Lower abdominal pain is usually related to organs present in this area of the abdomen, like the uterus, bladder or intestines. The most common causes of pain in this region are usually not serious and usually involve abnormalities in the intestinal tract, like constipation or indigestion, or a urinary tract infection. 

The pain may also occur due to more serious reasons, or could be due to injury in other areas of the abdomen that radiate pain to the lower area. 

If pain is very intense, if it persists, or if it accompanied by other symptoms like vomiting, nausea or fever, you are advised to seek medical assistance to diagnose the problem and to initiate appropriate treatment. 

The most common causes of lower abdominal pain are: 

1. Abnormalities in the intestinal tract

Intestinal tract abnormalities, like diarrhea, contipation or built-up gas, can cause abdominal pain for many reasons. A common reason is food intolerances, like dairy or gluten intolerance, but pain can also occur with viral infections or gastroenteritis. Pain can also occur with increased gas production that results from certain foods, like milk, cauliflower and cheese. 

What to do: To treat diarrhea more quickly, you should avoid fatty foods, eggs, and milk. You can drink black tea or chamomile tea, or add a probiotic supplement to your daily diet. 

To treat constipation or gas, you should maintain a healthy diet that is rich in fivers and drink plenty of water. You should avoid carbohydrate-heavy foods like rice, potato and white bread. You can also massage the abdomen, beneath the belly button, in a right-to-left direction.  There are also many natural teas that can help get rid of gas. Fennel tea, for example, is a natural way to quickly get rid of gas, although you can check out our other tea recipes that help to move gas along the intestinal tract.

Be sure to check out other home remedies for gas relief.

2. Indigestion

Indigestion can also cause pain and swelling at the bottom of the belly, as well as other symptoms like heartburn, nausea, vomiting, diarrhea or constipation.  

What to do: Indigestion can be treated with foods that are easy to digest and do not irritate the stomach, like jello, smoothies, bread, and dry biscuits. You should avoiding drinking fluids when digesting. 

Some changes to diet habits can also relieve symptoms, like eating slowly, chewing thoroughly before swallowing, and avoiding talking while eating. 

In some cases, the doctor can recommend medication to relieve symptoms associated with indigestion, like Gaviscon or milk of magnesia. You can also opt for home remedies like boldo tea or sweetgrass tea, which both contain anti-inflammatory and digestive properties. 

3. Urinary tract infection

A urinary tract infection (or UTI) is usually caused by intestinal bacteria that enter the urinary tract. It is more common in women due to the close proximity of the anus to the urethra. Symptoms vary with each person, but most people normally experience pain with urination, as well as foul odor, blood in the urine and pain or a feeling of heaviness in the lower abdomen.

What to do: UTIs are usually treated with antibiotics like ciprofloxacin and cephelaxin, and with analgesics like acetaminophen or phenazopyridine, which should be taken as prescribed by your doctor. Learn about the prescription medication that is commonly prescribed, as well as the natural options you can take to complement treatment.

4. Kidney stones

Kidney stones that are not eliminated in the urine can become stuck in the urinary tact, causing intense pain and, many times, blood in the urine. This intense pain is normally felt in the lower back, but it can also be felt in the lower abdomen, groin or testicles. Learn more about the symptoms of kidney stones and what can cause them.

What to do: Treatment consists of use of an analgesic like acetaminophen or Tramadol, as well as an antispasmodic to help relax the urinary tracts and facilitate urinary flow to reduce pain. In addition, drinking plenty of water and reducing salt intake are small tips that can make a difference.

5. Menstrual cramps 

Also known as dysmennhoria, period cramps can also cause intense lower abdominal and back pain in women. If pain is intolerable, you should follow-up with your doctor or gynecologist to identify whether there is a problem with your reproductive organs. 

What to do: There are many ways to manage cramping with periods, like using birth control to regulate the menstrual cycle (learn about the different birth control options you can consider), or using anti-inflammatories or analgesics, like acetaminophen and ibuprofen, to relieve pain. 

In addition, you can also try some abdominal stretches to help relieve cramping, like lying on your back and hugging your knees to your chest. You can also apply a warm compress to the affected area or engage in some light exercise. 

