Abdominal Pain: Types, Common Causes and When to Be Seen

What it involves

MedlinePlus defines abdominal pain as pain that you feel anywhere between your chest and groin, often called the stomach region or belly. It says almost everyone has it at some point and that most of the time it is not serious. It also warns that how bad the pain is does not always reflect how serious the cause is: severe pain can come from gas or a stomach virus, while some dangerous conditions cause only mild pain.

Who this is for

• Patients with belly pain that has lasted more than a day or two, or keeps coming back
• Patients with pain that comes with nausea, vomiting, bloating, or a change in bowel habits
• Patients who want to know whether new belly pain needs the ER or a regular visit
• Patients with a known digestive, kidney, or urinary condition whose pain has changed

What to expect

• Questions about where the pain is, what it feels like, when it started, and what makes it better or worse
• A physical exam of the belly, with questions about your medicines and recent injuries
• Tests chosen to fit the findings, which may include blood work, a urine test, or imaging through a referral
• A clear plan on comfort measures, follow-up timing, and the warning signs that mean returning or going to the ER

What the pattern of pain can suggest

MedlinePlus describes four patterns that help a provider narrow the cause:

• Generalized pain over more than half the belly is more typical of a stomach virus, indigestion, or gas
• Localized pain in one area is more likely a problem in an organ such as the appendix, gallbladder, or stomach
• Cramp-like pain is often gas and bloating, and is usually not serious
• Colicky pain that comes in waves is often from kidney stones or gallstones

Less serious causes and more serious ones

MedlinePlus lists constipation, irritable bowel syndrome, food allergies or intolerance such as lactose intolerance, food poisoning, and the stomach flu among the less serious causes. Others it lists include appendicitis, gallbladder inflammation, diverticulitis, kidney stones, pancreatitis, ulcers, hernia, and urinary tract infections. Our guides on heartburn and reflux, urinary symptoms, and stomach flu and dehydration cover three of the most common. Pain in the right upper abdomen that lasts at least 30 minutes may come from the gallbladder, and the gallstones guide explains the symptoms and tests MedlinePlus lists.

Go to the ER or call 911

MedlinePlus says to get medical help right away if you are being treated for cancer, cannot pass stool especially with vomiting, are vomiting blood or have blood in your stool, have chest, neck, or shoulder pain, or have sudden sharp abdominal pain. It also lists a tender, rigid, hard belly, a recent injury to the abdomen, difficulty breathing, and being pregnant or possibly pregnant. These are not situations for a routine visit. The sick visit versus urgent care versus ER guide sorts the settings.

When to call the office instead

MedlinePlus says to contact your provider for abdominal discomfort that lasts a week or longer, pain that does not improve in 24 to 48 hours or becomes more severe with nausea and vomiting, bloating that persists more than two days, diarrhea for more than five days, a fever over 100 degrees Fahrenheit with the pain, burning with urination, prolonged poor appetite, unexplained weight loss, or being unable to keep down any food or liquid. The unexplained weight gain and loss page helps if the scale is part of the story.

Easing mild pain at home

For mild pain, MedlinePlus suggests sipping water or other clear fluids, avoiding solid food for the first few hours, and, if you have been vomiting, waiting 6 hours before eating small amounts of mild foods such as rice, applesauce, or crackers. It suggests avoiding dairy products, and says antacids may help pain high in the belly after meals. It advises against taking any medicine without talking to your provider, and says people with diabetes must check blood sugar often and adjust their medicines as needed. Crampy pain with gas and a swollen belly has its own list of causes, and the bloating and gas guide explains which signs mean contacting a provider.

What your provider will ask you

MedlinePlus says your provider will do a physical exam and ask where the pain is, whether it is all over or in one spot, whether it moves into your back or groin, how severe and constant it is, whether it wakes you at night, and when it happens, for example after meals. They will also ask about your medicines, recent injuries, and pregnancy. Writing down your answers beforehand saves time. Liver numbers are sometimes part of the follow-up, as the liver function tests guide explains.

Sources

• MedlinePlus — Abdominal pain
• MedlinePlus — Abdominal Pain (Health Topic)