Did you know abdominal pain was the most common reason for emergency department visits in 2018?1 Abdominal pain, also called stomach ache, is any discomfort felt in the stomach area. The pain can be acute, chronic, or progressive. It may present itself as a dull, sharp, colicky (happens at intervals) or achy pain. It can also be mild or severe. Abdominal pain may be accompanied by nausea, vomiting, diarrhoea, constipation, weight loss, jaundice, fever, indigestion, bloating, and bloody stool.
What is abdominal pain?
Abdominal pain is any discomfort felt in the abdomen. The abdomen is the space between your chest and pelvis. It is home to a number of organs in your body. Pain from the abdomen may come from any of the organs in your abdomen. The organs found in the abdomen are the liver, spleen, gallbladder, stomach, appendix, large intestine, small intestine, and uterus.
Abdominal pain is commonly called stomach ache, tummy ache, and belly ache.
Types of abdominal pain
There are 4 types of abdominal pain based on where you feel the pain.
Upper right abdominal pain
Upper left abdominal pain
Lower right abdominal pain
This is pain that is felt in the lower right corner of your abdomen. A common cause of lower right abdominal pain is appendicitis.
Lower left abdominal pain
This is pain that is felt in the lower left corner of your abdomen. A common cause of lower left abdominal pain is diverticulitis.
Abdominal pain can happen in 3 patterns. These are known as visceral pain, parietal pain, and referred pain.2
Originates from the internal organ. It is usually characterised by dull pain or ache felt in your abdomen. The pain also feels general, rather than from a specific area.
Is a sharp and focused kind of pain that happens when something irritates the lining of the walls of your abdomen.
Is felt in a different part of the body than where the actual problem or injury happens. An example is shoulder pain in the inflammation of the gallbladder.
Abdominal pain can also be mild or severe. Please see a doctor immediately if you have any case of severe abdominal pain.
Causes of abdominal pain
Causes of abdominal pain can be acute, chronic, or progressive.
Acute abdominal pain usually lasts for some hours or days. It may also resolve on its own without the need for any treatment.
Chronic abdominal pain lasts longer, up to weeks, months, and even years. The pain may come and go at intervals or in episodes.
Progressive abdominal pain is the kind of pain that constantly gets worse with time.
Some causes of abdominal pain are also more common in certain age groups and sex. An example is period pain in those assigned females at birth.
Causes of acute abdominal pain
The cause of acute abdominal pain could be minor and resolve on its own, or it could be major which would require visiting A&E. If you feel a sudden excruciating pain in your abdomen, you should see a doctor immediately.
The following are some of the causes of acute abdominal pain:
- Abdominal aortic aneurysm (AAA) - a condition where the main artery that carries blood from the heart gets weak and bulges
- Appendicitis - inflammation of the appendix
- Cholangitis - inflammation and infection of the bile ducts
- Cholecystitis - inflammation of the gallbladder
- Cystitis - inflammation of the bladder usually due to an infection
- Diabetic ketoacidosis - a complication of diabetes characterised by ketones in the blood
- Diverticulitis - inflammation of small pockets (diverticula) that form in your intestines
Causes of chronic abdominal pain
The causes of chronic abdominal pain can be hard to diagnose. The symptoms may come and go but don't get worse over time.
The following are some of the causes of chronic abdominal pain:
- Angina - a condition where your heart receives enough oxygen, often characterised by chest pain
- Celiac disease - an autoimmune disorder that causes an immune reaction to gluten
- Endometriosis - a condition where similar tissue lining of the uterus grows outside of the uterus
- Functional dyspepsia - abdominal pain with no specific cause characterised by bloating and feeling full during and after meals
- Gastritis - inflammation of the stomach’s lining
Causes of progressive abdominal pain
is abdominal pain that gets worse with time. They can develop from causes of chronic abdominal pain and may have symptoms not necessarily associated with typical abdominal pain.
The following are some of the causes of progressive abdominal pain:
- Crohn's disease - a type of inflammatory bowel disease
- Enlarged spleen
- Gallbladder cancer
- Hepatitis - inflammation of the liver
- Kidney cancer
- Lead poisoning
- Liver cancer
Signs and symptoms of abdominal pain
Each cause of abdominal pain has specific symptoms that can help your doctor come up with an accurate diagnosis of your pain.
The following are common signs and symptoms that may accompany abdominal pain :4
- Weight loss
- Bloody stool
Management and treatment for abdominal pain
Knowing the cause of your abdominal pain would determine the type of management and treatment you will need. Some causes of abdominal pain may resolve on its own with no treatment, but there are others that will require medication and even surgery.
Your doctor would administer the appropriate analgesic agent (pain relievers) by the appropriate route based on your condition. However, conditions like gallstones and appendicitis would require surgery.5
It is important you visit the hospital for proper diagnosis, treatment and management of your abdominal pain.
