Abdominal pain is any pain that occurs in the region between your chest and your groin. Depending on the cause, abdominal pain can feel like a dull ache, a sharp, cramping pain or a sudden stabbing sensation. It can also be a constant pain, or it can come and go in waves.
According to a study by the Centres for Disease and Control, abdominal pain is one of the most common reasons that people visit emergency departments in the United States. Statistics released by the International Association for the Study of Pain (pdf) also show that between 15–25% of the population could be suffering from abdominal (belly) pain at any one time.
In some, abdominal pain is caused by digestive issues like IBS or gastroenteritis, and occurs alongside other symptoms like nausea, vomiting or diarrhoea. This is why some people refer to all abdominal pain as ‘stomach ache’ or ‘tummy ache’.
Your abdomen contains more than just your stomach though. Your liver, appendix, pancreas and intestines all sit in the region between your chest and your pelvis. Conditions that affect any one of these organs can cause abdominal pain.
This can make it difficult to work out what’s causing your pain, and make it easy for you to assume that there’s something seriously wrong. Try not to panic too much though, some of the conditions that cause abdominal pain do require immediate medical attention, but the most common triggers can be addressed from the comfort of your own home.
A useful way to start finding the cause for your pain is to work out how you’d describe it to a health professional. If you can decide whether you’d describe the pain as a stabbing sensation, cramping or an ache, you can begin to narrow down the potential causes.
It can also help to think about any other symptoms you’re experiencing — like bloating and vomiting — or to determine the general location of your pain. The different conditions that can cause abdominal pain do tend to affect specific areas, and understanding where your pain is centered could provide valuable insight.
Four key locations to consider are the:
- Upper abdomen
- Lower abdomen
- Right side of the abdomen
- Left side of the abdomen
Here, you can read about 11 common causes of abdominal pain, along with information about their symptoms, location and treatments.
When to worry
Sometimes, abdominal pain can be a sign of a serious illness, especially if it’s accompanied with these symptoms:
- The abdominal pain came on very suddenly or is severe
- It hurts to touch your abdomen
- You’re vomiting blood or your vomit looks like ground coffee
- Your poop is bloody
- Your poop is black, sticky and extremely smelly
- You can’t pee
- You can’t poop or fart
- You can’t breathe
- You have chest pain
- You’re diabetic and vomiting
- Someone has collapsed
If you experience any of these symptoms, you should seek immediate medical attention.
Common causes of upper abdominal pain
Trapped wind
Everyone produces gas; it’s a natural byproduct of the digestive process. Some people do produce more gas than others though.
Sometimes, this excess gas can get stuck and cause stomach pain. This is called ‘trapped wind’. If you are experiencing trapped wind you might also be experiencing symptoms such as:
- A bloated stomach or abdomen
- Farting or burping frequently
- Feeling uncomfortably full after eating
- Rumbling or gurgling noises in your stomach
- Stomach cramps
- Nausea
Trapped wind affects many people. For some people it just happens occasionally if they have over-indulged, but for others it is a daily occurrence that can affect their quality of life.
To try and reduce excess gas, cut down on foods such as:
- Beans
- Onions
- Broccoli
- Cabbage
- Sprouts
- Cauliflower
It can also be helpful to eat slowly, and avoid talking while you eat. This will help you to swallow less air when you’re eating. Reducing the amount of fizzy drinks you consume, and avoiding chewing gum can also help to prevent excess gas.
In some cases, trapped wind can be an indication of a more serious condition such as coeliac disease, which occurs when your body can’t absorb gluten. It can also be a sign of a food intolerance or irritable bowel syndrome.
When to worry
If you constantly have trapped wind, you should see your doctor to rule out any serious conditions.
Acid reflux
Acid reflux is a common condition that can cause a painful burning sensation in the back of your throat. It can also cause heartburn, which is a burning sensation felt in the centre of your chest.
Other less common symptoms of acid reflux are:
- A recurrent cough or hiccups
- A hoarse voice
- Bad breath
- Bloating
- Feeling sick
Acid reflux occurs when the acid from your stomach flows up into your oesophagus, resulting in a burning pain. It can affect people of all ages, and lifestyle factors like eating large meals are often to blame. However some causes remain unknown.