6. Endometriosis

Endometriosis is an illness characterized by the growth of endometrial tissue outside of the uterus. It results in intense abdominal pain during menstruation that increases over time. This illness is often only diagnosed in its later stages, leading to difficulty getting pregnant.

What to do: Women who desire to get pregnant can treat endometriosis by using oral birth control, hormonal medication or by using an intra-uterine device. Surgery may also be indicated to remove endometrial tissue that has spread. In women who are not planning to get pregnant, surgery to remove the uterus and any migrated tissue may be advised.  

7. Ovarian cysts

An ovarian cyst is characterized by a sac of fluid that growth inside or on the ovary, and it may or may not affect fertility. Large ovarian cysts can cause symptoms like pelvic pain or pain during sex, late periods, bleeding, nausea, vomiting and excessive fatigue. 

What to do: Treatment can vary depending on the type of cyst. It may resolve just be changing birth control, but in more serious cases, surgical removal may be necessary. 

8. Pregnancy

One of the first symptoms of pregnancy is cramping or abdominal swelling, due to increased blood flow to the pelvic area and due to evolving pelvic changes. In addition, around the 7th week of pregnancy, the area below the bellybutton starts to harden. 

What to do: Pain that occurs due to pregnancy can be managed by ensuring adequate fluid intake, ensuring you eat easy-to-digest foods and avoiding food with high fiber content like grains, fruit with their peels and legumes. If pain is very intense, you should see your doctor. 

9. Ectopic pregnancy 

Although lower abdominal pain is common during pregnancy, if it is very intense, it can be caused by an ectopic pregnancy. This occurs when the embryo starts to develop outside of the uterus, which can cause intense pain to one side of the abdomen, as well as abdominal swelling and vaginal bleeding. 

What to do: Treatment depends on the location of the embryo and the gestational age. It can involve use of medications to terminate the pregnancy, or a surgery to remove the embryo and reconstruct the ovarian tube. 

10. Pelvic inflammatory disease 

This condition is characterized by an infection that starts in the vagina or cervix that reaches the endometrium, ovaries and fallopian tubes. It can last for a few days, or it can become chronic, lasting for months or even years. The infection can be caused by a sexually transmitted infection, or it can be a result of vaginal procedures, like surgery or insertion of an IUD, that promote the growth of vaginal bacteria. 

In addition to lower abdominal pain, some people also experience faver, white or yellow vaginal discharge, and pain with sex.

What to do: Treatment involves the use of antibiotics for about 14 days. During treatment, you should limit or avoid sexual contact. If you use an IUD, it should be removed. 

11. Inguinal hernia

An inguinal hernia is more commonly seen in men and it consists of a small, protruding lump in the groin area. The lump is a part of the intestine that has poked through a weakened part of the abdominal wall. It causes pain and discomfort with some movement, like lifting or bending over. Learn more about the symptoms of an inguinal hernia and what causes them.

What to do: The best way to treat inguinal hernias is with surgery, in which the protruding portion of the intestine is returned to its original spot in the abdomen and the muscular wall is reinforced. This surgery is relatively simple and has a quick recovery. 

12. Testicular torsion

Testicular torsion is a problem that occurs in young boys. It is characterized by a testicle wrapping around the sperm canal, resulting in decreased circulation. It can lead to serious testicular injury if left untreated. The most common symptoms are intense testicular pain with swelling and increased scrotal sensitivity, as well as abdominal and groinal pain.  

This type of problem is more common in men who:

  • have some type of a testicular tumour,
  • have a family history of a horizontal lie of the testicle
  • have a history of incomplete descended testicles
  • have a large spermatic cord 

What to do: Treatment should be initiated as quickly as possible in the hospital. It usually involves surgical intervention, with placement of the testicle back to the correct spot to allow for adequate blood flow and prevent tissue death.

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Atualizado por Tua Saude editing team, em February de 2022. Medical review por Dr. Clarisse Bezerra - Family Doctor, em January de 2022.
Medical review:
Dr. Clarisse Bezerra
Family Doctor
Dr. Bezerra possesses a medical degree and specializes in family medicine. She is licensed to practice under CRM-CE licence #16976.