Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Abdominal pain is pain or discomfort that a person feels anywhere between the lower chest to the distal groin. Some health care professionals include the
diaphragm, pelvis (and genitals) and the retroperitoneal space. Chest and abdominal pain are the two top reasons why people go to emergency rooms,
according to the CDC.
What are the ways to describe abdominal pain?
There are three general categories that are often used to describe abdominal pain:
The location of pain,
The quality or type of pain and
The intensity of the pain.
Other qualifiers and questions are often used to describe these features:
Does the pain radiate anywhere?
Does the pain come and go?
What makes the pain better or worse?
The health care professional will ask the patient many other questions about the abdominal pain they are experiencing. The
goal of this article is to help readers understand that abdominal pain is common, and that the patient can help the doctor diagnose the source of abdominal
discomfort or pain by simply focusing on the location, type, and intensity of pain. In addition, this general article will describe some of the reasons why
some causes of abdominal pain are often difficult to identify initially. It is important to understand that although many times abdominal pain does not
represent a serious problem, at other times the pain indicates a medical emergency. Discerning the difference between serious and non-serious causes of
abdominal pain is sometimes a difficult challenge that you and your doctors face.
First, to understand the complexity of the diagnosis, a basic knowledge of the abdomen and its contents is needed. The illustration below is a diagram of the
abdomen and most of its contents (diaphragm, pelvis, genitals, mesentery and retroperitoneal space are not shown). The diagram also shows the various
areas of the abdomen that help define the location of pain and discomfort.
The abdomen can be roughly subdivided several ways; all of these ways (terms)
have appeared in the medical literature:
Upper abdomen (horizontal line about the level of the umbilicus), lower,
Right upper and lower,
Left upper and lower, and
Pelvis (right and left).
Using the illustration, most of the organs in the abdominal area can be seen. Those that are not shown can be localized easily (for example, the kidneys, ureters
and bladder located mainly in the lower abdomen, both left and right kidneys in the retroperitoneal space, behind the intestines with the bladder located in the
central pelvis area in front of the lower intestines). Using this type of diagram, you and your doctor may more easily localize abdominal pain and its
The type of pain may also give some clues as to the cause of abdominal pain. Unfortunately, sometimes the pain is diffuse; this can complicate the
However, there are some types of pain that can help narrow the diagnosis. There are several types of pain: sharp, dull, stabbing, tearing, cramps, twisting,
pressure, and bloating but patients may describe many others. The type of pain may be further described as constant, intermittent, variable, and modified by
movement, eating, bowel movements, walking, or changed by other situations like
stress or certain medications.
The doctor often enquires about the intensity of the pain, usually on a scale of 1 to 10, with 10 as the most pain (causes crying and inability to function or
move, for example). Just as the type of pain may be further described, the intensity of pain may be characterized as constant, intermittent, variable, and
changed by movement, eating, bowel movements, walking, or modified by other situations like stress or certain medications.
Pain in the belly (abdomen) can come from conditions affecting a variety of organs. The abdomen is an anatomical area that is bounded by the lower margin of the ribs above, the pelvic bone (pubic ramus) below, and the flanks on each side. Although abdominal pain can arise from the tissues of the abdominal wall that surround the abdominal cavity (for example, skin and abdominal wall muscles), the term abdominal pain generally is used to describe pain originating from organs within the abdominal cavity (for example, beneath the skin and muscles). These organs include the stomach, small intestine, colon, liver, gallbladder, and pancreas. Occasionally, pain may be felt in the abdomen even though it is arising from organs that are close to but not within the abdominal cavity, for example, the lower lungs, the kidneys, and the uterus or ovaries. This latter type of pain is called "referred" pain because the pain, though originating outside the abdomen, is being referred to (felt) in the abdominal area
Colonoscopy is a procedure that enables an examiner (usually a gastroenterologist) to evaluate the appearance of the inside of the colon (large bowel). This is accomplished by inserting a long flexible tube (the c"...