That said, you are more likely to experience acid reflux if you:
- Are overweight
- Smoke
- Are pregnant
- Are stressed or anxious
- Are taking certain medications e.g. ibuprofen
- Have a hiatus hernia
Diet can also play a role in acid reflux, and the following foods have been found to increase the likelihood of acid reflux:
- Caffeine
- Alcohol
- Spicy food
- Chocolate
- Carbonated drinks
- Acidic juices
To manage acid reflux, you might want to consider changing your diet and avoiding these foods, or any others that trigger your condition.
Some other useful tips are to:
- Eat smaller, more frequent meals
- Sleep with your chest and head above the level of your waist
- If you are overweight, lose weight
- Don’t smoke
- Limit your intake of alcohol
- Don’t eat within 3–4 hours of going to bed
If these changes don’t help, there are some other treatments that you can consider. Go and speak to a pharmacist and they will be able to recommend a medication that is appropriate for you, such as an antacid.
When to worry
You should see a doctor if you:
- Still have symptoms despite lifestyle changes and non-prescription medication
- Are worried about your symptoms
- Have heartburn frequently for three weeks or more
- Develop difficulty swallowing
- Have lost weight for no reason
- Are persistently vomiting or vomiting blood
- Are coughing frequently or coughing blood
- Have a hoarse voice
Stomach ulcers
Stomach ulcers can be extremely painful and cause a sharp pain in the centre of your abdomen. Equally, some people have minimal symptoms and only experience things like heartburn and reflux.
If you have the following symptoms you may have a stomach ulcer:
- Heartburn
- Feeling or being sick
- Indigestion
- Loss of appetite
It’s unclear how many people are affected by stomach ulcers but they are actually quite common. And whilst they can affect anyone, regardless of age or gender, they are most common in people over 60, and men tend to be more affected than women.
Stomach ulcers occur when the lining of your stomach is damaged, and they are caused by the bacteria Helicobacter pylori or as a side effect of taking anti-inflammatory medications, like ibuprofen or aspirin.
If your stomach ulcer is caused by H. pylori then your doctor may prescribe you an antibiotic and recommend a proton pump inhibitor (PPI), which reduces the amount of acid in your stomach.
If, however, your stomach ulcer is caused by anti-inflammatory medications, your doctor may prescribe PPIs and recommend you take paracetamol instead of ibuprofen.
Stomach ulcers will usually heal after 1–2 months, and to help aid the healing process you should try to avoid:
- Stress
- Spicy foods
- Smoking
You might also want to take an antacid to provide some short-term, immediate relief.
When to worry
If you are vomiting blood, you have sudden, sharp stomach pain, or your poop is dark and sticky, seek immediate medical advice.
Heart attack (angina)
A heart attack is a medical emergency, so if you believe you are having a heart attack you need to seek immediate medical attention.
Typically, people who are having a heart attack experience chest pain. However sometimes, people actually describe it as upper abdominal pain or heartburn. The pain can feel like a burning sensation or that your chest is being pressed or squeezed by something heavy. The pain can also go into the jaw, neck or arms.
In addition, a person having a heart attack may experience the following symptoms:
- Breathlessness
- Sweating
- Feeling weak and/or lightheaded
- Nausea or vomiting
Heart attacks are usually caused by coronary heart disease, which is when the vessels that supply blood to your heart are clogged up with cholesterol deposits, usually known as plaque. If the plaque bursts it can block the heart’s blood supply, triggering a heart attack.
You are more likely to have coronary heart disease if you:
- Smoke
- Have diabetes
- Have high cholesterol
- Have high blood pressure
- Are overweight or obese
- Have a high-fat diet
Therefore to prevent a heart attack you should:
- Eat a healthy and balanced diet
- Avoid smoking
- Lose weight if you are overweight
- Exercise regularly
- Reduce your alcohol intake
When to worry
If you experience any combination of these symptoms:
- Chest pain
- Shortness of breath
- Feeling weak and/or lightheaded
- Overwhelming feeling of anxiety
You might be experiencing a heart attack and you should seek immediate medical attention.
