Abdominal pain is one of the most common reasons for people to visit the doctor. It can be generalized throughout the abdomen or more localized to specific quadrants, depending on what causes it.
Most abdominal pain is not serious, but it can be a warning sign of a more serious condition. Detailed information about the location and pattern of your pain, along with other symptoms such as blood in your stool or urine, will help doctors figure out what’s wrong.
Causes
Pain in the abdomen is very common and just about everyone will experience it at one time or another. It can range from a mild discomfort to a severe ache. The pain can be located in several areas, including the belly (abdominal area), pelvic region and lower chest. Pain may come and go, be constant or episodic and be acute (short-lived) or chronic (lasting weeks to months).
Many conditions affecting the stomach, intestines and bowels can cause abdominal pain. These include gas and indigestion, menstrual cramps, food poisoning or the flu. Other causes are less familiar and more serious, such as appendicitis, gallstones, kidney stones or pancreatitis. Some problems outside the abdomen can also produce abdominal pain, such as heart attack or pneumonia, certain bacterial infections and twisting of a testis (testicular torsion).
The location and pattern of the pain helps a healthcare professional work out what’s causing it. It’s important for people to describe the exact location of the pain and any other symptoms they are experiencing, such as a dull or sharp ache, whether it comes and goes or is constant, and if it is constant or intermittent. It’s also helpful for doctors to know when the pain started and if it has got worse or better since then.
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In some cases, the doctor will diagnose a patient just from examining them and taking their history. In other cases, he or she will do diagnostic tests such as blood tests, ultrasound and CT scans to look for the cause of the pain. These tests are usually quick and painless and can be done at a clinic or hospital.
Whether the doctor diagnoses the problem in the clinic or in hospital, patients should be encouraged to take pain relievers until the cause is found. In some cases, it is a good idea to avoid eating or drinking for a few hours or days while tests are being done, especially if the pain is acute and getting worse. This is to reduce the risk of passing food or drink into the bowel and causing further damage.
Symptoms
The location, pattern and severity of abdominal pain can help doctors figure out what’s causing it. The way the pain moves — or doesn’t move — is important too, as is how much you can tolerate it, and whether the pain changes or gets worse over time. Pain that comes on quickly, for example, may be related to a disease that needs immediate treatment, such as appendicitis or a ruptured hernia. Pain that develops slowly, on the other hand, may be a sign of a chronic disease, such as diverticulosis or a bowel obstruction.
Abdominal pain typically occurs anywhere between your chest and your groin, but the term “belly” is used most often to refer to the lower part of the abdomen. The area on the right side of the belly houses the appendix, gallbladder, liver and bile ducts. The left side of the abdomen contains the spleen and kidneys. Sometimes, pain in one organ can be felt on the opposite side of the belly because of nerves that run between the organs and their surrounding tissues.
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Other symptoms that accompany abdominal pain — such as nausea, vomiting, constipation or diarrhea — can also provide clues about the cause. If the pain is accompanied by other symptoms that indicate severe or life-threatening conditions, such as blood in the stool, fever, chills and a rapid heart rate, you should seek medical care immediately.
How long the pain lasts is important too, because most diseases that cause abdominal pain come on suddenly and are temporary. However, some diseases that cause abdominal pain are chronic and can last for weeks, months or years. Chronic, progressive pain can be a sign of serious problems, such as colon cancer or inflammatory bowel disease.
Depending on what’s causing the abdominal pain, some patients will need to take medication and others may need more aggressive treatment, such as surgery or radiation. In some cases, the pain will resolve on its own. Other times, the condition will need to be managed with diet, exercise, medications or other treatments. Taking the time to understand and discuss your pain with your healthcare provider can help you find relief.
Diagnosis
Abdominal pain, also called bellyache or tummy ache, affects up to 1 in 4 people at some time. It can be mild or severe and may be constant or come and go. It can occur for weeks, months or years, which is called chronic abdominal pain. It is important to see your doctor if the pain is unexplained or it becomes worse over time.
When you visit your health care provider, be ready to describe the location and type of pain. Your doctor will take a careful medical history and do a physical exam. The location and description of your pain can help him or her find the cause of your problem. If the pain is generalized, felt in more than half of your stomach area, it could be due to gas, stomach viruses or menstrual cramps. If the pain is localized, felt in only one part of your stomach or pelvic area, it could be a sign of a problem with an organ like your appendix or gallbladder. Cramping pain that comes and goes or changes in severity can be a sign of a gallbladder or uterus disorder, such as peptic ulcers or Crohn’s disease.
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The onset of the pain can also be an indicator of the condition that is causing it. If the pain was sudden, it is more likely to be a life-threatening condition like appendicitis or a heart attack. Pain that has a gradual onset is more common with long-term diseases such as neoplasms or chronic inflammatory processes.
Your doctor may suggest a variety of tests to diagnose your abdominal pain. Depending on the results, your doctor can decide what treatment options are right for you.
If your abdominal pain is not caused by a serious illness, it probably will not require any further testing or treatment. However, you should always call your health care provider if your pain is severe, lasts a long time or interferes with daily activities, if it is accompanied by other symptoms such as blood in the stool or urine, or if you have diarrhea or fever.
Treatment
The treatment for abdominal pain depends on the cause. People with pain that is a clear sign of a medical problem, such as blood in the stool or urine, need to see a doctor immediately. People with mild to moderate pain can try home treatments, such as taking a hot water bottle or using a warm wheat bag on the abdomen, and over-the-counter medicine for pain.
For some conditions, a person with abdominal pain may need to stay in the hospital for tests and treatment. The first thing a doctor will do is ask about the person’s symptoms and history, and perform a physical examination, which includes pressing on the abdomen to find areas of tenderness. The doctor will also ask when the pain started and whether it is constant, or does it come and go.
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If the pain is of sudden onset, the person will often be able to tell the doctor exactly what they were doing at the time it began. This kind of pain is usually caused by an infection or injury to the intestines, such as a perforation from a gastric ulcer or colonic diverticulum. It can also be caused by a ruptured ectopic pregnancy or a mesenteric infarction.
Occasionally, pain from the abdomen can be felt in other places, such as the lower back or pelvis. This is called referred pain. It can be a symptom of certain conditions, such as gallstones, peptic ulcers and pancreatic cancer. It can also be a sign of pelvic inflammatory disease (PID), which is often caused by untreated gonorrhea or chlamydia, abortion or childbirth.
X-rays of the stomach and intestines (upper gastrointestinal series with a small bowel follow-through) can help diagnose problems, such as a peptic ulcer or a blockage in the bowels. Ultrasound may be used to diagnose gallstones, cholecystitis and appendicitis. Magnetic resonance imaging can also be useful, and is particularly helpful in diagnosing conditions such as pancreatic cancer. A barium X-ray can be used to help diagnose the cause of a bile duct obstruction or a peptic ulcer.
