Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Provider photo for Jeremy Swartzberg

Jeremy Swartzberg, MD

Hospital Medicine

Welcome to My Doctor Online, a web site that my colleagues and I developed to make it easier for you to take care of your healthcare needs. On this site you will find answers to many of your questions about my clinical practice. Also included are several online features that will allow you to e-mail me, check your laboratory results and refill prescriptions. I hope you find its content informative and useful.

My Offices

Oakland Medical Center
Appt/Advice: 510-752-1190

See all office information »

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Overview

Your abdomen, or belly, is the area between your chest and groin. Most of us have occasional abdominal pain that isn’t serious. However, it can also alert us that something is wrong.

The amount of pain you feel doesn’t always tell us if the cause is serious. For example, you might feel:

  • Mild pain with a serious illness, such as appendicitis or colon cancer.
  • Severe pain with a nonserious condition, such as gas, stomach flu, or a pulled muscle.

Depending on the cause, we may treat:

  • Sudden pain with antibiotics, bowel rest, or surgery.
  • Long-term pain with medications.

Sometimes, we can’t identify the cause of the pain. If so, follow up with your doctor to get help managing symptoms.

Symptoms

Abdominal pain may be:

  • Centered in one area or felt all over your belly.
  • Constant or come and go in waves.
  • Sudden or last for weeks or months.

When abdominal pain is:

  • In one area of your belly, you might have a problem with your appendix, stomach, kidneys, or gallbladder.
  • In more than half of your belly, you may have a stomach virus, gas, or indigestion.
  • Severe, you might have a blockage in your intestines that prevents you from passing stool (bowel obstruction). This is serious and needs immediate medical attention.
  • Severe and comes in waves, you may have kidney stones or gallstones.
  • Associated with cramps and diarrhea, you may have gas and bloating. This is usually not serious.

Seek immediate medical attention when:

  • Pain lasts longer than 24 hours.
  • Pain gets worse.
  • You also develop a fever.
  •  You also vomit, including fluids.

Causes of Sudden Pain

Abdominal pain that comes on suddenly (acute pain) often needs immediate medical treatment. Common causes are:

  • Appendicitis.
  • Problems with pregnancy.
  • Women’s health issues, such as a ruptured ovarian cyst.
  • Urinary tract infection (UTI).

 Underlying diseases that can cause acute abdominal pain include:

  • Inflammation of your pancreas or liver.
  • Infection of the colon or gallbladder.
  • Sores in your colon and rectum.
  • Cancer, such as colorectal or stomach cancer.
  • Bowel blockage or damage from poor blood flow.
  • A tear or leaking of a large blood vessel.
  • Heart attack or pneumonia.

Sudden abdominal pain can also be triggered by substance abuse, or result from taking too much aspirin or NSAID (nonsteroidal anti-inflammatory drug).

Additional References:

Causes of Long-Term Pain

Long-term (chronic) abdominal pain lasts 1 week or longer. This kind of pain has many causes.

Your risk of developing conditions that cause abdominal pain increases as you age. Examples of more serious causes include:

  • A flare-up of pancreatitis, diverticulitis, colitis, or Crohn’s disease
  • Bleeding ulcer
  • Ulcerative colitis
  • Colorectal or stomach cancer

In some cases, we aren’t able to diagnose the cause of chronic abdominal pain. This doesn’t mean that your pain isn’t real.

Diagnosis

We’ll ask about your symptoms and perform a physical exam. Be prepared to describe your pain. Questions we might ask are:

  • Is the pain sharp, dull, or cramping?
  • Where do you feel it: all over your abdomen or in one area?
  • Is it mild, moderate, or severe?
  • Is it constant, or does it come and go?
  • Does it wake you up at night?
  • Does it move (down your legs or up your back, for example)?
  • Have you ever felt this type of pain before? If so, when?

We’ll also ask when your pain is worse, and what seems to make it worse, or better.

Be sure to let us know if you:

  • Are pregnant.
  • Have cancer or another chronic condition.
  • Have a recent injury.
  • Are taking any medications.

Tests

We may order tests to identify the cause of your abdominal pain, such as blood, urine, or stool tests. We might also order other tests, such as:

  •  CT scan.
  • Ultrasound.
  • X-rays.
  • Heart tests, such as electrocardiogram (ECG).

We might also place a small flexible tube, with a tiny camera on one end, either:

  • Down your throat to view your digestive system (endoscopy).
  • Through your anus to view your rectum, colon, and intestines (colonoscopy).

We may also remove and evaluate a small sample of tissue (biopsy). For example, we may biopsy your liver, stomach, or colon.

Treatment

Treatment of abdominal pain depends on the cause.

We may recommend:

  • Nonprescription medicine, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). They can make ulcers worse, so don’t take them unless we unless we recommend it.
  • Antibiotics if you have an infection.
  • Other medicines, such as for vomiting or constipation.
  • Surgery to treat a serious condition, such as appendicitis or a bowel obstruction.
  • Future, scheduled surgery to treat cancer and other conditions.
  • Intravenous (IV) fluids, if you’re in the hospital.
  • A clear liquid diet to rest your bowels. This may also help us diagnose the cause of your pain.

When you begin to eat regular food, eat a bland diet of low-fat, high-fiber foods for a few days. Eat rice, applesauce, crackers, and oatmeal. Avoid sugary foods, caffeine, and spicy foods.

