends to weaken the abdominal muscles and causing abdominal pain.