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Abdominal Pain (Causes, Remedies, Treatment)

 

   Abdominal pain definition and facts

   What is abdominal pain?

   What causes abdominal pain?

   Signs, symptoms, locations, types, and severity of abdominal pain

   How is the cause of abdominal pain diagnosed?

   What exams and tests help diagnose the cause of abdominal pain?

   How does IBS (irritable bowel syndrome) cause abdominal pain?

   Foods, natural remedies, and OTC treatments for certain causes of abdominal pain

   Why can diagnosis of the cause of abdominal pain be difficult?

   What medications can be used to treat certain causes of abdominal pain?

   What lifestyle choices can I make to prevent abdominal pain?

   When should I call my doctor about abdominal pain?

 

A woman on her bed experiencing abdominal pain.

Abdominal pain definition and facts

 

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   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.

   It is caused by inflammation, distention of an organ, or by loss of the blood supply to an organ.

   In irritable bowel syndrome (IBS) it may be caused by contraction of the intestinal muscles or hyper-sensitivity to normal intestinal activities.

   Symptoms associated with it may include:

       Bloating

       Belching

       Gas (flatus, farting)

       Indigestion

       Discomfort in the upper left or right; middle; or lower left or right abdomen

       Constipation

       Diarrhea

       GERD (gastro-esophageal reflux disease)

       Heartburn

       Chest discomfort

       Pelvic discomfort

   The cause of abdominal pain is diagnosed on the basis of its characteristics, the physical examination, and testing. Occasionally, surgery is necessary for diagnosis.

   The medical diagnosis of the cause is challenging because the characteristics may be atypical, tests are not always abnormal, diseases causing pain may mimic each other, and the characteristics of the pain may change over time.

   Medical treatment depends upon the patient’s history of disease or other health conditions that may be the cause.

 

What is abdominal pain?

 

Abdominal pain is felt in the abdomen. 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 pain can arise from the tissues of the abdominal wall that surround the abdominal cavity (such as the skin and muscles), the term abdominal pain generally is used to describe discomfort originating from organs within the abdominal cavity. Organs of the abdomen include the stomach, small intestine, colon, liver, gallbladder, spleen, and pancreas.

 

Technically, the lowermost portion of the area described previously, is the pelvis, which contains the urinary bladder and rectum, as well as the prostate gland in men, and the uterus, Fallopian tubes, and ovaries in women. Often, it can be difficult to know if lower abdominal pain is coming from the lower abdomen or pelvis (pelvic pain).

 

Occasionally, pain may be felt in the belly even though it is arising from organs that are close to, but not within, the abdominal cavity, for example, conditions of the lower lungs, the kidneys, and the uterus or ovaries. On the other hand, it also is possible for pain from organs within the belly to be felt outside of the it. For example, the pain of pancreatic inflammation may be felt in the back. These latter types of pain are described as "referred” because it does not originate in the location that it is felt. Rather, the cause is located away from where it is felt (i.e., it is referred to a different area).

 

Picture of the organs and glands in the abdomen.

 

Picture of the organs and glands in the abdomen

 

What causes abdominal pain?

 

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Abdominal pain is caused by inflammation of an organ (for example, appendicitis, diverticulitis, colitis), by stretching or distention of an organ (for example, obstruction of the intestine, blockage of a bile duct by gallstones, swelling of the liver with hepatitis), or by loss of the supply of blood to an organ (for example, ischemic colitis).

 

To complicate matters, however, abdominal pain also can occur without inflammation, distention or loss of blood supply. An important example of the latter is the irritable bowel syndrome (IBS). It is not clear what causes the belly pain in IBS, but it is believed to be due either to abnormal contractions of the intestinal muscles (for example, spasm) or abnormally sensitive nerves within the intestines that give rise to painful sensations inappropriately (visceral hyper-sensitivity). This often is referred to as functional pain because no recognizable specific abnormality to account for the cause of the pain has been found - at least not yet.

Quick GuideWhat's Causing Your Abdominal Pain?

What's Causing Your Abdominal Pain?

Abdominal Pain Causes

 

Abdominal pain is a common symptom, and most people have experienced some sort of abdominal pain (belly or stomach pain). Causes of more serious causes of abdominal pain include:

 

   Bloody stools

   Black tarry stools

   Dehydration

   Painful urination

   Lack of urination

   Abrupt cessation of bowel movements

   Dehydration

 

Learn more about abdominal pain causes »

A collage highlighting the locations of abdominal pain on a female model at various angles.

Signs, symptoms, locations, types, and severity of abdominal pain

 

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Doctors will ask you a variety of questions about your belly pain in order to help find the possible causes of it, for example:

How did the pain begin?

 

   If it comes on suddenly, this may suggest a problem with an organ within the belly; for example, the interruption of the supply of blood to the colon (ischemia) or obstruction of the bile duct by a gallstone (biliary colic).

 

Where is the pain located?

 

   Appendicitis typically causes discomfort in the middle of the abdomen, and then moves to the right lower abdomen, the usual location of the appendix.

