Abdominal Pain (Stomach Ache)

Abdominal pain is pain that occurs between the chest and pelvic regions. Abdominal pain can be crampy, achy, dull, intermittent or sharp. It’s also called a stomachache.

Inflammation or diseases that affect the organs in the abdomen can cause abdominal pain. Major organs located in the abdomen include:

  • Intestines (small and large)
  • kidneys
  • appendix (a part of the large intestine)
  • spleen
  • stomach
  • gallbladder
  • liver
  • pancreas

Viral, bacterial, or parasitic infections that affect the stomach and intestines may also cause significant abdominal pain.

Technically, the lowermost portion of the area described previously, is the pelvis, which contains the urinary bladder and rectum, as well as the prostate gland in men, and the uterus, Fallopian tubes, and ovaries in women. Often, it can be difficult to know if lower abdominal pain is coming from the lower abdomen or pelvis. Occasionally, pain may be felt in the belly even though it is arising from organs that are close to, but not within, the abdominal cavity, for example, conditions of the lower lungs, the kidneys, and the uterus or ovaries. On the other hand, it also is possible for pain from organs within the belly to be felt outside of the it. For example, the pain of pancreatic inflammation may be felt in the back. These latter types of pain are described as "referred” because it does not originate in the location that it is felt. Rather, the cause is located away from where it is felt (i.e., it is referred to a different area).

Picture of the organs and glands in the abdomen

No health feed found.

Abdominal pain is caused by inflammation of an organ (for example, appendicitis, diverticulitis, colitis), by stretching or distention of an organ (for example, obstruction of the intestine, blockage of a bile duct by gallstones, swelling of the liver with hepatitis), or by loss of the supply of blood to an organ (for example, ischemic colitis).

To complicate matters, however, abdominal pain also can occur without inflammation, distention or loss of blood supply. An important example of the latter is the irritable bowel syndrome (IBS). It is not clear what causes the belly pain in IBS, but it is believed to be due either to abnormal contractions of the intestinal muscles (for example, spasm) or abnormally sensitive nerves within the intestines that give rise to painful sensations inappropriately (visceral hyper-sensitivity). This often is referred to as functional pain because no recognizable specific abnormality to account for the cause of the pain has been found - at least not yet.

  • Bloody stools
  • Black tarry stools
  • Dehydration
  • Painful urination
  • Lack of urination
  • Abrupt cessation of bowel movements
  • Dehydration

Medical history can reveal other abdominal problems or chronic illnesses (for example, angina) that may point you towards a diagnosis. Certain drugs are associated with gastrointestinal side effects. Non-steroidal anti-inflammatory agents increase risk of peptic ulceration and bleeding.

Gastroenteritis (stomach flu)

Abdominal pain may be caused by constipation, which puts pressure on the colon.

In this case, the abdominal pain is often accompanied by nausea, vomiting, and loose, fluid-filled stools that occur much sooner and more frequently than normal after eating.

Bacteria or viruses cause most cases, and symptoms usually resolve within a few days. Symptoms that last longer than 2 days may be a sign of more serious health problems, such as infection or inflammatory conditions, such as inflammatory bowel disease.

Common symptoms include:

  • nausea
  • vomiting
  • fever
  • abdominal cramping
  • bloating
  • gas

2. Gas

Gas occurs when bacteria in the small intestine break down foods that the body finds intolerant. An increased pressure of gas in the intestine can cause sharp pain. Gas can also cause tightness or restriction in the abdomen and flatulence or belching.

3. Irritable bowel syndrome (IBS)

For unknown reasons, those with IBS are less able to digest certain foods or types of foods.

Abdominal pain is the primary symptom for many people with IBS and is often relieved after a bowel movement. Other common symptoms include gas, nausea, cramping, and bloating.

4. Acid reflux

Occasionally stomach acids travel backward, moving up into the throat. This reflux almost always causes a burning sensation and accompanying pain. Acid reflux also causes abdominal symptoms, such as bloating or cramps.

5. Vomiting

Vomiting often causes abdominal pain as stomach acids travel backward through the digestive tract, irritating tissues along the way. The physical act of vomiting also may cause abdominal muscles to become sore.

6. Gastritis

When the stomach lining becomes inflamed or swollen, pain may occur. Nausea, vomiting, gas, and bloating are other common symptoms of gastritis.

