Abdominal Pain

The most common abdominal pain and discomfort come from treatment side effects on bowel function. This results in three major agonies: constipation, gas, and diarrhea.

Pain and pain medications—especially opioids (pronounced OH-pee-oydz; also called narcotics)—cause bowel slowing, resulting in constipation. Sometimes, there even may be a complete halt to bowel movement.

Stool softeners and gentle laxatives should be taken as soon as you begin taking opioid (narcotic) pain medication. Discuss this with your doctor if it hasn't already been suggested. See our recommendations if you are already severely constipated.

Diarrhea and gas caused by chemotherapy or radiation to the abdomen are managed by changing to a low-residue diet (no fresh fruits or vegetables, limited fiber) and the use of medication such as Pepto-Bismol, Imodium AD, or Lomotil (chemical name: diphenoxylate and atropine) and/or Bentyl (chemical name: dicyclomine).

Antibiotics may cause diarrhea. This needs to be evaluated first with a stool sample, because it may be the result of an infection that is treated with another kind of antibiotic.

Women who have had the TRAM flap reconstruction operation have abdominal pain. This usually lasts a few months and comes from the "tummy tuck" that goes with the procedure.

Surgical scar tissue or cancer may obstruct the bowel, producing crampy belly pain and bloating, followed by nausea and vomiting. This condition requires immediate evaluation and management by your oncologist and surgeon.

In women with advanced (metastatic) breast cancer, pain in the center of the abdomen may come from enlarged lymph nodes invading or compressing organs and nerves. Liver pain, in the upper right hand side of the abdomen, occurs when the liver has cancer in it that stretches the fibrous capsule around it.

When pain in one or two areas remains uncontrolled and progressive—and these areas are the only sites of metastatic disease—radiation can be given. This is usually performed one site at a time. If the area is too big, radiation will not be used because the side effects could be too great.

If you have diffuse metastatic disease (many areas of disease throughout the body), and your pain in these abdominal or other areas is significant, your doctor may recommend opioid pain medication that you receive by intravenous drip or a pump under the skin.