Abdominal pain is mainly caused by changes in the bowel, stomach, bladder, gallbladder or uterus. Where the pain is felt will depend on the organ that is having functional problems. For example, pain that appears on the upper left side of the abdomen may indicate a gastric ulcer in the stomach, whereas pain on the upper right side may indicate problems with the liver.
Reasons for pain vary from simple situations, like excessive gas, to more complicated ones, like appendicitis or kidney stones.
Therefore, if you are experiencing severe abdominal pain, if it lasts for over 24 hours or if you are experiencing other symptoms, like fever, vomiting and blood in the stool or urine, you should seek medical attention immediately.
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:
Abdominal region (The number indicates where the region is in the image) | ||
| Right side | Middle | Left side |
| 1 | 2 | 3 |
Gallstone or gallbladder inflammation; Liver disease; Problems in the right lung; Excessive gas. | Acid reflux; Bad digestion; Gastritis; Gallbladder inflammation; | Gastric ulcer; Problems in the left lung; Excessive gas. |
| 4 | 5 | 6 |
Inflammation of the intestine; Excessive gas; Gallbladder inflammation; Renal colic; Spinal problems. | Gastric ulcer; Pancreatitis; Gastroenteritis; Early stage of appendicitis; Constipation. | Inflammation of the intestine; Excessive gases; Renal colic; Spinal problems. |
| 7 | 8 | 9 |
Excessive gas; Inflammation of the intestine; Ovarian cyst. | Menstrual cramps; cystitis or urinary infection; Diarrhea or constipation; Irritable colon; Bladder problems. | Inflammation of the intestine; Excessive gas; |
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 gas, 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. These causes 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 felt in the stomach and happens with gastritis, a stomach ulcer or acid reflux.
- Colic pain: Problems in the gut, such as diarrhea or constipation, and also in the gallbladder, can appear as a colic or cramping. This type of pain can also appear due to uterine pain related to menstruation.
- Stabbing or sharp pain: pain caused by accumulated 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 an assessment of the patient’s personal history.
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 once assessment is complete and testing confirms a diagnosis. Some of the most commonly used remedies for treating minor problems are:
- Antacids: e.g. such as omeprazole or ranitidine, which are used in cases of pain in the stomach area that is caused by poor digestion, acid reflux or gastritis;
- Anti-flatulents or antispasmodics: e.g. dimethicone or buscopan, which relieve pain caused by excessive gas or diarrhea;
- Laxatives: e.g. such as lactulose or mineral oil, which speed up the intestinal flow to treat constipation;
- Antibiotics: e.g. such as amoxicillin or penicillin, which are used to treat infections in the bladder or stomach.
In addition to prescribing medication, the doctor may also recommend making diet changes, as diet is one of the main causes of abdominal pain. Some suggestions may include avoiding fried foods and soda or eating less gas-inducing foods like beans, chickpeas, lentils or eggs. Learn more about foods that cause gas and bloating.
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 is it serious?
You should be concerned when other signs appear with the pain as they may indicate serious illnesses like organ inflammation or serious infections. Some examples of symptoms that require medical attention include:
- Fever above 38ºC (100.4ºF);
- 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.
Another serious symptom is when burning pain radiates away from the stomach area, as it may be a sign of a heart attack. If you feel this symptoms along with shortness of breath, cold sweats, and chest pain, you should proceed immediately to the emergency room.
Abdominal pain in pregnancy
Abdominal pain during pregnancy is common and usually occurs due to changes in the uterus and/or constipation, which are both normal findings.
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. In these cases, you should seek prompt medical attention.
Abdominal pain at the end of pregnancy is also normal and is usually related to stretching of the muscles, ligaments and tendons that happens with belly growth. Pregnant women are advised to rest as much as possible to avoid pain.