7. Food intolerances

When the body is unable to digest food materials, they are broken down by intestinal and stomach bacteria, which release gas in the process. When large amounts of undigested materials are present, a lot of gas is produced, causing pressure and pain.

Nausea, vomiting, bloating, diarrhea, and abdominal pain are other symptoms.

8. Constipation

When the bowel becomes backed up with waste, the pressure on the colon is increased, which may cause pain.

9. Gastroesophageal reflux disease (GERD)

GERD can cause abdominal pain as well as heartburn and nausea.

10. Stomach or peptic ulcers

Ulcers or wounds that will not heal tend to cause severe and persistent abdominal pain.

The most common causes of stomach and peptic ulcers are the bacteria H. pylori and the overuse or continued use of non-steroidal anti-inflammatory medications (NSAIDS).

11. Crohn's disease

Crohn's causes inflammation of the digestive tract lining, which results in pain, gas, diarrhea, nausea, vomiting, and bloating. Given its chronic nature, the condition may lead to malnutrition, causing weight loss and exhaustion.

12. Celiac disease

An allergy to gluten, a protein found in many grains, such as wheat and barley, causes inflammation in the small intestine, resulting in pain.

Diarrhea and bloating are also common symptoms. Over time, malnutrition can occur, resulting in weight loss and exhaustion.

13. Pulled or strained muscles

Because many daily activities require the use of the abdominal muscles, injury or strain is common. Many people also focus heavily on abdominal exercises, increasing the risk of damage.

14. Menstrual cramps or endometriosis

Menstruation can cause inflammation and pain in the abdomen. Bloating, gas, cramping, and constipation can also occur during menstruation, causing abdominal discomfort.

Women who have endometriosis may experience more severe or chronic inflammation and pain.

15. Urinary tract and bladder infections

Urinary tract infections are most often caused by bacteria, primarily E.coli species, that colonize the urethra and bladder, causing a bladder infection or cystitis.

Symptoms include pain, pressure, and bloating in the lower abdominal area. Most infections also cause painful urination and cloudy, strong-smelling urine.

Uncommon causes

In some cases, abdominal pain is a sign of a medical condition that can be fatal without immediate medical care.

Less common causes of abdominal pain include:

  • appendicitis (ruptured appendix) or any other ruptured abdominal organ
  • kidney infection, disease, or stones
  • hepatitis (inflammation of the liver)
  • gallbladder stones (hard deposits in the gallbladder)
  • food poisoning
  • parasitic infections
  • abdominal organ infection or infarction (when the organ dies due to lack of blood supply)
  • cardiac conditions, such as atypical angina or congestive heart failure
  • organ cancer, notably stomach, pancreatic, or bowel cancer
  • hiatal hernia
  • cysts that have become invasive or compromise organ space or function
The cause of abdominal pain can be diagnosed through a series of tests. Before ordering tests, your doctor will do a physical examination. This includes gently pressing down on various areas of your abdomen to check for tenderness and swelling. This information, combined with the severity of the pain and its location within the abdomen, will help your doctor determine which tests to order.

Imaging tests, such as MRI scans, ultrasounds, and X-rays, are used to view organs, tissues, and other structures in the abdomen in detail. These tests can help diagnose tumors, fractures, ruptures, and inflammation.

Other tests include:

  • colonoscopy (to look inside the colon and intestines)
  • endoscopy (to detect inflammation and abnormalities in the esophagus and stomach)
  • upper GI (a special X-ray test that uses contrast dye to check for the presence of growths, ulcers, inflammation, blockages, and other abnormalities in the stomach)

Blood, urine, and stool samples may also be collected to look for evidence of bacterial, viral, and parasitic infections.

For other types of pain, acetaminophen (Aspirin Free Anacin, Liquiprin, Panadol, Tylenol) might be helpful. But stay away from non-steroidal anti-inflammatories (NSAIDs) like aspirinibuprofen (Advil, Midol, Motrin), or naproxen (Naprosyn, Aleve, AnaproxNaprelan). They can irritate your stomach.

Not all forms of abdominal pain are preventable. However, you can minimize the risk of developing abdominal pain by doing the following:

  • Eat a healthy diet.
  • Drink water frequently.
  • Exercise regularly.
  • Eat smaller meals.

If you have an intestinal disorder, such as Crohn’s disease, follow the diet your doctor has given you to minimize discomfort. If you have GERD, don’t eat within two hours of bedtime.

Lying down too soon after eating may cause heartburn and abdominal pain. Try waiting at least two hours after eating before lying down.

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