Common causes of lower abdominal pain
Period pain
Period pain affects many women both before and during their menstrual cycle, and everyone experiences it differently. It can range from an annoying, dull ache to a more severe and debilitating pain.
There are two types of period pain: primary dysmenorrhea and secondary dysmenorrhea.
If you are experiencing primary dysmenorrhea symptoms that may occur in addition to lower abdominal pain are:
- Tiredness
- Feeling sick or being sick
- Diarrhoea
- Backache
- Headaches
- Bloating
- Emotional symptoms
If your period pain is caused by secondary dysmenorrhea then you may also experience:
- Heavy or irregular periods
- Bleeding in-between periods
- Unusual discharge from your vagina
- Painful sex or bleeding after sex
Primary dysmenorrhea is type of pain you would usually associate with menstruation. It typically starts within 6–12 months of your first period and the pain lasts between eight hours and three days.
Whereas, secondary dysmenorrhea is period pain caused by a particular condition such as endometriosis. This type of period pain is more common in your 30s and 40s and it can occur at any point during your menstrual cycle.
In order to treat painful periods you need to know what is causing the pain, if it’s primary dysmenorrhea then you should be able to treat it with painkillers and a few at home treatments including:
- Heat — either with a heat patch or hot water bottle
- A transcutaneous electrical nerve stimulation (TENS) machine placed near where you feel pain. This can help by sending electrical signals, which are thought to disrupt the pain signals that get sent to your brain.
- Not smoking if you are a smoker
- Doing some physical activity
If you have secondary dysmenorrhoea, your doctor will try and find out what condition is causing your symptoms and discuss your treatment options with you.
When to worry
See a doctor if you have severe period pain or if your period suddenly changes, for example if they become heavier than usual or irregular. You should also see a doctor if you have symptoms of secondary dysmenorrhoea, like intense pain or heavy periods.
Constipation
Constipation is more common than you might think. It actually affects about 20% of Americans each year. In many cases, constipation is caused by something you ate, your lifestyle choices, medication, or a condition. But for some people the cause of their constipation is unknown and this is called chronic idiopathic constipation.
You are likely to be constipated if:
- You haven’t pooped at least 3 times in a week
- It’s difficult to poop and you have to strain
- Your poop is larger than normal
- Your poop is dry, hard, or lumpy
As well as these symptoms constipation can have other unpleasant side effects, including abdominal bloating and pain. These symptoms can have a negative effect on your physical and mental health, but luckily there are some ways you can try and relieve constipation at home.
You can start by making some simple changes to your diet. For example you can try:
- Drinking more water and less alcohol
- Increasing your intake of fibre
- Adding some wheat bran, oats, or linseed to your diet
You can also try and increase your activity and create a toilet routine. For example, go to the toilet at regular times and don’t hold poop in if you feel the need to go. You can also try putting your feet on a small stool when you’re on the toilet, ideally your knees should be above your hip.
If these changes aren’t helping speak to a pharmacist and they may give you a laxative, which should work within three days. However they are not suitable for long term use.
When to worry
See a doctor if you:
- Are not improving with changes to your diet
- Are regularly constipated
- Are bloated frequently
- Have blood in your poo
- Have unexpectedly lost weight
- Feel tired all the time
UTI
UTIs are fairly common, and whilst both men and women can get them, they occur more frequently in women. In fact, the National Kidney Foundation found that 1 in 5 women will get a UTI in their lifetime (pdf).
The good news is that if treated early UTIs don’t have to be serious, if you think that you have a UTI you should see a doctor, they will most likely prescribe you antibiotics which will clear up the infection.
However, if a UTI goes untreated it can spread to the kidneys, at which point the infection can be more serious.
The symptoms of a UTI include:
- Needing to pee suddenly or more often than usual
- Pain or a burning sensation when peeing
- Smelly or cloudy pee
- Blood in your pee
- Pain in your lower abdomen
- Feeling tired and unwell
- Older people might have changes in behaviour such as confusion or agitation
No one wants to experience the unpleasant symptoms of a UTI, and whilst you can’t always prevent one, there are things you can do to reduce their likelihood.
