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All You Need to Know About Abdominal Pain

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Abdominal pain can be attributed to several causes. What can seem like a harmless stomachache, can be caused by organs outside your digestive system or by organs in your abdomen. If your abdominal pain is severe, persistent, and unexplained, seek medical care right away.

Abdominal Pain Explained

Abdominal pain refers to any discomfort that you feel anywhere in your belly region—the area between your pelvis and ribs. While many people perceive abdominal pain as stomachache or stomach pain, it is possible that pain can come from other organs as well. 

The abdomen is home to the:

While stomach pain can be caused by the organs found in the digestive system, pain can also originate in the outer shell (i.e., muscles and skin) or in the abdominal wall. In some cases, the pain felt in the belly can come from somewhere else like the back, pelvis, or chest.

Types of Abdominal Pain

Abdominal pain can mean different things and can take on several forms. For instance, it can feel:

  • Colicky or crampy
  • Severe or mild
  • Achy or burning
  • Intermittent or constant
  • Localized (in one spot)
  • Generalized (all over)

Not all abdominal pain will feel the same. For instance, if you have acute abdominal pain, it is likely that you have dealt with the discomfort for a week or less. On the other hand, chronic abdominal pain is recurring and constant. 

Chronic abdominal pain can last for 3 months (or longer). Since there are some systemic and gastrointestinal disorders that result in abdominal pain, doctors need to identify the root cause of the pain. 

Progressive abdominal pain is the type that worsens over time. In most cases, other symptoms can manifest as the pain progresses. Progressive abdominal pain is caused by a serious medical condition. 

At one point or another, people will experience abdominal pain. Often, the cause is not serious and will resolve by itself. Other times, it can also be caused by a serious underlying condition or even an emergency. At least 5% of emergency room visits are attributed to abdominal pain.

The Four Areas of Abdominal Pain

Since the abdomen is home to many organs, the kind of pain you will have will be narrowed down to the region you are feeling it in. Typically, your doctor will divide the abdomen into four parts or quadrants. They will ask if the pain is located in the following:

  • Right upper quadrant
  • Left upper quadrant
  • Right lower quadrant
  • Left lower quadrant

Causes of Abdominal Pain

While many conditions can result in abdominal pain, some of the primary causes include:

  • Illnesses that affect the organs found in the abdomen
  • Inflammation
  • Obstruction (blockage)
  • Abnormal growths
  • Infection
  • Intestinal disorders

Infections in the blood, intestines, and throat can cause bacteria to enter the digestive tract and cause abdominal pain. Infections might also cause changes in digestion such as constipation or diarrhea. Cramps that are caused by menstruation can be another likely source of lower abdominal pain.

The lower region of the abdomen is where the colon is located. Lower abdominal pain can be caused by different conditions that affect the intestines, reproductive organs, or the urinary system. Pain located near the colon or the large intestine can indicate:


Hernia is the protrusion of the organs through the fat or muscles that surround them. Symptoms of hernia include:

  • Obvious swelling or lump
  • Heartburn
  • Heavy feeling in the abdomen
  • Pain when moving


Appendicitis is the inflammation of the appendix found at the end of the intestines. Some of the common symptoms of appendicitis include:

  • Fever
  • Abdominal swelling
  • Nausea
  • Vomiting
  • Loss of appetite
  • Dull pain that becomes sharp when it moves from the middle to the lower abdomen

Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease is the condition that affects the different parts of the colon. This includes ulcerative colitis and Crohn’s disease. Symptoms of IBD include:

  • Blood in stools
  • Weight loss
  • Abdominal pain
  • Bloating
  • Visible colon damage (when viewed internally)

Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome is a common problem with digestion that affects your bowel habits. Common symptoms of IBS include:

  • Constipation or diarrhea
  • Irregular bowel movements
  • Gas and bloating
  • Stomach cramps


Diverticulitis refers to the inflammation of small pouches known as diverticula. The infection develops along the walls of the intestine. Some of the common symptoms of diverticulitis include:

  • Fever
  • Cramping (commonly on the stomach’s left side)
  • Blood in the stool
  • Severe abdominal pain

Pain in the lower abdomen can also be the result of bladder issues like:

Urinary Tract Infection (UTI)

