Abdominal Pain Among Older Adults

M. Bachir Tazkarji, MD, CCFP

Disclosures

Geriatrics and Aging. 2008;11(7):410-415. 

In This Article

Conclusion

Given the likelihood of atypical presentations, unreliability of physical examination findings, and lack of sensitivity of laboratory testing, the older adult who has abdominal pain should be approached systematically, keeping the differential diagnosis broad and searching for potentially life-threatening etiologies. The clinician should keep in mind that a lack of findings in the history, normal vital signs, and laboratory values that are seemingly normal or laboratory abnormalities that do not explain the patient's presentation are common among older adults. Imaging and early surgical consultation are encouraged. Serial examinations and even serial laboratory studies are vital to rule out serious conditions.

The option to admit to the hospital or to an observation unit for further monitoring should always be kept in mind if the discharge diagnosis is not clear. Those patients who are selected for discharge home should have a repeat abdominal examination documented, an improvement in their clinical course noted, a normal imaging study in most cases, and the ability to tolerate oral nutrition. They also should have a reliable caretaker and a timely follow-up evaluation.

Finally, the clinician should avoid labelling undifferentiated abdominal pain with a more benign diagnosis, such as gastroenteritis. Patients should be informed that the cause of their symptoms is unclear, and they should be given specific instructions to monitor for certain signs and symptoms or to seek further medical attention.

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