   Diverticulitis typically causes discomfort in the left lower abdomen where most colonic diverticuli are located.

   Discomfort from the gallbladder (biliary colic or cholecystitis) typically is felt in the middle, upper abdomen or the right upper abdomen near where the gallbladder is located.

 

What is the type and pattern of the pain?

 

   Is it severe, crampy, steady; or does it wax and wane? Obstruction of the intestine initially causes waves of crampy pain due to contractions of the intestinal muscles and distention of the intestine. True cramp-like pain suggests vigorous contractions of the intestines.

   Obstruction of the bile ducts by gallstones typically causes steady (constant) upper belly pain that lasts between 30 minutes and several hours.

   Acute pancreatitis typically causes severe, unrelenting, steady pain in the upper abdomen and upper back.

   The pain of acute appendicitis initially may start near the umbilicus, but as the inflammation progresses, it moves to the right lower abdomen.

   The character of pain may change over time. For example, obstruction of the bile ducts sometimes progresses to inflammation of the gallbladder with or without infection (acute cholecystitis). When this happens, the characteristics change to those of inflammatory pain.

 

How long does the pain last?

 

   The discomfort of IBS typically waxes and wanes over months or years and may last for years or decades.

   Biliary colic lasts no more than several hours.

   The pain of pancreatitis lasts one or more days.

   The pain of acid-related diseases - gastroesophageal reflux disease (GERD) or duodenal ulcers - typically occurs over a period of weeks or months that is worse followed by periods of weeks or months during which it is better (periodically).

   Functional pain may show this same pattern of periodicity.

 

What makes the pain worse?

 

   Pain due to inflammation (appendicitis, diverticulitis, cholecystitis, and pancreatitis) typically is aggravated by sneezing, coughing or any jarring motion. Individuals with inflammation prefer to lie still.

   What health conditions make abdominal pain worse or better?

 

What relieves the pain?

 

   The pain of IBS and constipation often is relieved temporarily by bowel movements and may be associated with changes in bowel habit.

   Pain due to obstruction of the stomach or upper small intestine may be relieved temporarily by vomiting which reduces the distention that is caused by the obstruction.

   Eating or taking antacids may temporarily relieve ulcer pain from the stomach or duodenum because both food and antacids neutralize the acid that is responsible for irritating the ulcers and causing the pain.

   Pain that awakens a patient from sleep is more likely to be due to non-functional causes and is more significant.

   Other associated symptoms that accompany abdominal pain may suggest:

   Fever suggests inflammation or infection.

   Diarrhea or rectal bleeding suggests an intestinal cause.

   Fever and diarrhea suggest inflammation of the intestines that may be infectious or non-infectious.

   How is the cause of abdominal pain diagnosed?

   Doctors determine the cause of the pain by relying on:

   Its characteristics, physical signs, and other accompanying symptoms

   Findings on physical examination

   Medical laboratory, radiological, and endoscopic testing

   Surgery

 

How is the cause of abdominal pain diagnosed?

 

   Read Doctor's View

   Readers Comments 11

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Doctors determine the cause of the pain by relying on:

 

   Characteristics, physical signs, and other accompanying symptoms

   Findings on physical examination

   Laboratory, radiological, and endoscopic testing

   Surgery

 

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A doctor examines a small boy that is experiencing stomach and abdominal pain.

What exams and tests help diagnose the cause of abdominal pain?

Physical examination

 

Examining the patient will provide the doctor with additional clues to the cause of the pain. The doctor will determine:

 

   The presence of sounds coming from the intestines that occur when there is obstruction of the intestines,

   The presence of signs of inflammation (by special maneuvers during the examination),

   The location of any tenderness

   The presence of a mass within the abdomen that suggests a tumor, enlarged organ, or abscess (a collection of infected pus)

   The presence of blood in the stool that may signify an intestinal problem such as an ulcer, colon cancer, colitis, or ischemia.

 

For example:

 

   Finding tenderness and signs of inflammation in the left lower abdomen often means that diverticulitis is present, while finding a tender (inflamed) mass in the same area may mean that the inflammation has progressed and that an abscess has formed.

   Finding tenderness and signs of inflammation in the right lower abdomen often means that appendicitis is present, while finding a tender mass in the same area may mean that the inflammation has progressed and that an abscess has formed.

   Inflammation in the right lower abdomen, with or without a mass, also may be found in Crohn's disease. (Crohn's disease most commonly affects the last part of the small intestine, usually located in the right lower abdomen.)

   A mass without signs of inflammation may mean that a cancer is present.

 

While the health history and physical examination are vitally important in determining the cause of abdominal pain, other medical tests often are necessary to determine the cause.

Laboratory tests

 

Laboratory tests such as the complete blood count (CBC), liver enzymes, pancreatic enzymes (amylase and lipase), pregnancy test and urinalysis are frequently ordered.

 

   An elevated white count suggests inflammation or infection (as with appendicitis, pancreatitis, diverticulitis, or colitis).