This condition develops when bacteria enters the urethra and the bladder gets infected. UTI can also cause kidney issues. Some of the symptoms of UTI include:

  • Dark, cloudy or bloody urine
  • Pain in the abdomen
  • Burning sensation when urinating
  • Constant urge to urinate

Acute Retention of Urine

This occurs when you are unable to empty your bladder (even when it is still full). Common symptoms include:

  • Leaking urine (however, not enough to feel relief)
  • Pain in the lower abdomen
  • Inability to urinate

Bladder Stones

These are the hard masses of minerals found in your urine. Common symptoms of bladder stones include:

  • Dark or cloudy urine
  • Blood in the urine
  • Burning sensation when urinating
  • Uneven flow of urine
  • Difficulty urinating
  • Back pain that radiates to the groin

Bladder Cancer

This occurs when cancerous tumors or cells develop in the bladder. Some of the symptoms include:

  • Dark red, orange, or pink blood in the urine
  • Burning sensation or pain when urinating
  • Constant feeling to urinate
  • Inability to urinate
  • Aching bones
  • Swollen feet

When to See a Doctor

Mild abdominal pain can go away even without treatment. Case in point: if you are experiencing pain in the abdomen because of bloating or gas, it just needs to run its course. 

However, some cases of abdominal pain can warrant a visit to the doctor. You need to seek immediate medical care if the abdominal pain is severe and associated with trauma from injury or accident or pain or pressure in your chest.

You should also seek immediate medical attention if the abdominal pain is so severe that you need to curl into a ball just to get comfortable, you can’t sit still, or if you have the following symptoms:

  • Difficulty breathing
  • Severe pain or swelling of the abdomen
  • Persistent vomiting or nausea
  • Bloody stools
  • Vomiting blood (called hematemesis)
  • Yellowing of the eyes or skin
  • Fever (38°C or higher)

Visit your doctor immediately if you also notice any of the following symptoms:

  • Unexplained weight loss
  • Fever
  • Loss of appetite
  • Abdominal pain lasting over 24 hours
  • Prolonged constipation
  • Vomiting
  • Burning sensation when urinating

Abdominal Pain Diagnosis

The primary cause of abdominal pain can be diagnosed through several tests and an honest discussion with your doctor about the symptoms you are experiencing. Prior to ordering any tests, your doctor will first conduct a physical examination. 

This can include gently pressing certain areas of the abdomen to check for swelling or tenderness. Your doctor might also ask about the following:

  • Where the exact location of the pain is
  • Does the pain move or does it stay in one location
  • The severity of the pain
  • If the pain is constant or does it come and go in waves
  • If the pain interferes with your daily life
  • What you did when the pain began
  • The time of the day when the pain feels the worst
  • Your last bowel movement
  • If your bowel movement is regular
  • If you noticed any noticeable changes in your urine
  • If you have made any major changes to your diet

The location of the pain and the severity can help doctors determine the kind of tests to order. Imaging tests like ultrasounds, X-rays, MRI scans will be used to view in detail the tissues, organs, and other structures in the abdomen. The tests can also help diagnose fractures, ruptures, tumors, and inflammation.

Other possible tests that will be recommended can include:

  • Colonoscopy – done to check inside the intestines and colon
  • Upper gastrointestinal studies – special X-ray that checks for the presence of inflammation, blockages, ulcers, growths, and other abnormalities
  • Gastroscopy – This detects abnormalities and inflammation in the stomach and esophagus

Stool, urine, and blood samples may also be collected to check for viral, parasitic, and bacterial infections.

How to Prevent Abdominal Pain

While not all types of abdominal pain can be prevented, you can minimize the risk of developing the condition by:

  • Drinking adequate amounts of water
  • Exercising regularly
  • Eating a healthy diet

Those with intestinal disorder such as Crohn’s disease should follow a diet specified by the doctor to minimize the discomfort. If you have GERD (gastroesophageal reflux disease), it is recommended that you don’t eat within 2 hours before your bedtime. 

Also, if you lie down right away after eating, you might experience abdominal pain and heartburn. Wait for at least 2 hours after eating before lying down. If you experience abdominal pain, you must not jump to conclusions. Visit your doctor first so you can be properly evaluated to ensure the right course of treatment.

Dr Frances Lim

SAB accredited (Since 2010)



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