This includes:
- Wiping from front to back when you go to the toilet
- Making sure you are fully emptying your bladder when you pee
- Drinking more water
- Taking showers instead of baths
- Wearing loose cotton underwear
- Peeing as soon as possible after sex
And don’t:
- Use perfumed bubble bath, soap or talcum powder
- Hold your pee in if you feel the urge to go
- Wear tight, synthetic underwear, such as nylon
- Wear tight jeans or trousers
- Use spermicidal lube try non-spermicidal lube or a different type of contraception that doesn’t require spermicide
UTIs can be prevented and are usually easily treatable. Knowing the symptoms and getting treatment early can help prevent it from becoming something more serious, like a kidney infection.
When to worry
You should see a doctor if you think you have symptoms of a UTI and you are male or pregnant. You should also see a doctor if:
- It’s your first UTI
- You have blood in your pee
- Your symptoms don’t improve within a few days
- Your symptoms come back after treatment
You should seek urgent treatment if you:
- Have pain in your sides or lower back
- Have a fever, feel hot or shivery
- You feel or have been sick
- Have diarrhoea
Common causes of right sided abdominal pain
Gallstones
Gallstones are extremely common in adults and about 25% of people experience them in the western hemisphere. They are small stones — ranging in size from a grain of sand to the size of a golf ball — that develop in your gallbladder, and they’re usually made up of cholesterol.
Not everyone who has gallstones will have symptoms, but for those that do pain is the most common. It tends to originate in the upper right side of the abdomen, and it can spread to the tip of your right shoulder blade.
In more severe cases you might also:
- Feel sick
- Vomit
- Have a high temperature
- Be shivering and sweating
- Experience more persistent pain
- Have a rapid heartbeat
- Have yellowing of the skin and whites of the eyes
- Experience itchy skin
- Have diarrhoea
- Be confused
- Lose your appetite
Gallstones are usually formed when there are unusually high levels of cholesterol, or the waste-product bilirubin, in your gallbladder. Although some causes remain unknown.
It is thought that having a healthy and balanced diet can help to prevent gallstones from forming. If you are worried that you might have gallstones, you should book an appointment with your doctor straight away. They will be able to verify whether or not you have gallstones, and help you to treat the condition.
Treatment depends on a number of things such as the symptoms or complications you experience. This can include monitoring for any symptoms, dietary changes, medications to dissolve the gallstones or a procedure to remove the gallbladder through surgery or an endoscopic retrograde cholangio-pancreatography (ERCP) procedure.
When to worry
If you experience any of the more severe symptoms, you should book an appointment with your doctor immediately. There are various treatment options available, depending on the severity and frequency of your symptoms.
Appendicitis
Appendicitis is relatively common, and it affects about 1 in 13 people at some point in their lives. The condition can occur at any age but it’s more common between the ages of 10 and 20.
Appendicitis tends to cause general abdominal pain that comes and goes, but within a few hours the pain usually moves to the lower right side of your abdomen, where it is constant and more severe. The pain is usually made worse by coughing or walking.
Other symptoms can include:
- Feeling or being sick
- Loss of appetite
- Diarrhoea
- A high temperature and a flushed face
The appendix doesn’t really have a function, but it can become inflamed. Since removing it doesn’t cause any long-term problems treatment of appendicitis tends to involve surgical removal, and time is of the essence.
Ideally a surgeon will remove an inflamed appendix before it bursts and releases infectious fluid into the rest of your stomach. So, it’s crucial that you see a doctor if you suspect you have appendicitis.
When to worry
Abdominal pain that is gradually getting worse can be a sign of several different conditions, but regardless of the cause these symptoms mean you should see or talk to a doctor immediately.
Also, if you have sudden severe pain that spreads across your abdomen you should call an ambulance, because this could indicate your appendix has burst. A burst appendix can cause peritonitis, which is an infection of the inner lining of the abdomen, and it can be very serious.
Common causes of left abdominal pain
Kidney stones and kidney infections
Kidney stones or a kidney infection can cause a lot of pain in either the left or right side of your abdomen. Your kidneys are located just below your ribcage on each side of your spine, and they remove waste and extra fluids from your body.
