Original Research Article
Year: 2019 | Month: May | Volume: 9 | Issue: 5 | Pages: 59-67
Epidemiological Profiling of Pain Abdomen Cases Presenting to a Rural Hospital of South Rajasthan
Dr. Pratik Vasantbhai Patel1, Dr. Somendra Mohan Sharma2, Dr. Nikhil G. Patel3, Dr. Nabajyoti Upadhyaya4
1Senior Resident (DNB Family Medicine), J.W. Global Hospital & Research Centre, Mount Abu, Rajasthan, India.
2Consultant General Surgeon, 4Senior Clinical Associate,
Dept. of Surgery, J.W. Global Hospital & Research Centre, Mount Abu, Rajasthan ,India.
3Consultant Neuropsychiatrist, Dept. of Psychiatry, J.W. Global Hospital & Research Centre, Mount Abu, Rajasthan, India.
Corresponding Author: Dr. Pratik Vasantbhai Patel
ABSTRACT
Introduction: Pain Abdomen is one of the most common complaints of patients coming to a hospital. Pain Abdomen is caused by a wide variety of disorders ranging from organic to functional. Epidemiological profiling of various causes of Pain Abdomen in a region can not only reduce the preventable causes of it & improve quality of life of population, but also can greatly reduce the economic burden upon the society.
Materials & Methods: We studied all the patients above 12 years of age, presenting to J. Watumull Global Hospital & Research Centre (GHRC), Mount Abu, Rajasthan, with the complaint of Pain Abdomen; during a period of 18 months from September 2015 to March 2017. GHRC being an important primary and secondary care hospital of the region with a wide rural penetration through its village out-reach and community health projects, the study population was supposed to be largely a sample population of South West Rajasthan. Thorough physical examination and basic investigations (CBC, urine examination, stool examination and abdomen ultrasound) were done to find out the cause of Pain Abdomen. Other specific investigations were done as and when required to reach a definitive diagnosis. Rome III diagnostic criteria based questionnaire was used to find out Functional G I disorders.
The data collected were analysed to find a trend and a possibility to use the data to institute effective preventive measures.
Results: Total 760 patients were registered.
In our study population, slight female predominance (52.9%) was observed.
As expected, system wise, Gastro Intestinal disorders topped the list (49.5%) followed by Urinary system (34.3%), Gynaecological system (16%) and Functional Disiorders (13.3%) with several overlap, but classifying according to various groups of disorders, the commonest cause of Pain Abdomen was found to be urolithiasis (27%), followed by infective/infestatational intestinal disorders (22.4%) , Gynaecological disorders (Pelvic Inflammatory Disease, Dysmenorrhoea etc) (16%), Acid Peptic (including Gastro Esophageal Reflux) Disease in (14.2%), functional G I disorders in (13.3%) and gall bladder and liver diseases in (12.9%).
Among investigations, USG abdomen was found to be the most useful diagnostic modality with highest contribution (79.3%) in providing a definitive diagnosis. Rome III diagnostic criteria was useful to diagnose functional G I disorders. Majority (63.6%) patients reported consumption of Government supplied water.
Conclusion: Urolithiasis and Inflammatory/Infective Gut Disorders, in that order, are the two most common causes of Pain Abdomen in South West Rajasthan. Functional G.I. Disorders contribute to a lesser extent compared to the global and Indian prevalence rate. Clean and safe drinking water and life style modification can possibly reduce the prevalence to a great extent.
Key words: abdominal pain, epidemiology of Pain Abdomen, South Rajasthan, urolithiasis, functional G.I. disorders