Abdominal Pain Among Older Adults

M. Bachir Tazkarji, MD, CCFP


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

In This Article

Abstract and Introduction

As the population is aging, physicians from all specialties are expected to see more older adults at their outpatient practices and in the acute settings. Abdominal pain remains one of the most common and potentially serious complaints that emergency physicians encounter. Vascular pathology should be considered early in the diagnostic course of all older adults who have abdominal pain because the time for intervention is critical.

A thorough workup and broad differential diagnosis are essential elements to establishing a correct diagnosis. Older adults may have delayed presentations of serious illnesses, and their signs and symptoms of disease may be atypical. If a diagnosis is unclear, an early surgical consultation and hospital admission should always be considered.

In Canada, 13.7% of the population is older than 65 years[1] and this number is expected to increase to 20% by the year 2030. As a result, the number of older patients who present to the emergency department (ED) with abdominal pain complaint will increase. This complaint must be considered seriously because nearly half of patients >65 years who present to the ED with abdominal pain are admitted, and as many as one-third require surgical intervention at some time during their admission.[2] Older adults may initially present to outpatient offices but frequently need additional evaluation in a more acute setting, either an ED or an inpatient unit. Older adults with abdominal pain who present to the ED typically require many resources (diagnostic tests, medications, and length of stay in the ED) and careful assessment for the decision of admission versus discharge. Of those older adults who have abdominal pain and are discharged home, nearly one-third return to the ED with continued symptoms.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.