Kidney stones are relatively common, and affect about 3 in 20 men, and up to 2 in 20 women, and they usually affect people aged 30–60.
Kidney stones and kidney infections cause symptoms including:
- Pain in your left and/or right abdomen, lower back, or pain around your genitals
- A fever, shivers or chills
- Feeling weak or tired
- Loss of appetite
- Feeling sick or being sick
Not all kidney stones cause symptoms, but larger stones, or ones that block your ureter (tube where urine passes from the kidney to the bladder) can cause:
- Constant lower back pain and sometimes groin pain (men may have pain in their testicles and scrotum)
- Intense pain in your back or the sides of your abdomen which can last for minutes or hours
- Feeling restless
- Peeing more often than normal
- Pain when you pee
- Blood in your pee
Kidney stones are created by the build up of certain salts or minerals in your urine. Most kidney stones will pass on their own and you can encourage this by drinking lots of water. If you’re in a lot of pain or feeling sick, your doctor can provide you anti-nausea medication and some pain relief.
Sometimes you need to be admitted to hospital because your kidney stone is too big to pass on its own, or it has moved into you ureter and is causing severe pain and potential complications.
In hospital there are various treatments available to either break the kidney stone up into smaller pieces or to manually remove it.
To reduce your chances of getting a kidney stone you should work with your doctor to find out their cause, and then make adjustments accordingly. That said, it’s always helpful to stay hydrated to prevent a build up of waste products.
When to worry
Most kidney stones are resolved without medical treatment but you should see a doctor straight away if:
- You have a fever, start to shiver or shake
- The pain gets suddenly and severely worse
Diverticulitis
Diverticulitis is an infection that can occur following diverticular disease. Diverticula refers to small bulges that can develop and stick out of the side of the large intestine.
People with diverticula will rarely have symptoms, unless the small bulges become inflamed or infected. This is know as diverticulitis.
Diverticulitis causes symptoms such as:
- Constant, severe abdominal pain
- A fever
- Feeling sick or vomiting
- Feeling tired
- Blood in your poop or bleeding from your bottom
These symptoms differ from diverticular disease which usually causes:
- Lower left sided abdominal pain that comes and goes and can get worse after eating
- Feeling bloated
- Constipation, diarrhoea or both
- Mucus in your poop
There is no concrete cause of diverticular disease but it has been linked with age, diet and lifestyle, and genetics. It appears that you are more likely to develop diverticular disease as you get older, most likely because the walls of your intestines are not as strong and so the pressure of hard stools can cause small bulges, or pockets, to form.
Other suspected causes are:
- A lack of dietary fibre
- Smoking
- Obesity
- Frequent constipation
- Overuse of painkillers such as ibuprofen and aspirin
- Genetics — you are more likely to have the disease if a relative had, or has it, especially before they were 50
Diverticular disease can usually be treated with dietary changes by including more fibre in your diet. In addition to diet your doctor might prescribe you some medication such as a bulk-forming laxative to help reduce symptoms of constipation or diarrhoea. They might also prescribe you a painkiller.
If you have diverticulitis then depending on the severity you will either be prescribed antibiotics or you will need hospital treatment. Hospital treatment might just include intravenous antibiotics and fluids, but for more serious cases you may require surgery.
When to worry
If you have symptoms of either disease you should see your doctor. And if you have bleeding or severe pain contact a doctor immediately.
Conclusion
Abdominal pain can be caused by a number of different conditions, from relatively mild cases of gastroenteritis, to more serious illnesses like appendicitis. In many cases, abdominal pain will resolve on its own but if you are worried about your pain, you should see a doctor as soon as possible.
They will be able to check for a serious medical condition, and help you to manage your pain.
You should also seek immediate medical attention if your pain is very sudden and intense, or:
- It hurts to touch your abdomen
- You’re vomiting blood or your vomit looks like ground coffee
- Your poop is bloody
- Your poop is black, sticky and extremely smelly
- You can’t pee
- You can’t poop or fart
- You can’t breathe
- You have chest pain
- You’re diabetic and vomiting
- Someone has collapsed
Originally published at https://www.your.md on October 2, 2018.
Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.