   A low red blood cell count may indicate a bleed in the intestines.

   Amylase and lipase (enzymes produced by the pancreas) commonly are elevated in pancreatitis.

   Liver enzymes may be elevated with gallstone attacks or acute hepatitis.

   Blood in the urine suggests kidney stones.

   When there is diarrhea, white blood cells in the stool suggest intestinal inflammation or infection.

   A positive pregnancy test may indicate an ectopic pregnancy (a pregnancy in the fallopian tube instead of the uterus).

 

Plain X-rays of the abdomen

 

Plain X-rays of the abdomen also are referred to as a KUB (because they include the kidney, ureter, and bladder). The KUB may show enlarged loops of intestines filled with copious amounts of fluid and air when there is intestinal obstruction. Patients with a perforated ulcer may have air escape from the stomach into the abdominal cavity. The escaped air often can be seen on a KUB on the underside of the diaphragm. Sometimes a KUB may reveal a calcified kidney stone that has passed into the ureter and resulted in referred abdominal pain or calcifications in the pancreas that suggest chronic pancreatitis.

Radiographic studies

 

   Ultrasound is useful in diagnosing gallstones, cholecystitis appendicitis, or ruptured ovarian cysts as the cause of the pain.

   Computerized tomography (CT) of the abdomen is useful in diagnosing pancreatitis, pancreatic cancer, appendicitis, and diverticulitis, as well as in diagnosing abscesses in the abdomen. Special CT scans of the abdominal blood vessels can detect diseases of the arteries that block the flow of blood to the abdominal organs.

   Magnetic resonance imaging (MRI) is useful in diagnosing many of the same conditions as CT tomography.

   Barium X-rays of the stomach and the intestines (upper gastrointestinal series or UGI with a small bowel follow-through) can be helpful in diagnosing ulcers, inflammation, and blockage in the intestines.

   Computerized tomography (CT) of the small intestine can be helpful in diagnosing diseases in the small bowel such as Crohn's disease.

   Capsule enteroscopy, uses a small camera the size of a pill swallowed by the patient, which can take pictures of the entire small bowel and transmit the pictures onto a portable receiver. The small bowel images can be downloaded from the receiver onto a computer to be inspected by a doctor later. Capsule enteroscopy can be helpful in diagnosing Crohn's disease, small bowel tumors, and bleeding lesions not seen on x-rays or CT scans.

 

Endoscopic procedures

 

   Esophagogastroduodenoscopy or EGD is useful for detecting ulcers, gastritis (inflammation of the stomach), or stomach cancer.

   Colonoscopy or flexible sigmoidoscopy is useful for diagnosing infectious colitis, ulcerative colitis, or colon cancer.

   Endoscopic ultrasound (EUS) is useful for diagnosing pancreatic cancer or gallstones if the standard ultrasound or CT or MRI scans fail to detect them.

   Balloon enteroscopy, the newest technique allows endoscopes to be passed through the mouth or anus and into the small intestine where small intestinal causes of pain or bleeding can be diagnosed, biopsied, and treated.

 

Surgery. Sometimes, diagnosis requires examination of the abdominal cavity either by laparoscopy or surgery.

Abdominal Pain: Causes, Symptoms and Diagnosis

 

Abdominal Pain Slideshow Pictures

Pelvic Pain:What's Causing Your Pelvic Pain?

 

Pelvic Pain Pictures Slideshow

Appendicitis Symptoms & Appendectomy Surgery

 

Appendicitis & Appendectomy Slideshow Pictures

An illustration of a constipated colon which is associated with irritable bowel syndrome (IBS).

How does IBS (irritable bowel syndrome) cause abdominal pain?

 

As previously mentioned, the discomfort of irritable bowel syndrome is due either to abnormal intestinal muscle contractions or visceral hypersensitivity. Generally, abnormal muscle contractions and visceral hypersensitivity are much more difficult to diagnose than other diseases or other health conditions, particularly since there are no typical abnormalities on physical examination or the usual diagnostic tests. The diagnosis is based on the history (typical symptoms) and the absence of other cause.

Foods, natural remedies, and OTC treatments for certain causes of abdominal pain

 

If you aren’t sure if you need to seek medical advice for belly pain, contact your doctor or other health care professional before using any home remedies.

 

Common home remedies and over-the-counter (OTC) medicines include:

 

   Eat less food

   Take small amounts of baking soda

   Use lemon and/or lime juice

   Start a BRAT diet (banana, rice, applesauce and toast) for a day or so for symptom relief.

   Don’t smoke or drink alcohol.

 

Some health care professionals recommend:

 

   Taking ginger

   Peppermint

   Licorice

   Chamomile tea

   Medications such as bismuth subsalicylate (Pepto-Bismol), loperamide (Imodium), ranitidine (Zantac) and other over-the-counter substances

 

Some of these may help reduce symptoms, but if symptoms persist, seek medical care. Beware of "cures" advertised as a single treatment that can cure all causes of this problem because no such remedy or cure exists.

