Abdominal Pain Types, Causes, Locations, Diagnosis, Prevention, FAQs

Abdominal Pain

The abdomen is an anatomical area that is bounded by the lower margin of the ribs and diaphragm above, the pelvic bone (pubic ramus) below, and the flanks on each side. Although abdominal pain can arise from the tissues of the abdominal wall that surround the abdominal cavity (such as the skin and abdominal wall muscles), the term abdominal pain generally is used to describe pain originating from organs within the abdominal cavity.

The abdominal area includes organs such as the stomach, small intestine, colon, liver, gallbladder, spleen, and pancreas. Abdominal pain can range in intensity from a mild stomach ache to severe acute pain. The pain is often nonspecific and can be caused by a variety of conditions.

  Abdominal Pain Types

The type and location of pain may help the doctor find the cause. The intensity and duration of pain must also be considered when making a diagnosis. A few general characteristics of abdominal pain are:

  • What the pain feels like: Abdominal pain can be sharp, dull, stabbing, cramp-like, knifelike, twisting, or piercing. Many other types of pain are also possible.
  • How long the pain lasts: Abdominal pain can be brief, lasting for a few minutes, or it may persist for several hours and longer. Sometimes the abdominal pain comes on strongly for a while and then lessons in intensity for a while. Is the pain continuous or does it come and go?
  • Events that trigger pain: The pain may be worsened or relieved by certain events, such as worse after meals, better with a bowel movement, better after vomiting, or worse when lying down. Do certain foods trigger the pain?
  • Location of the pain – The location often will help your doctor diagnose the cause of the pain.

    • Upper left abdominal pain: Enlarged spleen
    • Upper right abdominal pain: Gallbladder disease, hepatitis
    • Lower left abdominal pain: Diverticulitis, ovarian cysts, ovarian torsion
    • Lower right abdominal pain: Appendicitis, right ovary problems
    • Upper abdominal pain: Stomach ulcers, gastritis, pancreatitis
    • Lower abdominal pain: Urinary tract infections, gynecologic problems like uterine fibroids and cancer

Abdominal Pain Causes

Many acute (short-duration) and chronic (long-duration) diseases cause abdominal pain.

The diseases that most people are concerned about having are:

  • Gastritis,
  • Appendicitis,
  • Kidney stones,
  • Gallbladder pain disease,
  • Duodenal and gastric ulcers,
  • Infections, and
  • Pregnancy-associated problems since these are the most common.

Doctors also are concerned about the other causes

  • Ruptured blood vessels,
  • Heart attacks,
  • Liver and pancreas inflammation,
  • Kidney stones,
  • Problems with the blood circulation to the intestine,
  • Diverticulitis,
  • Cancers, and
  • Other diseases.

Abdominal pain may not arise from the abdomen.

  • Some heart attacks and pneumonia can cause abdominal pain and even nausea.
  • Diseases of the pelvis or groin can also cause abdominal pain in adults.
  • Testicular problems often can cause lower abdominal pain.
  • Certain skin rashes, such as shingles, can feel like abdominal pain, even though the person has nothing wrong inside their body.
  • Even some poisonings and bites, such as a black widow spider bite, can cause severe abdominal pain.

 Ulcers

An ulcer is a sore in the lining of the stomach or intestine. Causes of ulcers include:

  • Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
  • A Helicobacter pylori infection
  • Noncancerous stomach growths

People with ulcers typically experience a sharp, burning sensation in the stomach. The burning may travel up the chest and into the mouth or throat, causing heartburn or indigestion.

Symptoms are usually worse after a large or very acidic meal. The pain may come and go. A person may notice no symptoms for several months, then find that symptoms get steadily worse.

Antacids may help. A range of brands are available over the counter or online. A doctor can also prescribe medication to treat the pain.

 Menstrual cramps

Menstrual cramps can feel sharp or dull. They may affect just one area of the abdomen or spread to the back and legs. Some people also experience diarrhea or nausea.

Menstrual cramps may occur during or right before a period. They typically come in waves, getting better and worse again throughout the day.

