Characteristics of Upper Abdominal Pain in

liver411

Digestive Diseases and Sciences  48 (10)   p.1914-1918  October 2003

Characteristics of Upper Abdominal Pain in Those with Chronic Liver Disease

Riley III Thomas R.1    and  Koch Kenneth2

1.The Hershey Medical Center, Pennsylvania College of Medicine, Department
of Medicine, Hershey, Pennsylvania, USA; [email protected]
2.The Hershey Medical Center, Pennsylvania College of Medicine, Department
of Medicine, Hershey, Pennsylvania, USA


Chronic hepatitis has many causes. Symptoms include upper abdominal pain. To
allow for a better understanding of this pain we compare HCV patients with
other liver diseases and normal controls on their reporting of pain over one
month and describe associations. A cross-sectional, case control study was
performed. Three groups are studied: (1) normal individuals (NC) (N = 64),
(2) patients with chronic liver diseases other than HCV (LD) (N = 53), and
(3) HCV infection (N = 64). A dyspepsia questionnaire was utilized, which
inquired about a one-month symptom presence of upper abdominal pain and
associated symptoms. There was a one-month period prevalence of upper
abdominal pain of 45.3% in the HCV group vs 32% in the LD and 20.3% in the
NC groups (P = 0.01). The LD (22.6%) and HCV (26.6%) groups had markedly
more pain that was worsened by eating compared with NC (1.6%) (P = .003). On
univariate analysis, when comparing those with upper abdominal pain to those
without, there was a lower age (41.3 vs 44.5), a higher BMI (30.3 vs 26),
and more symptoms of fatigue, bloating, and pain worsened by eating and
early satiety. On multivariate analysis, age < 50 (OR 5.1; CI 1.5-17), BMI >
30 (OR 4.1; CI 1.5-10.9), nausea (OR 4.1; CI 1.6-10.4), and pain with eating
(OR 30: CI 6.7-133) predicted upper abdominal pain. In conclusion, upper
abdominal pain is more commonly reported over one month in those with
chronic liver diseases. That the abdominal pain worsened after meals in
liver patients but not in the normal subjects was a surprise. Possible
explanations for this finding are offered.