Main causes of abdominal pain and how to treat it

Abdominal pain is mainly caused by changes in the bowel, stomach, bladder, gallbladder or uterus. The location where the pain appears may indicate the organ that is having problems so, for example, pain that appears on the top left side of the abdomen may indicate a gastric ulcer, whereas pain on the right side may indicate problems with the liver.

The reasons for the pain vary from simple situations, like excessive gas, to more complicated ones, like appendicitis or kidney stones. Therefore, if there is severe abdominal pain for more than 24 hours or you are also suffering from other symptoms such as fever, persistent vomiting and blood in the stool or urine, you should go to the emergency room or see your general practitioner.

Main causes for abdominal pain

Abdominal pain can happen in different areas according to the organ that is affected:

According to the area where the pain is felt, the main causes are:

This guideline applies to the main causes of abdominal pain, but there are other problems that cause pain in more than one place, such as the pain caused by gases, or those that manifest in places far from the organ, for example, in cases of gallbladder inflammation.

Persistent or chronic abdominal pain, which lasts for more than 3 months, is usually caused by acid reflux, food intolerances, inflammatory bowel disease, pancreatitis, intestinal worms or even cancer, and may be more difficult to identify.

Types of abdominal pain

How pain manifests itself can also help you find its cause, such as:

• Burning pain: This is usually pain in the stomach due to gastritis, ulcer and acid reflux and is felt as a burning sensation in that area.
• Colic pain: Problems in the gut, such as diarrhea or constipation, and also in the gallbladder, can appear as a colic. Cramps can also appear due to uterine pain because of menstrual cramps, for example.
• Stabbing or sharp pain: pain caused by too much gas, or by an abdominal inflammation, such as appendicitis or intestinal inflammation.

There are also other types of abdominal pain, such as a feeling of a full or swollen stomach, feeling of tightness or nonspecific pain sensation, when the person does not know how to identify the source of the pain.

In these cases, the cause is usually identified after diagnostic tests such as an ultrasound, blood tests or through personal history, done by the general practitioner or gastroenterologist.

How to treat it

The treatment for abdominal pain depends on its cause and its location. A general practitioner or a gastroenterologist will recommend the most appropriate treatment after physical, blood and, if necessary, abdominal ultrasound tests. Some of the most commonly used remedies for treating minor problems are:

• Antacids, such as Omeprazole or Ranitidine: used in cases of pain focused in the stomach area and caused by poor digestion, acid reflux or gastritis;
• Anti-flatulents or antispasmodics, such as dimethicone or buscopan: relieve pain caused by excessive gas or diarrhea;
• Laxatives, such as lactulose or mineral oil: speed up the intestinal rhythm to treat constipation;
• Antibiotics, such as amoxicillin or penicillin: are used to treat infections in the bladder or stomach, for example.

In addition to the use of these drugs, in some cases, the doctor may also recommend making changes to your diet, such as avoiding fried foods and soda, as well as eating less flatulent foods such as beans, chickpeas, lentils or eggs, since the diet is one of the main causes of abdominal pain.

In more severe cases where there is infection or inflammation of an organ, such as appendicitis or inflammation of the gallbladder, surgery may be recommended to remove the affected organ.

When can it be serious?

You should be alarmed when some signs appear together with the pain as they may indicate serious illnesses, such as inflammation or serious infections, and if you have any of them, go to the emergency room. Some examples of these signs are:

• Fever above 38ºC;
• Persistent or bloody vomiting;
• Stools with blood;
• Intense pain that wakes you up in the middle of the night;
• Diarrhea more than 10 times a day;
• Weight loss;
• Lethargy or paleness;
• Pain that appears after a fall or trauma.

A very serious symptom is when the pain radiates from the stomach area, like a burning sensation, because it may indicate a heart attack. So, if you also have shortness of breath, cold sweat, chest pain or if it radiates to the arms, you should seek immediate care.

Abdominal pain in pregnancy

Abdominal pain during pregnancy is common because of changes in the woman's uterus, as well as constipation, which are normal in this phase.

However, when pain gets worse over time or you also have other symptoms, such as bleeding, it can indicate more serious problems, like an ectopic pregnancy or miscarriage, and in these cases, an obstetrician should be consulted as soon as possible.

In addition, abdominal pain at the end of pregnancy is also normal and is usually related to the muscles, ligaments and tendons stretching. This is due to belly growth, so pregnant women should rest several times during the day.