For an accurate diagnosis of the cause of your abdominal pain, your doctor needs to understand the pain well. They need to know where you feel the pain (its location), how the pain feels (character) when it started (onset), and the severity (intensity) of the abdominal pain.6
To do so, your doctor will check your health history and carry out a physical examination. They may also conduct some laboratory evaluation and imaging studies.7 The imaging studies could include a CT (computed tomography) scan, ultrasonography, and radiography. To further narrow your diagnosis, laboratory tests such as stool tests, urinalysis, urine culture, blood culture, enzyme markers, and liver function tests may be done.
How can I prevent abdominal pain?
There are many causes of abdominal pain, however, with good eating habits, exercise and good hygiene, you should be able to prevent some of the causes of abdominal pain.
How common is abdominal pain?
Abdominal pain is common and nearly half of adults have experienced abdominal pain in their lifetime.8 Abdominal pain is one of the major causes of A&E visits1.
Who is at risk of abdominal pain?
Those assigned females at birth, older adults, obese adults, and children are at risk of abdominal pain compared to others. Abdominal pain may also present in people who smoke, have psychological disorders, have had a family history of IBS (Inflammatory Bowel Syndrome), have had traumatic and stressful events, and have had abdominal surgery.9
What can I expect if I have abdominal pain?
You may experience pain in your abdomen that could resolve on its own. However, you may need to visit the hospital for proper diagnosis and treatment or management. Your doctor may conduct a physical examination, imaging studies, and lab tests. Treatment will involve the use of analgesics and other appropriate medication to treat or manage your abdominal pain.
When should I see a doctor?
You should see a doctor if you feel persistent or severe pain in your abdomen that is sudden or unexplained. Also, see a doctor if your abdominal pain lasts more than a few days or affects your daily life.
Abdominal pain is any discomfort felt in the abdomen. The pain can be acute, chronic, or progressive. Abdominal pain may be accompanied by nausea, vomiting and diarrhoea. Although abdominal pain can be mild or severe, you should visit a doctor if you feel persistent or severe pain in your abdomen that is sudden or unexplained if it lasts more than a few days, and if it interferes with your daily life. Your doctor would check your history and conduct physical examinations, imaging studies, and lab tests to accurately diagnose the cause of your abdominal pain.
- Weiss AJ, Jiang HJ. Most frequent reasons for emergency department visits in 2018. Agency for Healthcare Research and Quality [Internet]. 2021 Dec;#286(HCUP Statistical Brief):1–15. Available from: https://hcup-us.ahrq.gov/reports/statbriefs/sb286-ED-Frequent-Conditions-2018.pdf
- Flasar MH, Cross R, Goldberg E. Acute abdominal pain. Primary Care: Clinics in Office Practice [Internet]. 2006 Sep 1 [cited 2023 Jul 13];33(3):659–84. Available from: https://www.sciencedirect.com/science/article/pii/S0095454306000613
- Munro K, Gharaibeh A, Nagabushanam S, Martin C. Diagnosis and management of tubo-ovarian abscesses. Obstet Gynecol [Internet]. 2018 Jan [cited 2023 Jul 14];20(1):11–9. Available from: https://onlinelibrary.wiley.com/doi/10.1111/tog.12447
- Alex N. Gastrointestinal tract and abdomen - Acute abdominal pain. In: AGS surgery: Principles and Practice [Internet]. 2009 [cited 2023 Jul 13]. Available from: https://www.academia.edu/10255189/BC_Decker_Inc_ACS_Surgery_Principles_and_Practice_5_GASTROINTESTINAL_TRACT_AND_ABDOMEN_1_ACUTE_ABDOMINAL_PAIN_1_1_ACUTE_ABDOMINAL_PAIN
- Falch C, Vicente D, Häberle H, Kirschniak A, Müller S, Nissan A, et al. Treatment of acute abdominal pain in the emergency room: A systematic review of the literature: Acute abdominal pain therapy in emergency patients. EJP [Internet]. 2014 Aug [cited 2023 Jul 14];18(7):902–13. Available from: https://onlinelibrary.wiley.com/doi/10.1002/j.1532-2149.2014.00456.x
- Macaluso C, McNamara. Evaluation and management of acute abdominal pain in the emergency department. IJGM [Internet]. 2012 Sep [cited 2023 Jul 13];789. Available from: http://www.dovepress.com/evaluation-and-management-of-acute-abdominal-pain-in-the-emergency-dep-peer-reviewed-article-IJGM
- Lyon C, Clark DC. Diagnosis of acute abdominal pain in older patients. AFP [Internet]. 2006 Nov 1 [cited 2023 Jul 13];74(9):1537–44. Available from: https://www.aafp.org/pubs/afp/issues/2006/1101/p1537.html
- Lakhoo K, Almario CV, Khalil C, Spiegel BMR. Prevalence and characteristics of abdominal pain in the United States. Clinical Gastroenterology and Hepatology [Internet]. 2021 Sep [cited 2023 Jul 13];19(9):1864-1872.e5. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1542356520309290
- Zia JK, Lenhart A, Yang PL, Heitkemper MM, Baker J, Keefer L, et al. Risk factors for abdominal pain–related disorders of gut–brain interaction in adults and children: a systematic review. Gastroenterology [Internet]. 2022 Oct [cited 2023 Jul 13];163(4):995-1023.e3. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9509486/