Abdominal Pain (Causes, Remedies, Treatment)

  • Medical Author:
    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

  • Medical Author: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    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.

  • Medical Editor: Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)
    Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)

    Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)

    Dr. Anand received MBBS degree from Medical College Amritsar, University of Punjab. He completed his Internal Medicine residency at the Postgraduate Institute of medical Education and Research, Chandigarh, India. He was trained in the field of Gastroenterology and obtained the DPhil degree. Dr. Anand is board-certified in Internal Medicine and Gastroenterology.

Quick GuideWhat's Causing Your Abdominal Pain?

What's Causing Your Abdominal Pain?

Signs, symptoms, locations, types, and severity of abdominal pain

Doctors will ask you a variety of questions about your belly pain in order to help find the possible causes of it, for example:

How did the pain begin?

  • If it comes on suddenly, this may suggest a problem with an organ within the belly; for example, the interruption of the supply of blood to the colon (ischemia) or obstruction of the bile duct by a gallstone (biliary colic).

Where is the pain located?

  • Appendicitis typically causes discomfort in the middle of the abdomen, and then moves to the right lower abdomen, the usual location of the appendix.
  • Diverticulitis typically causes discomfort in the left lower abdomen where most colonic diverticuli are located.
  • Discomfort from the gallbladder (biliary colic or cholecystitis) typically is felt in the middle, upper abdomen or the right upper abdomen near where the gallbladder is located.

What is the type and pattern of the pain?

  • Is it severe, crampy, steady; or does it wax and wane? Obstruction of the intestine initially causes waves of crampy pain due to contractions of the intestinal muscles and distention of the intestine. True cramp-like pain suggests vigorous contractions of the intestines.
  • Obstruction of the bile ducts by gallstones typically causes steady (constant) upper belly pain that lasts between 30 minutes and several hours.
  • Acute pancreatitis typically causes severe, unrelenting, steady pain in the upper abdomen and upper back.
  • The pain of acute appendicitis initially may start near the umbilicus, but as the inflammation progresses, it moves to the right lower abdomen.
  • The character of pain may change over time. For example, obstruction of the bile ducts sometimes progresses to inflammation of the gallbladder with or without infection (acute cholecystitis). When this happens, the characteristics change to those of inflammatory pain.

How long does the pain last?

  • The discomfort of IBS typically waxes and wanes over months or years and may last for years or decades.
  • Biliary colic lasts no more than several hours.
  • The pain of pancreatitis lasts one or more days.
  • The pain of acid-related diseases - gastroesophageal reflux disease (GERD) or duodenal ulcers - typically occurs over a period of weeks or months that is worse followed by periods of weeks or months during which it is better (periodically).
  • Functional pain may show this same pattern of periodicity.

What makes the pain worse?

  • Pain due to inflammation (appendicitis, diverticulitis, cholecystitis, and pancreatitis) typically is aggravated by sneezing, coughing or any jarring motion. Individuals with inflammation prefer to lie still.
  • What health conditions make abdominal pain worse or better?

What relieves the pain?

  • The pain of IBS and constipation often is relieved temporarily by bowel movements and may be associated with changes in bowel habit.
  • Pain due to obstruction of the stomach or upper small intestine may be relieved temporarily by vomiting which reduces the distention that is caused by the obstruction.
  • Eating or taking antacids may temporarily relieve ulcer pain from the stomach or duodenum because both food and antacids neutralize the acid that is responsible for irritating the ulcers and causing the pain.
  • Pain that awakens a patient from sleep is more likely to be due to non-functional causes and is more significant.
  • Other associated symptoms that accompany abdominal pain may suggest:
  • Fever suggests inflammation or infection.
  • Diarrhea or rectal bleeding suggests an intestinal cause.
  • Fever and diarrhea suggest inflammation of the intestines that may be infectious or non-infectious.
  • How is the cause of abdominal pain diagnosed?
  • Doctors determine the cause of the pain by relying on:
  • Its characteristics, physical signs, and other accompanying symptoms
  • Findings on physical examination
  • Medical laboratory, radiological, and endoscopic testing
  • Surgery

How is the cause of abdominal pain diagnosed?

Doctors determine the cause of the pain by relying on:

  1. Characteristics, physical signs, and other accompanying symptoms
  2. Findings on physical examination
  3. Laboratory, radiological, and endoscopic testing
  4. Surgery
Reviewed on 2/27/2017

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

Penner, RB., MD. et al. "Evaluation of the adult with abodminal pain." UptoDate. Updated: Feb 22, 2016.
<http://www.uptodate.com/contents/evaluation-of-the-adult-with-abdominal-pain> IMAGES:




4.Getty Images

5.Getty Images

Subscribe to MedicineNet's Newsletters

Get the latest health and medical information delivered direct to your inbox!

By clicking Submit, I agree to the MedicineNet's Terms & Conditions & Privacy Policy and understand that I may opt out of MedicineNet's subscriptions at any time.

Health Solutions From Our Sponsors