 

Taking aspirin or NSAIDs should be avoided until the cause of the pain is diagnosed because the medications could make some causes worse (for example, peptic ulcers, intestinal bleeding).

Why can diagnosis of the cause of abdominal pain be difficult?

 

Modern advances in technology have greatly improved the accuracy, speed, and ease of establishing the cause of belly pain, but significant challenges remain. There are many reasons why diagnosing the cause of it can be difficult.

Symptoms may be atypical

 

   For example, the pain of appendicitis sometimes is located in the right upper abdomen, and of diverticulitis on the right side. Elderly patients and those taking corticosteroids may have little or no pain and tenderness when there is inflammation, for example, with cholecystitis or diverticulitis. This occurs because corticosteroids reduce the inflammation.

 

Tests are not always abnormal.

 

   Ultrasound examinations can miss gallstones, particularly small ones.

   CT scans may fail to show pancreatic cancer, particularly small ones.

   The KUB can miss the signs of intestinal obstruction or stomach perforation.

   Ultrasounds and CT scans may fail to demonstrate appendicitis or even abscesses, particularly if the abscesses are small.

   The CBC and other blood tests may be normal despite severe infection or inflammation, particularly in individuals receiving corticosteroids or other drugs that suppress the immune system.

 

Diseases can mimic one another.

 

   IBS symptoms can mimic bowel obstruction, cancer, ulcer, gallbladder attacks, or even appendicitis.

   Crohn's disease can mimic appendicitis.

   Infection of the right kidney can mimic acute cholecystitis.

   A ruptured right ovarian cyst can mimic appendicitis; while a ruptured left ovarian cyst can mimic diverticulitis.

   Kidney stones can mimic appendicitis or diverticulitis.

 

The characteristics of the pain may change.

 

   Examples discussed previously include the extension of the inflammation of pancreatitis to involve the entire abdomen and the progression of biliary colic to cholecystitis.

 

A close up of a doctor holding a bottle of pills and writing a prescription.

What medications can be used to treat certain causes of abdominal pain?

 

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Medications that are used for the treatment of underlying cause(s) of the pain are the medications of choice. For example, medications are not needed for the treatment of simple viral gastroenteritis (stomach flu or stomach bug), while surgery and/or chemotherapy may be the best approach to treat certain cancers in the abdomen. Other causes may require antispasmodics, antimicrobials, H2 blockers, or even nitrates or morphine. The diagnosed cause usually narrows the choice of medications. A few causes can only be treated by surgery (for example incarcerated hernia, abdominal adhesions from previous surgeries, and certain abdominal injuries), although some medications may be used (for example, morphine) while the person is waiting to have surgery.

What lifestyle choices can I make to prevent abdominal pain?

 

Lifestyle changes really depend on the cause of the pain.

 

   Eat a healthy diet, exercise, and avoid smoking and excess alcohol consumption to reduce the chances that you will experience certain causes.

   Good hygiene, especially hand washing and avoiding materials and foods contaminated with viruses and bacteria will reduce your chances of developing illness from many infectious causes.

 

When should I call my doctor about abdominal pain?

 

Some doctors suggest that if you have a "less serious" cause of abdominal pain you likely won’t need to see a doctor if the symptoms resolve in about 24 to 48 hours. For example, if you have viral or bacterial food poisoning, have had discomfort, but aren’t dehydrated.

 

If you have a chronic problem that occasionally causes abdominal discomfort, most doctors suggest you contact the person treating you for the ailment for an appointment or prescription (refill). However, if you have any of the problems or symptoms listed in the "serious abdominal pain "section above, you should seek immediate medical care.

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Medically Reviewed on 11/10/2017

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   Colorectal cancer (colon cancer) is the cause of many cancer deaths. Learn about the warning signs, symptoms, screening process, stages, and treatment related to colorectal cancer.

   Complete Blood Count

   A complete blood count (CBC) is a calculation of the cellular makeup of blood. A CBC measures:

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           malignancy, anemia, or blood clotting problems.

   Diarrhea

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   Endometriosis implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. They also can be found in the vagina, cervix, and bladder. Endometriosis may not produce any symptoms, but when it does the most common symptom is pelvic pain that worsens just prior to menstruation and improves at the end of the menstrual period. Other symptoms of endometriosis include pain during sex, pain with pelvic examinations, cramping or pain during bowel movements or urination, and  infertility.

 

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   Stomach flu (gastroenteritis) is a term referred used to describe a variety of gastrointestinal problems. The most common signs and symptoms of gastroenteritis are nausea, vomiting, diarrhea, and abdominal pain.

 

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Abdominal Pain: What You Should Know

In this Article

 

   What Are the Most Common Causes of Abdominal Pain?

   When Should You Contact Your Doctor?

   How Does Your Doctor Figure Out the Cause of Your Abdominal Pain?

 

Just about everybody at one time or another will get a bellyache. Most causes of abdominal pain aren't worrisome, and your doctor can easily diagnose and treat the problem. Sometimes, though, it can be a sign of a serious illness. Learn which symptoms to watch out for and when you should get medical help.