If your pain continues or we’re not able to identify the cause, we may recommend additional treatment.

When to Call Us

Contact our Advice Call Center if you’re not sure when to seek treatment.

Contact us immediately or seek urgent medical care if you have sudden, sharp abdominal pain that’s worse when you move or that occurs with any of these symptoms:

  • Pain in your chest, back, shoulder, or neck.
  • Pain between your shoulder blades and nausea.
  • Difficulty breathing.
  • Fever of over 100°F for adults or 100.4°F for children.
  • Blood in your stool (it may look black or like coffee grounds).
  • Inability to have a bowel movement, especially if you’re vomiting.

Contact us or seek urgent care if you have abdominal pain and:

  • Vomit blood.
  • A stiff, rigid belly that’s sore when touched.
  • Vaginal bleeding that doesn't stop when expected.
  • Dry mouth and skin, headache, tiredness, and less urination (dehydration).

Seek urgent care if you have abdominal pain and are:

  • Having cancer treatment.
  • Pregnant.
  • Recovering from an injury.

Your Care with Me

As your hospital medicine physician, my first contact with you will be either in the Emergency Department or in your hospital room.  Together we will go over your medical history and medications you are currently taking, perform a physical examination, and come up with a treatment plan.

While you are in the hospital

I will work closely with your bedside nurse and patient care coordinator each day of your stay to improve your health and to plan for a safe return home. We will also inform your family members of your care plan. If you are having symptoms that concern you when you are in the hospital, please inform me or one of the hospital staff immediately.

If specialty care is needed during your hospital stay, I may contact one of my specialty colleagues and discuss your care with them.

If I prescribe medications

During your hospital stay, we will work together to monitor and assess how your medications are working and make adjustments over time. Before you leave, we will go over each new medication, how to take it, and when/if to stop the medication. At the time of discharge, all medications can be picked up at the discharge pharmacy. 

After you are discharged from the hospital, you will have a follow up visit with your primary care clinician. You may also receive a follow up phone call from one of the hospital staff to see how you are doing once you are at home.

If you are having symptoms that concern you and you are not currently in the hospital:

  • You may contact your personal physician, who will evaluate your health and symptoms.
  • If you have urgent concerns or issues or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice and make an appointment with your doctor if needed.  
  • If you are experiencing an emergency, call 911 or go to the nearest Emergency Room.

Coordinating Your Care

Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.

Another major benefit is our comprehensive electronic medical record system that allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate. When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.

This applies especially to your primary care physician, who will be notified electronically when you are hospitalized, and may review the care you are receiving while in the hospital. Upon discharge, your doctor will receive a summary of your care in the hospital, including some tests or imaging results that may still be pending.

Care After Hospital Discharge

If you require further testing and medications, or are having symptoms after leaving the hospital, we recommend that you contact your primary care physician.
You can also call the Appointment and Advice line. Our call centers are open every day of the year around the clock. If you need advice, we will transfer you to one of our skilled advice nurses (RNs). They can help you determine when you need to be seen and in what location. The advice nurse can often start your treatment by telephone depending on the situation and has access to your electronic medical record.

If refills are needed in the future after you leave the hospital, you can:

  • Contact your primary care physician.
  • Order them online or by phone.
  • Order future refills from my home page or your primary care physician’s home page.
  • Order by phone using the pharmacy refill number on your prescription label.
  • Have them delivered to you by mail at no extra cost.
  • Or pick up your medications at the pharmacy. If no refills remain when you place your order, the pharmacy will contact your primary care physician regarding your prescription.
If further lab testing or imaging is needed 

For lab tests that are needed after discharge, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures we will schedule an appointment with the radiology department. Your primary care physician will follow up on these results unless your condition needs immediate attention. In addition, you can view most of your laboratory results online, along with any comments that your primary care physician may have attached to explain them.

If I refer you to another specialty colleague

If we decide together that your condition would also benefit from the care of other types of specialists, I will make an electronic referral to the appropriate department and they will contact you for an appointment.

If Surgery or a Procedure is a Treatment Option

Occasionally, a procedure and/or surgery can be postponed until you are healthier and have recovered from your hospitalization. Then I will refer you to the appropriate service and they will follow up with you once you are discharged from the hospital.

If you are considering a procedure or surgery, please take a moment to go to the “Tools & Classes” tab above and select the “Prepare for Your Procedure - Emmi” link. There you can watch videos about different procedures.

Convenient Resources for You

As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.

My Doctor Online is available at any time that is most convenient for you. From my home page you can:

Manage your care securely
  • View and compose secure e-mail messages to your primary care physician and specialist.
  • Manage your prescriptions.
  • View your past visits and test results. View your preventive services to see whether you are due for a routine screening or updated immunization.
  • Manage your family’s health by setting up access to act on their behalf. Learn how to coordinate care for the ones you love.
Learn more about your condition
  • Read about causes, symptoms, treatments, and procedures of common conditions we take care of in the hospital.
  • Find interactive health tools, videos, and podcasts to help you manage your condition.
  • View programs to help you decide on or prepare for a surgery or procedure.
Stay healthy
  • Locate Health Education classes and support groups offered at every medical center.
  • Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
  • View your Preventive Services to see whether you are due for a routine screening or updated immunization.

Related Health Tools:

Prepare for Your Procedure

See more Health Tools »

If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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