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Abdominal pain

DEFINITION

Everyone experiences abdominal pain from time to time. Other terms used to describe abdominal pain are stomachache, tummy ache, gut ache and bellyache. Abdominal pain can be mild or severe. It may be continuous or come and go. Abdominal pain can be short-lived (acute) or occur over weeks and months (chronic).

Call your doctor right away if you have abdominal pain so severe that you can’t move without causing more pain, or you can’t sit still or find a comfortable position. Also, seek immediate medical help if pain is accompanied by other worrisome signs and symptoms, such as fever, bloody diarrhea or severe tenderness in your abdomen.

CAUSES

Abdominal pain has many potential causes. Many causes, such as gas pains or a pulled muscle, aren’t serious, while other conditions require timely medical attention.

Often, the location of the abdominal pain can provide an important clue as to its cause. At other times, abdominal pain may occur in unexpected patterns, and its cause is less obvious. Nonetheless, it is helpful to think about abdominal pain in terms of its location.

The following conditions may cause generalized abdominal pain, which is abdominal pain that isn’t focused in one specific area:

  1. Appendicitis

  2. Crohn’s disease

  3. Diabetic ketoacidosis (high levels of ketones in the blood)

  4. Diverticulitis

  5. Injury

  6. Intestinal obstruction

  7. Intussusception (in children)

  8. Irritable bowel syndrome

  9. Lead poisoning

  10. Mesenteric lymphadenitis (swollen lymph nodes in the folds of membrane that hold the abdominal organs in place)

  11. Pancreatitis (pancreas inflammation)

  12. Pelvic inflammatory disease (PID) (infection of the female reproductive organs)

  13. Peritonitis (infection of the abdominal lining)

  14. Sickle cell anemia

  15. Strained or pulled abdominal muscle

  16. Thoracic aortic aneurysm

  17. Ulcerative colitis

  18. Uremia (buildup of waste products in your blood)

  19. Urinary tract infection

Viral gastroenteritis (stomach inflammation)

The following conditions often cause lower abdominal pain, sometimes described as pelvic pain:

  1. Appendicitis

  2. Cystitis (bladder inflammation)

  3. Diverticulitis

  4. Problems with the cervix, such as a cervical infection, inflamed cervix or growths on the cervix

  5. Endometriosis

  6. Intestinal obstruction

  7. Mittelschmerz (pain associated with ovulation)

  8. Ovarian cysts

  9. Pelvic inflammatory disease (PID) (infection of the female reproductive organs)

  10. Salpingitis (inflammation of the fallopian tubes)

The following conditions often cause upper abdominal pain:

  1. Angina (reduced blood flow to the heart)

  2. Appendicitis

  3. Cholangitis (bile duct inflammation)

  4. Cholecystitis (gallbladder inflammation)

  5. Duodenitis (inflammation of the initial portion of the small intestine)

  6. Hepatitis

  7. GERD (gastroesophageal reflux disease)

  8. Heart attack

  9. Hepatitis (liver inflammation)

  10. Intestinal obstruction

  11. Mesenteric ischemia (decreased blood flow to the intestines)

  12. Non-Hodgkin’s lymphoma

  13. Nonulcer stomach pain

  14. Pancreatitis (pancreas inflammation)

  15. Peptic ulcer

  16. Pericarditis (inflammation of the tissue around the heart)

  17. Pleurisy (inflammation of the membrane surrounding the lungs)

  18. Pneumonia

  19. Pneumothorax (lung collapse caused by air that leaks inside chest wall)

  20. Pyloric stenosis (in infants)

  21. Thoracic aortic aneurysm

The following conditions often cause pain in the center of the abdomen:

  1. Appendicitis

  2. Diabetic ketoacidosis (high levels of ketones in the blood)

  3. Injury

  4. Intestinal obstruction

  5. Mesenteric thrombosis (blood clot in a vein carrying blood away from your intestines)

  6. Pancreatitis (pancreas inflammation)

  7. Thoracic aortic aneurysm

  8. Uremia (buildup of waste products in your blood)

The following conditions often cause lower left abdominal pain:

  1. Appendicitis

  2. Cancer

  3. Crohn’s disease

  4. Diverticulitis

  5. Problems with the cervix, such as a cervical infection, inflamed cervix or growths on the cervix

  6. Endometriosis

  7. Inguinal hernia

  8. Injury

  9. Intestinal obstruction

  10. Kidney infection

  11. Kidney stones

  12. Mittelschmerz (pain associated with ovulation)

  13. Ovarian cysts

  14. Seminal vesiculitis (inflammation of the seminal vesicles)

  15. Thoracic aortic aneurysm

  16. Torn colon

  17. Tuboovarian abscess (pus-filled pocket involving a fallopian tube and an ovary)

  18. Ulcerative colitis

The following conditions often cause upper left abdominal pain:

  1. Angina (reduced blood flow to the heart)

  2. Cancer

  3. Diverticulitis

  4. Empyema (infection of the lining around the lungs)

  5. Enlarged spleen (splenomegaly)

  6. Fecal impaction (hardened stool that can’t be eliminated)

  7. Gastritis (inflammation of the stomach lining)

  8. Heart attack

  9. Hiatal hernia

  10. Injury

  11. Kidney infection

  12. Kidney stones

  13. Pancreatitis (pancreas inflammation)

  14. Pneumonia

  15. Pulmonary infarction (loss of blood flow to the lungs)

  16. Pyloric stenosis (in infants)

  17. Ruptured spleen

  18. Shingles

  19. Spleen infection

  20. Splenic abscess (pus-filled pocket in the spleen)

  21. Thoracic aortic aneurysm

  22. Torn colon

The following conditions often cause lower right abdominal pain:

  1. Appendicitis

  2. Cancer

  3. Cholecystitis (gallbladder inflammation)

  4. Diverticulitis

  5. Problems with the cervix, such as a cervical infection, inflamed cervix or growths on the cervix

  6. Endometriosis

  7. Inguinal hernia

  8. Injury

  9. Intestinal obstruction

  10. Kidney infection

  11. Kidney stones

  12. Mittelschmerz (pain associated with ovulation)

  13. Ovarian cysts

  14. Salpingitis (inflammation of the fallopian tubes)

  15. Seminal vesiculitis (inflammation of the seminal vesicles)

  16. Thoracic aortic aneurysm

  17. Tuboovarian abscess (pus-filled pocket involving a fallopian tube and an ovary)

  18. Viral gastroenteritis (stomach inflammation)

The following conditions often cause upper right abdominal pain:

  1. Appendicitis

  2. Cholangitis (bile duct inflammation)

  3. Diverticulitis

  4. Fecal impaction (hardened stool that can’t be eliminated)

  5. Gallbladder cancer

  6. Hepatitis

  7. Gastritis (inflammation of the stomach lining)

  8. Hepatitis (liver inflammation)

  9. Hiatal hernia

  10. Injury

  11. Intestinal obstruction

  12. Kidney cancer

  13. Kidney infection

  14. Kidney stones

  15. Liver abscess (pus-filled pocket in the liver)

  16. Liver cancer

  17. Liver hemangioma

  18. Pancreatic cancer

  19. Pancreatitis (pancreas inflammation)

  20. Peptic ulcer

  21. Pericarditis (inflammation of the tissue around the heart)

  22. Pleurisy (inflammation of the membrane surrounding your lungs)

  23. Pneumonia

  24. Pulmonary infarction (loss of blood flow to the lungs)

  25. Pyloric stenosis (in infants)

  26. Shingles

  27. Stomach cancer

WHEN TO SEE A DOCTOR

Call 911 or emergency medical assistance
Seek help if your abdominal pain is severe and is associated with:

  • Trauma, such as an accident or injury

  • Pressure or pain in your chest

Seek immediate medical attention
Have someone drive you to urgent care or the emergency room if:

  • Pain is so severe that you can’t sit still or need to curl into a ball to find relief

  • Pain is accompanied by bloody stools, persistent nausea and vomiting, skin that appears yellow, severe tenderness when you touch your abdomen, or swelling of the abdomen

Schedule a doctor’s visit
Make an appointment with your doctor if your abdominal pain worries you or lasts more than a few days.

In the meantime, find ways to ease your pain. For instance, eat smaller meals if your pain is accompanied by indigestion. Avoid taking over-the-counter pain relievers such as aspirin or ibuprofen (Advil, Motrin IB, others) because these can cause stomach irritation that may worsen abdominal pain.