What Are the Most Common Causes of Abdominal Pain?

 

Whether you've got a mild stomachache, sharp pain, or cramps, abdominal pain can have many causes. For instance, you might have indigestion, constipation, a stomach virus, or, if you're a woman, menstrual cramps.

 

Other possible causes include:

 

   Irritable bowel syndrome (IBS)

   Crohn's disease

   Food poisoning

   Food allergies

   Gas

 

You may also get abdominal pain if you're lactose intolerant or have ulcers or pelvic inflammatory disease. Some other causes include:

 

   Hernia

   Gallstones

   Kidney stones

   Endometriosis

   Gastroesophageal reflux disease (GERD)

   Appendicitis

 

When Should You Contact Your Doctor?

 

If your abdominal pain is severe, doesn't go away, or keeps coming back, talk to your doctor. Call 911 right away if your belly hurts because you had a recent injury there or if you have any chest pain.

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You should also contact her as soon as you can if you have symptoms along with the pain, such as:

 

   Fever

   Can't keep food down for more than 2 days

   Signs you're getting dehydrated

   Can't have a bowel movement, especially if you're also vomiting

   Pain when you pee, or you need to urinate often

 

Also call your doctor if:

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   Your belly is tender to the touch.

   Pain lasts more than a few hours.

 

You may also get symptoms that could be a sign of a problem inside your body that needs treatment as soon as possible. For example, get medical care right away if you have abdominal pain and you also:

 

   Vomit blood

   Notice bloody or black, tarry bowel movements

   Have trouble breathing

   Vomit constantly

   Have swelling in your belly

   Have yellow skin

   Are pregnant

 

How Does Your Doctor Figure Out the Cause of Your Abdominal Pain?

 

Since there are so many possible causes, your doctor will do a thorough physical exam. She'll also ask you some questions about your symptoms. She'll want to know what type of pain you have. For instance, is it a severe stabbing pain or a dull ache?

 

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Joint Pain

Pain Management Guide

 

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Abdominal pain

 

Find possible causes of abdominal pain based on specific factors. Check one or more factors on this page that apply to your symptom.

Pain is

 

   Burning

   Crampy

   Dull

   Gnawing

   Intense

   Intermittent or episodic

 

   Ongoing (chronic)

   Sharp

   Steady

   Sudden (acute)

   Worsening or progressing

 

Pain located in

 

   Abdomen but radiates to other parts of the body

   Lower abdomen

   Middle abdomen

 

   One or both sides

   Upper abdomen

 

Triggered or worsened by

 

   Coughing or other jarring movements

   Drinking alcohol

   Eating certain foods

 

   Menstrual cycle

   Stress

 

Relieved by

 

   Antacids

   Avoiding certain foods

   Changing position

 

   Drinking more water

   Eating certain foods

   Eating more fiber

 

Accompanied by

 

   Abdominal swelling

   Black or bloody stools

   Constipation

   Diarrhea

   Fever

   Inability to move bowels in spite of urge

   Loose, watery stools

 

   Nausea or vomiting

   Passing gas

   Pulsing sensation near the navel

   Rash

   Stomach growling or rumbling

   Unintended weight loss

   Urgent need to have a bowel movement

 

References

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Abdominal Pain (Adults)

Medical Author:

Jerry R. Balentine, DO, FACEP

Medical Editor:

Jay W. Marks, MD

 

Facts and Definition of Abdominal Pain in Adults

 

   Abdominal pain is the feeling of pain in a person's stomach, upper or lower abdomen, and can range in intensity from a mild stomach ache to severe acute pain.

   Causes of symptoms of abdominal pain vary and may include gallbladder disease, ulcers of the stomach, food poisoning, diverticulitis, appendicitis, cancers, gynecologic (for example, fibroids, cysts, sexually transmitted diseases - STDs), and vascular problems.

   Some women experience abdominal pain during pregnancy.

   Abdominal pain can be acute or chronic and include sharp pain as well as dull pain.

   The location of the abdominal pain may be in the upper right or left side (quadrant), lower right or left side, and upper, middle, and lower.

   The cause of abdominal pain is diagnosed by a combination of history (questions the doctor asks you about your problem), physical examination (examination by a doctor), and testing (for example, X-rays and blood tests).

   Treatment for abdominal pain depends upon the cause and may include anything from observation, medications, and procedures that include endoscopy, and surgery.

   The prognosis for abdominal pain depends on the cause and the promptness of medical care and diagnosis.

 

Abdominal Pain: Causes, Symptoms and Diagnosis

 

Abdominal Pain Slideshow Pictures

Pelvic Pain:What's Causing Your Pelvic Pain?

