From the Guidelines
Causes of Cramps and Abdominal Pain Post Upper GI Endoscopy
Cramps and abdominal pain after an upper GI endoscopy are most commonly caused by air insufflation during the procedure, which can lead to irritation of the stomach lining and cramp-like pain 1. Other potential causes include reaction to sedation, perforation, and intra-abdominal contamination 1.
- Symptoms can vary widely, but the most common symptom is abdominal pain associated with distension, and cramp-like pain has also been described 1.
- Diagnosis is based on clinical, laboratory, and radiologic findings, including imaging studies such as upright or decubitus abdominal radiographs, ultrasound, and computed tomography (CT) scan with contrast enhancement 1.
- Management of these symptoms may involve taking an antispasmodic medication such as dicyclomine (Bentyl) 20-40 mg orally every 6-8 hours as needed, or an anti-inflammatory medication like acetaminophen (Tylenol) 650-1000 mg orally every 4-6 hours as needed 1.
- Additionally, applying a warm compress to the abdomen and avoiding heavy meals for a few hours after the procedure may help alleviate discomfort.
- If symptoms persist or worsen, it is essential to contact the healthcare provider for further evaluation and guidance, as delayed diagnosis of complications such as perforation can lead to more invasive treatments 1.
From the Research
Causes of Cramps and Abdominal Pain Post Upper GI Endoscopy
- Cramps and abdominal pain post Upper GI endoscopy can be caused by various factors, including:
- Intestinal perforation, which is extremely rare, but can occur due to air insufflations during the procedure, especially in patients with advanced colon cancer 2
- Gastritis, which is a common endoscopic finding in patients with upper GI symptoms, and can cause abdominal pain and other symptoms 3
- Marginal ulcer, stomal stenosis, and staple-line dehiscence, which are common endoscopic findings in patients with symptoms after gastric bypass surgery, and can cause abdominal pain, nausea, vomiting, and dysphagia 4
- The type of insufflation used during the procedure may also play a role in causing cramps and abdominal pain, with carbon dioxide (CO₂) potentially causing less luminal distension and abdominal pain compared to air 5
- However, it's worth noting that the yield of upper GI endoscopy in patients with low-risk dyspeptic symptoms is very limited, and the procedure may not always identify the cause of abdominal pain and other symptoms 6
Risk Factors for Cramps and Abdominal Pain
- Advanced colon cancer, which can increase the risk of intestinal perforation during upper GI endoscopy 2
- Gastritis, marginal ulcer, stomal stenosis, and staple-line dehiscence, which are common endoscopic findings in patients with symptoms after gastric bypass surgery, and can cause abdominal pain and other symptoms 4
- Use of air insufflation during the procedure, which can cause more luminal distension and abdominal pain compared to CO₂ 5
Prevention and Management
- Careful patient selection and evaluation before undergoing upper GI endoscopy, especially in patients with advanced colon cancer or other high-risk conditions 2
- Use of CO₂ insufflation instead of air to reduce luminal distension and abdominal pain 5
- Treatment of underlying conditions, such as gastritis, marginal ulcer, stomal stenosis, and staple-line dehiscence, to manage symptoms and prevent complications 3, 4