A heating pad, OTC pain relievers, and gentle stretching can help relieve menstrual pain. Heating pads for pain relief are available for purchase online.

Menstrual cramps are not dangerous, but severe cramps can make daily life difficult. A person should see a doctor if menstrual cramps are severe, have gotten worse, or interfere with work or school.

 Ovarian cysts

Cysts in the ovaries are common and usually harmless. Most people do not even realize that they have them. Many ovarian cysts form after ovulation, then disappear a few months later.

Sometimes, ovarian cysts can cause intermittent pain. The pain from an ovarian cyst is often low in the abdomen and on just one side. It may be worse during specific times of the menstrual cycle.

If a person suspects that they have a painful ovarian cyst, they may wish to speak to a doctor. The doctor can diagnose a cyst using imaging tests.

OTC pain medication and applying warm compresses can help relieve the pain.

Sudden, intense pain in the lower pelvis may be a sign of ovarian torsion, which is when the ovary twists. This is sometimes a complication of a cyst.

Ovarian torsion is a medical emergency. Without treatment, it can cause severe internal bleeding, damage to the ovary, or an infection.

 Ovulation

During ovulation, an egg ruptures from its follicle in the ovary and enters the fallopian tube. Some people experience ovulation pain, or mittelschmerz, which a brief pain around ovulation.

Pain that occurs monthly toward the middle of the menstrual cycle may be ovulation pain. Ovulation pain is not dangerous and can even be a helpful fertility cue if the person is trying to conceive.

 Labor or Braxton-Hicks contractions

In pregnant women, sharp abdominal pain may indicate labor or Braxton-Hicks contractions.

Braxton-Hicks contractions are common and are sometimes called “false labor,’ as they may feel like real contractions.

They are often irregular or appear only at certain times, such as if a woman is dehydrated.

By contrast, labor contractions get progressively more intense. Signs that a woman is in labor include:

  • A discernible pattern to the contractions
  • Contractions that get closer together
  • Bleeding or discharge from the vagina
  • Pain that begins at the top of the uterus

Call a doctor or midwife at any signs of labor, especially if the pregnancy has not reached full term.

Abdominal Pain Locations

The location of the pain within the abdomen may be a clue as to its cause.

Pain that is generalized throughout the abdomen (not in one specific area) may indicate:

  • Appendicitis (inflammation of the appendix)
  • Crohn’s disease
  • Traumatic injury
  • Irritable bowel syndrome
  • Urinary tract infection
  • The flu

Pain that is focused in the lower abdomen may indicate:

  • Appendicitis
  • Intestinal obstruction
  • Ectopic pregnancy (a pregnancy that occurs outside the womb)

In women, pain in the reproductive organs of the lower abdomen can be caused by:

  • Severe menstrual pain (called dysmenorrhea)
  • Ovarian cysts
  • Miscarriage
  • Fibroids
  • Endometriosis
  • Pelvic inflammatory disease
  • Ectopic pregnancy

Upper abdominal pain may be caused by:

  • Gallstones
  • Heart attack
  • Hepatitis (liver inflammation)
  • Pneumonia

Pain in the center of the abdomen might be from:

  • Appendicitis
  • Gastroenteritis
  • Injury
  • Uremia (buildup of waste products in your blood)

Lower left abdominal pain may be caused by:

  • Crohn’s disease
  • Cancer
  • Kidney infection
  • Ovarian cysts
  • Appendicitis

Upper left abdominal pain is sometimes caused by:

  • Enlarged spleen
  • Fecal impaction (hardened stool that can’t be eliminated)
  • Injury
  • Kidney infection
  • Heart attack
  • Cancer

Causes of lower right abdominal pain include:

  • Appendicitis
  • Hernia (when an organ protrudes through a weak spot in the abdominal muscles)
  • Kidney infection
  • Cancer
  • Flu

Upper right abdominal pain may be from:

  • Hepatitis
  • Injury
  • Pneumonia
  • Appendicitis

When to see the doctor

Mild abdominal pain may go away without treatment. However, in some cases, abdominal pain may warrant a trip to the doctor.