 

Pelvic Pain Slideshow Pictures

Appendicitis Symptoms & Appendectomy Surgery

 

Appendicitis & Appendectomy Slideshow Pictures

 

Type and Location of the Abdominal Pain

 

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 abdominal pain comes on strongly for a while and then lessens 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 and Location (Right, Left, Lower, Upper)

 

Abdominal pain is caused by

 

   inflammation (appendicitis, diverticulitis, colitis),

   by stretching or distention of an organ (for example, gallstones, hepatitis), or

   by loss of the supply of blood to an organ (for example, ischemic colitis).

 

Learn more about the causes of abdominal pain »

 

What are Symptoms of Abdominal Pain in Adults?

 

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Abdominal pain is a symptom. It may mean that the person has a medical problem that needs treatment.

 

Abdominal pain may go along with other symptoms. Keep track of your symptoms because this will help the doctor find the cause of your pain. Make a special note if there is sudden abdominal pain, severe abdominal pain after eating, or abdominal pain with diarrhea.

 

What Are the Causes of Abdominal Pain in Adults?

 

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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 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 pneumonias 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.

 

Abdominal Pain: Causes, Symptoms and Diagnosis

 

Abdominal Pain Slideshow Pictures

Pelvic Pain:What's Causing Your Pelvic Pain?

 

Pelvic Pain Slideshow Pictures

Appendicitis Symptoms & Appendectomy Surgery

 

Appendicitis & Appendectomy Slideshow Pictures

 

What are Some of the Causes of Abdominal Pain by Location?

 

Abdominal pain can occur in any area of the abdomen. You might experience pain in one area of the abdomen although the cause for the pain is in a different area. Some diseases can cause pain in multiple areas of the abdomen. Below are the usual pain patterns associated with diseases, but please note that this does not include all diseases and conditions, and the below do not hold true all of the time.

Pain in the Upper Abdomen

 

   Stomach Ulcers

   Gastritis

   Pancreatitis

 

Pain in the Upper Right Side

 

   Gallbladder Disease

   Liver Inflammation (Hepatitis)

 

Pain in the Upper Left Side

 

   Enlarged Spleen

 

Pain in the Lower Right Side

 

   Other diseases and conditions of the uterus

   Appendicitis

   Right Ovarian Inflammation or Torsion

   Right Ovarian Cyst

 

Pain in the Lower Left Side

 

   Diverticulitis

   Left Ovarian Inflammation or Torsion

   Left Ovarian Cyst

 

Pain in the Lower Abdomen

 

   Urinary tract infections (UTI)

   Fibroids

 

From the above it is apparent that abdominal pain can have many causes, some linked directly to the abdomen and others caused by non-abdominal disease. Sometimes the cause of abdominal pain is not determined, and the you may be asked to return the next day to recheck and you perhaps need more tests. In some cases, no specific cause is determined, and the pain gets better in hours or days.

 

When Should an Adult Seek Medical Care for Abdominal Pain?

 

Call or see a doctor if the affected person has any of the following:

 

   Abdominal pain that lasts more than six hours or continues to worsen

   Severe abdominal pain

   Abdominal pain after eating

   Pain that stops a person from eating

   Pain accompanied by vomiting more than three or four times

   Abdominal pain during pregnancy

   Pain that worsens when a person tries to move around

   Pain that starts all over, but settles into one area, especially the right lower abdomen

   Pain that awakens a person up at night

   Pain with vaginal bleeding or pregnancy, even if a female only thinks she might be pregnant

   Pain accompanied by fever over 101 F (38.3 C)

   Pain along with inability to urinate, move the bowels, or pass gas

   Any other pain that feels different from a simple stomach ache

   Any other pain that alarms a person, or concerns them in any way

 

If the person has any of the following, or cannot reach their doctor, go to a hospital emergency department:

 

   Very severe pain

   Pain so bad the affected person passes out or almost passes out

   Pain so bad the affected person cannot move

   Pain and vomiting blood, or any vomiting that lasts more than six hours

   Pain and no bowel movement for more than three days

   Pain the person thinks might be in their chest, but they aren't sure

   Pain that seems to come from the person's testicles

 

What Kind of Doctor Treats Abdominal Pain in Adults?

 

Abdominal pain can be treated by a variety of doctors depending on the cause of the pain. It is usually best to start off with a primary care physician who can start the process of diagnosing the origin of the pain. Depending on the final diagnosis you will be treated by a primary care doctor (i.e. ulcers, infection) or referred to a surgeon (appendicitis, ovarian torsion), gastroenterologist, or gynecologist. If the pain is severe you might end up in the emergency department where an emergency medicine physician will be the first one to take care of you.

Abdominal Pain: Causes, Symptoms and Diagnosis

 

Abdominal Pain Slideshow Pictures

Pelvic Pain:What's Causing Your Pelvic Pain?

 

Pelvic Pain Slideshow Pictures

Appendicitis Symptoms & Appendectomy Surgery

 

Appendicitis & Appendectomy Slideshow Pictures

 

What Questions will the Doctor ask about my Abdominal Pain?

 

Diagnosing the cause of abdominal pain is one of the hardest tasks for a doctor. Sometimes all that the professional can do is be sure that the pain does not require surgery or admission to the hospital.

