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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 continuous or come and go. Abdominal pain can be short-lived (acute) or occur over weeks, months or years (chronic).

Call your doctor right away if you have abdominal pain so severe that you can't move without causing more pain, or you can't sit still or find a comfortable position.

Seek immediate medical help if pain is accompanied by other worrisome signs and symptoms, including:

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

Causes

Abdominal pain has many potential causes. The most common causes — such as gas pains, indigestion or a pulled muscle — usually aren't serious. Other conditions may require more-urgent medical attention.

While the location and pattern of abdominal pain can provide important clues, its time course is particularly useful when determining its cause.

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

Acute

The various conditions that cause acute abdominal pain are usually accompanied by other symptoms and develop over hours to days. Causes can range from minor conditions that resolve without any treatment to serious medical emergencies, including:

  • Abdominal aortic aneurysm
  • Appendicitis
  • Cholangitis (bile duct inflammation)
  • Crohn's disease
  • Cystitis (bladder inflammation)
  • Diabetic ketoacidosis (high levels of ketones in the blood)
  • Diverticulitis
  • Intestinal obstruction
  • Ectopic pregnancy
  • Fecal impaction (hardened stool that can't be eliminated)
  • Heart attack
  • Injury
  • Intussusception (in children)
  • Kidney infection
  • Kidney stones
  • Liver abscess (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 (blood clot in a vein carrying blood away from your intestines)
  • Pancreatitis (pancreas inflammation)
  • 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 (loss of blood flow to the lungs)
  • Ruptured spleen
  • Kidney stones
  • Sclerosing mesenteritis
  • Shingles
  • Spleen infection
  • Splenic abscess (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 worsening over time. Conditions that may cause chronic abdominal pain include:

  • Angina (reduced blood flow to the heart)
  • Celiac disease
  • Endometriosis
  • Gallstones
  • Gastritis (inflammation of the stomach lining)
  • GERD (gastroesophageal reflux disease)
  • Hiatal hernia
  • Inguinal hernia
  • Enlarged spleen (splenomegaly)
  • Mittelschmerz (pain associated with ovulation)
  • Nonulcer stomach pain
  • Ovarian cysts
  • Pelvic inflammatory disease (PID) — infection of the female reproductive organs
  • Peptic ulcer
  • Sickle cell anemia
  • Strained or pulled abdominal muscle
  • Ulcerative colitis

Progressive

Abdominal pain that steadily worsens over time, often accompanied by the development of other symptoms, is usually serious. Causes of progressive abdominal pain include:

  • Cancer
  • Crohn's disease
  • Enlarged spleen (splenomegaly)
  • Gallbladder cancer
  • Hepatitis (liver inflammation)
  • Kidney cancer
  • Lead poisoning
  • Liver cancer
  • Non-Hodgkin's lymphoma
  • Pancreatic cancer
  • Stomach cancer
  • Tubo-ovarian abscess (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 yellow
  • Severe tenderness when you touch your abdomen
  • Swelling of the abdomen

Schedule a doctor's visit

Make an appointment with your doctor 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. Avoid taking over-the-counter pain relievers such as aspirin or ibuprofen (Advil, Motrin IB, others) because these can cause stomach irritation that may worsen abdominal pain.

Last updated: October 25th, 2016

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