Abdominal pain

Definition

Everyone experiences abdominal pain from time to time. Other terms used to describe abdominal pain are stomachache, tummy ache, gut ache and bellyache. Abdominal pain can be mild or severe. It may be constant or come and go. Abdominal pain can be short-lived, also called acute. It also may occur over weeks, months or years, also known as chronic.

Call your health care provider right away if you have abdominal pain so severe that you can't move without causing more pain. Also call if you can't sit still or find a comfortable position.

Causes

Abdominal pain can have many causes. The most common causes usually aren't serious, such as gas pains, indigestion or a pulled muscle. Other conditions may need urgent medical attention.

The location and pattern of abdominal pain can provide important clues, but how long it lasts is especially useful when figuring out its cause.

Acute abdominal pain develops and often goes away over a few hours to a few days. Chronic abdominal pain may come and go. This type of pain may be present for weeks to months, or even years. Some chronic conditions cause progressive pain, which steadily gets worse over time.

Acute

Conditions that cause acute abdominal pain usually happen at the same time as other symptoms that develop over hours to days. Causes can range from minor conditions that go away without any treatment to serious medical emergencies, including:

• Abdominal aortic aneurysm
• Appendicitis — when the appendix becomes inflamed.
• Cholangitis, which is inflammation of the bile duct.
• Cholecystitis
• Cystitis (irritation of the bladder)
• Diabetic ketoacidosis (in which the body has high levels of blood acids called ketones)
• Diverticulitis — or inflamed or infected pouches in the tissue lining the digestive tract.
• Duodenitis, which is inflammation of the top part of the small intestine.
• Ectopic pregnancy (in which the fertilized egg implants and grows outside of the uterus, such as in a fallopian tube)
• Fecal impaction, which is hardened stool that can't be passed.
• Heart attack
• Injury
• Intestinal obstruction — when something blocks food or liquid from moving through the small or large intestine.
• Intussusception (in children)
• Kidney infection (also called pyelonephritis)
• Kidney stones (Hard buildups of minerals and salt that form inside the kidneys.)
• Liver abscess, a pus-filled pocket in the liver.
• Mesenteric ischemia (decreased blood flow to the intestines)
• Mesenteric lymphadenitis (swollen lymph nodes in the folds of membrane that hold the abdominal organs in place)
• Mesenteric thrombosis, a blood clot in a vein carrying blood away from your intestines.
• Pancreatitis
• Pericarditis (inflammation of the tissue around the heart)
• Peritonitis (infection of the abdominal lining)
• Pleurisy (inflammation of the membrane surrounding the lungs)
• Pneumonia
• Pulmonary infarction, which is loss of blood flow to the lungs.
• Ruptured spleen
• Salpingitis, which is inflammation of the fallopian tubes.
• Sclerosing mesenteritis
• Shingles
• Spleen infection
• Splenic abscess, which is a pus-filled pocket in the spleen.
• Torn colon.
• Urinary tract infection (UTI)
• Viral gastroenteritis (stomach flu)

Chronic (intermittent, or episodic)

The specific cause of chronic abdominal pain is often difficult to determine. Symptoms may range from mild to severe, coming and going but not necessarily getting worse over time. Conditions that may cause chronic abdominal pain include:

• Angina (reduced blood flow to the heart)
• Celiac disease
• Endometriosis — when tissue that's similar to the tissue that lines the uterus grows outside the uterus.
• Functional dyspepsia
• Gallstones
• Gastritis (inflammation of the stomach lining)
• Gastroesophageal reflux disease (GERD)
• Hiatal hernia
• Inguinal hernia (A condition in which tissue bulges through a weak spot in the muscles of the abdomen and can descend into the scrotum.)
• Irritable bowel syndrome — a group of symptoms that affect the stomach and intestines.
• Mittelschmerz (ovulation pain)
• Ovarian cysts — fluid-filled sacs that form in or on the ovaries and aren't cancer.
• Pelvic inflammatory disease (PID) — an infection of the female reproductive organs.
• Peptic ulcer
• Sickle cell anemia
• Strained or pulled abdominal muscle.
• Ulcerative colitis — a disease that causes ulcers and swelling called inflammation in the lining of the large intestine.

Progressive

Abdominal pain that steadily worsens over time is usually serious. This pain often leads to the development of other symptoms. Causes of progressive abdominal pain include:

• Cancer
• Crohn's disease — which causes tissues in the digestive tract to become inflamed.
• Enlarged spleen (splenomegaly)
• Gallbladder cancer
• Hepatitis
• Kidney cancer
• Lead poisoning
• Liver cancer
• Non-Hodgkin lymphoma
• Pancreatic cancer
• Stomach cancer
• Tubo-ovarian abscess, which is a pus-filled pocket involving a fallopian tube and an ovary.
• Uremia (buildup of waste products in your blood)

When to see a doctor

Call 911 or emergency medical assistance

Seek help if your abdominal pain is severe and is associated with:

• Trauma, such as an accident or injury.
• Pressure or pain in your chest.

Seek immediate medical attention

Have someone drive you to urgent care or the emergency room if you have:

• Severe pain.
• Fever.
• Bloody stools.
• Persistent nausea and vomiting.
• Weight loss.
• Skin that appears discolored.
• Severe tenderness when you touch your abdomen.
• Swelling of the abdomen.

Schedule a doctor's visit

Make an appointment with your health care provider if your abdominal pain worries you or lasts more than a few days.

In the meantime, find ways to ease your pain. For instance, eat smaller meals if your pain is accompanied by indigestion and drink enough fluids. Avoid taking nonprescription pain relievers or laxatives unless directed by your health care provider.