 

The healthcare professional may ask these or similar questions to try to determine what is causing the patient's pain. Some may seem unrelated to the patient's current condition, but it is important to try to answer them as completely as possible. The answers to these questions can help the healthcare professional find the cause of the patient's pain more quickly and easily.

 

   How long have you had the pain?

   What were you doing when it started?

   How did you feel before the pain started?

   Have you felt OK over the last few days?

   What have you tried to make the pain better? Did it work?

   What makes the pain worse?

   Where is the pain located?

       Right side?

       Left side?

   Does the pain make you want to stay in one place or move around?

   How was the ride to the hospital? Did riding in the car hurt you?

   Is the pain worse when you cough?

   Have you thrown up?

   Did throwing up make the pain better or worse?

   Have your bowel movements been normal?

   When was your last bowel movement?

   Are you passing gas?

   Do you feel you might have a fever?

   Have you had a pain like this before? When? What did you do for it?

   Have you ever had surgery? What surgery? When?

   Are you pregnant? Are you sexually active? Are you using birth control?

   Have you been around anyone with symptoms like this?

   Have you traveled out of the country recently?

   When did you eat last? What did you eat?

   Did you eat anything out of the ordinary?

   Did your pain start all over your stomach and move to one place?

   Does the pain go into your chest? Into your back? Where does it go?

   Can you cover the pain with the palm of your hand, or is the hurting area bigger than that?

   Does it hurt to breathe?

   Do you have any medical problems such as heart disease, diabetes, or AIDS?

   Do you take steroids? Pain medicine such as aspirin or Motrin?

   Do you take antibiotics? Over-the-counter pills, herbs, or supplements?

   Do you drink alcohol? Coffee? Tea?

   Do you smoke cigarettes?

   Of course, the doctor may not need to ask all if these questions or may need to ask additional questions depending on the symptoms.

 

How Is the Cause of the Abdominal Pain Diagnosed?

 

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Physical Examination

 

Physical examination will include a careful examination of the patient's abdomen, heart, and lungs in order to pinpoint the source of the pain.

 

   The doctor will touch different parts of the abdomen to check for tenderness or other signs that indicate the source of the pain.

   The doctor may do a rectal exam to check for small amounts of blood in the stool or other problems, such as a mass or internal hemorrhoids.

   If the patient is a man, the doctor may check the penis and testicles.

   If the patient is a woman, the doctor may do a pelvic exam to check for problems in the uterus, Fallopian tubes, and ovaries.

   The doctor also may look at the patient's eyes for yellow discoloration (jaundice) and in the mouth to be sure the patient is not dehydrated.

 

Laboratory Tests

 

Laboratory tests may or may not help to determine the cause of the abdominal pain. Combined with the information gained from the questions the patient was asked and the physical examination performed by the doctor, certain blood or urine tests may be ordered and could assist in determining the diagnosis.

 

   One of the most important tests is to see if a woman is pregnant.

   A raised white blood cell count may mean infection or may just be a reaction to the stress of pain and vomiting.

   A low red blood count (hemoglobin) may mean that a patient is bleeding internally, but most conditions that involve bleeding are not painful.

   Blood in the urine, which may not be visible to the eye, suggests that a patient may have a kidney stone.

   Other blood tests, such as liver enzymes and pancreas enzymes, can help determine which organ is the cause of the pain, but they do not point to a diagnosis.

 

Radiology Tests

 

Radiology studies of the patient's abdomen can be useful, but are not always necessary or helpful.

 

   Occasionally, an X-ray will show air outside of the bowel, meaning that something has ruptured or perforated.

   An X-ray also can help diagnose bowel obstruction.

   Sometimes X-rays can show a kidney stone.

 

Ultrasound is a painless procedure useful in finding some causes of abdominal pain.

 

   This may be done if the doctor suspects problems with the gallbladder, pancreas, liver, or the reproductive organs of women.

   Ultrasound also assists in the diagnosis of problems with the kidneys and the spleen, or the large blood vessels that come from the heart and supplies blood to the lower half of the body.

 

Computerized tomography (CT scan) provides useful information about the liver, pancreas, kidneys and ureters, spleen, and small and large intestine.

 

The patient and doctor should discuss the need for an X-ray or CT scan and their associated radiation exposure before proceeding with any radiological examination.

 

MRI is usually less helpful than a CT scan when the abdomen is examined, although with certain problems and symptoms your healthcare professional may order an MRI rather than a CT scan or in follow up to any of the above examinations.

 

The doctor may perform no tests at all. The cause of the patient's pain may be clear without any tests and may be known not to be serious. If the patient does undergo tests, the professional should explain the reason for the test and any contraindications. When the results are available, the professional should discuss them with the patient, as well as whether the results impact the treatment.

Abdominal Pain: Causes, Symptoms and Diagnosis

 

Abdominal Pain Slideshow Pictures

Pelvic Pain:What's Causing Your Pelvic Pain?