Call 911 if your abdominal pain is severe and associated with trauma (from an accident or injury) or pressure or pain in your chest.

You should seek immediate medical care if the pain is so severe that you can’t sit still or need to curl into a ball to get comfortable, or if you have any of the following:

  • Bloody stools
  • High fever (greater than 101°F)
  • Vomiting up blood (called hematemesis)
  • Persistent nausea or vomiting
  • Yellowing of the skin or eyes
  • Swelling or severe tenderness of the abdomen
  • Difficulty breathing

Make an appointment with your doctor if you experience any of the following symptoms:

  • Abdominal pain that lasts longer than 24 hours
  • Prolonged constipation
  • Vomiting
  • A burning sensation when you urinate
  • Fever
  • Loss of appetite
  • Unexplained weight loss

Call your doctor if you’re pregnant or breastfeeding and you experience abdominal pain.

Abdominal Pain Diagnosis

The cause of abdominal pain can be diagnosed through a series of tests. Before ordering the tests, your doctor will do a physical examination. This includes gently pressing down on various areas of your abdomen to check for tenderness and swelling.

This information, combined with the severity of the pain and its location within the abdomen, will help your doctor determine which tests to order.

Imaging tests, such as MRI scans, ultrasounds, and X-rays, are used to view organs, tissues, and other structures in the abdomen in detail. These tests can help diagnose tumors, fractures, ruptures, and inflammation.

Other tests include:

  • Colonoscopy (to look inside the colon and intestines)
  • Endoscopy (to detect inflammation and abnormalities in the esophagus and stomach)
  • Upper GI (a special X-ray test that uses contrast dye to check for the presence of growths, ulcers, inflammation, blockages, and other abnormalities in the stomach)

Blood, urine, and stool samples may also be collected to look for evidence of bacterial, viral, and parasitic infections.

Abdominal Pain Prevention

Not all forms of abdominal pain are preventable. However, you can minimize the risk of developing abdominal pain by doing the following:

  • Eat a healthy diet.
  • Drink water frequently.
  • Exercise regularly.
  • Eat smaller meals.

If you have an intestinal disorder, such as Crohn’s disease, follow the diet your doctor has given you to minimize discomfort. If you have GERD, don’t eat within two hours of bedtime.

Lying down too soon after eating may cause heartburn and abdominal pain. Try waiting at least two hours after eating before lying down.

Frequently Asked Questions about Abdominal Pain

Which doctor should I visit in case of abdominal pain?

You could visit your family doctor or a surgeon for abdominal pain. You may be referred to a specialist depending on the cause of pain.

What are the common tests used to evaluate abdominal pain?

A careful history often helps in diagnosing the cause of abdominal pain. Some tests that assist in the diagnosis are:

  • Complete blood counts, liver and pancreatic enzyme estimation and urinalysis. A pregnancy test may be done in women to rule out an ectopic pregnancy.
  • Radiological tests like plain x-ray, ultrasound, CT scan, MRI and barium x-ray.
  • Endoscopic procedures like esophagogastroduodenoscopy, colonoscopy, flexible sigmoidoscopy and balloon enteroscopy

How is colic in infants treated?

The exact cause of colics in infants is not known. It usually disappears as the infant gets older. Holding the baby and gently rocking her could help to pacify the baby. A gentle massage over the abdomen may also help.

Where is abdominal pain located?

Abdominal (belly) pain is pain or discomfort that is felt in the part of the trunk below the ribs and above the pelvis. It comes from organs within the abdomen or organs adjacent to the belly.

What does abdomen pain feel like?

Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly. Since the abdominal area contains many different organs it is divided into smaller areas.

How do I know if it’s gas or appendicitis?

Pain from gas can feel like knots in your stomach. You may even have the sensation that gas is moving through your intestines. Unlike appendicitis, which tends to cause pain localized on the lower right side of the abdomen, gas pain can be felt anywhere in your abdomen. You may even feel the pain up in your chest.

 

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