 

Pelvic Pain Slideshow Pictures

Appendicitis Symptoms & Appendectomy Surgery

 

Appendicitis & Appendectomy Slideshow Pictures

 

What Home Remedies Soothe Abdominal Pain in Adults?

 

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Abdominal pain without fever, vomiting, vaginal bleeding, passing out, chest pain, or other serious symptoms often get better without special treatment.

 

   If the pain persists or if a person believes the pain may represent a serious problem, they should see a doctor.

   A heating pad or soaking in a tub of warm water may ease pain.

   Over-the-counter (OTC) antacids, such as Tums, Maalox, or Pepto-Bismol, also can reduce some types of abdominal pain. Activated charcoal capsules also may help.

   Acetaminophen (common brand names are Arthritis Foundation Pain Reliever, Aspirin Free Anacin, Panadol, Tylenol) may help. This product should be avoided if liver disease is suspected. Patients should try to avoid aspirin or ibuprofen (common brand names are Advil, Motrin, Nuprin, Pamprin IB) stomach or intestinal ulcer disease is suspected; these drugs can make the pain worse.

 

What is the Medical Treatment for Causes of Abdominal Pain in Adults?

 

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The patient's treatment will depend on what the doctor thinks is causing the abdominal pain.

 

The patient may be given IV (intravenous) fluids. The doctor may ask the patient not to eat or drink anything until the cause of the pain is known. This is done to avoid worsening certain medical conditions (for example adding food to the stomach if there is a ruptured ulcer) or to prepare the patient in case they need to have surgery. (An empty stomach is better when general anesthesia is needed.)

 

The patient may be given pain medication.

 

   For pain caused by bowel spasm, they may be given a shot in the hip, arm, or leg.

   If the patient is not throwing up, they may receive a drink that has antacid in it or pain medication.

   Although the patient's pain may not go away completely, they have the right to be comfortable and should ask for pain medicine until they are made comfortable.

 

Is Surgery Necessary for Some Causes of Abdominal Pain in Adults?

 

Some types of abdominal pain require surgical treatment.

 

   If the patient's pain comes from an infected internal organ, such as the appendix or gallbladder, hospitalization, observation, and possibly surgery are indicated.

   Bowel obstruction sometimes requires surgery, depending on what is causing the obstruction, how much bowel is obstructed, and whether or not the obstruction is temporary.

   If the patient's pain comes from a ruptured or perforated organ, such as the bowel or stomach, they will need immediate surgery and will be taken directly to an operating room.

 

Do I Need to Follow-up with My Doctor After Having Abdominal Pain?

 

If the person is allowed to go home after their evaluation, they may be given instructions about what they can and cannot eat and drink and which medications they may take. The person may be told to return to the emergency department if certain conditions develop.

 

If the person is given no specific instructions they should follow these recommendations:

 

   As soon as you feel like eating, start with clear liquids.

   If clear liquids cause no further pain or vomiting, progress to "bland" foods such as crackers, rice, bananas, applesauce, or toast.

   If your symptoms don't return in a few days return to your normal diet.

 

Patients should return to the emergency department or doctor in the following situations.

 

   The pain worsens or if the patient starts vomiting, has a high fever, or cannot urinate or move their bowels

   Any symptom that worsens or is alarming

   Abdominal symptoms are not better in 24 hours

 

Abdominal Pain: Causes, Symptoms and Diagnosis

 

Abdominal Pain Slideshow Pictures

Pelvic Pain:What's Causing Your Pelvic Pain?

 

Pelvic Pain Slideshow Pictures

Appendicitis Symptoms & Appendectomy Surgery

 

Appendicitis & Appendectomy Slideshow Pictures

 

Can Abdominal Pain in Adults be Prevented?

 

If the cause of the pain determined a person should follow the instructions specific for the diagnosis.

 

   If, for example, an ulcer causes the pain, the person must avoid nicotine, caffeine, and alcohol.

   If it is caused by gallbladder disease, the person should avoid greasy, fatty, and fried foods.

 

What is the Outlook for an Adult with Abdominal Pain?

 

Overall, many types of pain go away without surgery and never determining the cause, and most people need only relief from their symptoms.

 

Medical causes of abdominal pain generally have a good outcome, but there are exceptions.

 

Surgical causes of abdominal pain have varying outcomes depending on the severity of the condition and the person's underlying medical condition.

 

   If the patient has uncomplicated appendicitis requiring surgery or uncomplicated gallstones, they should recover from the surgery with no long-term problems.

   If the patient has a ruptured appendix or infected gallbladder, recovery may take longer.

   Abdominal pain from a perforated ulcer or blocked bowel may mean major surgery and a long recovery.

 

For problems with a major blood vessel, such as rupture or blood clot, the prognosis may be less poor.

 

In general, the older the person is and the more underlying conditions they have, the worse the outcome of a surgical intervention.

Reviewed on 5/16/2018

 

Medically reviewed by John A. Daller, MD; American Board of Surgery with subspecialty certification in surgical critical care

 

REFERENCE:

 

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

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