Abdominal pain is pain that occurs between the chest and pelvic regions. It is one of the most common reasons people see their doctor or visit the emergency room. There are many possible causes of abdominal pain, from minor and temporary conditions to serious diseases. Knowing the most frequent causes of abdominal pain can help determine whether the pain is likely to resolve on its own or may require medical treatment. This article will review the most common types of abdominal pain in adults, their characteristics, what tests may be required, and treatment options.
Most Common Types of Abdominal Pain
Gas Pain
Gas pain is one of the most prevalent reasons people experience abdominal discomfort. Gas pain results from increased gas production and buildup in the gastrointestinal tract. Typical symptoms include bloating, pressure, cramping, and sharp pains that may come and go. Gas pain is usually temporary and improves with passing gas or having a bowel movement. Dietary changes to avoid gas-producing foods and over-the-counter medications that reduce gas production can relieve gas pain. If it persists, a doctor may do tests to look for underlying gastrointestinal conditions.
Constipation
Constipation is having infrequent, difficult, or incomplete bowel movements. It affects 16-33% of people and becomes more common with age. Symptoms include hard stool, straining, abdominal swelling, discomfort, and pain. Occasional constipation is usually temporary, but chronic constipation may result from poor diet, inadequate fluid intake, certain medications, hypothyroidism, or colorectal cancer. Tests like bloodwork, colonoscopy, or CT scan may be required. Adding fiber, exercising, and over-the-counter laxatives can often relieve constipation.
Indigestion
Indigestion causes burning sensations in the upper abdomen, bloating, early fullness with meals, and pain. It happens when stomach acids irritate the stomach lining or esophagus. Common causes are spicy or fatty foods, smoking, excess alcohol, stress, eating too fast, gastric ulcers, gastritis, and gastroesophageal reflux disease (GERD). Antacids, H2 blockers, proton pump inhibitors, or prokinetics may relieve symptoms. If severe or persistent, endoscopy, ultrasound, CT scan, or testing for H. pylori infection could be done.
Diverticular Disease
Diverticula are small pouches that bulge outward in weak spots of the colon wall, usually around the sigmoid colon. Diverticulosis affects over 60% of people over 50. Complications like diverticulitis with infection or bleeding can cause abdominal pain. Diverticulitis symptoms include fever, nausea, vomiting, sharp abdominal cramps, constipation or diarrhea. Diagnosis involves CT scan, colonoscopy, blood tests, or ultrasound. Treatment may require antibiotics, pain relievers, liquid diet, and surgery in severe cases.
Food Poisoning
Consuming contaminated food or water gives bacteria, viruses, or parasites that cause food poisoning. Symptoms like nausea, vomiting, diarrhea, fever, chills, and abdominal cramps start hours to days after exposure. Mild food poisoning usually resolves within 24 hours, while severe cases may require hospitalization. Diagnosis is mostly based on symptoms. Treatment involves rest, hydration, and sometimes antibiotics or anti-nausea medication. Preventing food poisoning involves safe food handling and cooking practices.
Kidney Stones
Kidney stones are crystalized minerals that form in the kidneys and travel to the ureters and bladder. Typical symptoms are intense flank, abdominal, or groin pain, nausea, vomiting, painful urination, blood in urine, and fever and chills. Stones under 5mm usually pass on their own, while larger ones may require lithotripsy or surgery. CT scan or ultrasound confirm diagnosis. Pain control, hydration, diuretics, or alpha-blockers help pass the stones. Prevention involves increased fluids, dietary changes, and sometimes medication.
Appendicitis
Appendicitis is inflammation of the appendix causing abdominal pain. It affects about 5% of the population, usually between ages 10-30. Typical features include pain starting around the navel before localizing to the lower right abdomen, loss of appetite, nausea, vomiting, fever, and abdominal swelling. It is considered a medical emergency since a ruptured appendix can be life-threatening. Diagnosis often uses CT scan, ultrasound, MRI, or laparoscopy. Treatment is surgical removal of the appendix.
Abdominal Muscle Strains
Straining or overstretching the abdominal muscles leads to tears in the muscle fibers and surrounding connective tissue. This often causes mild to moderate pain in the abs that worsens with movement or coughing. Diagnosis is based on physical exam. Initial treatment is rest, ice packs, NSAIDs, and avoiding activities that aggravate the injury. Healing takes several weeks. Severe injuries may require imaging tests and surgery. Preventive measures include proper warm-up, technique, hydration, and not overtraining.
Ulcers
Ulcers are open sores that develop on the lining of the stomach, esophagus, or small intestine. Pain is often described as burning, dull, or gnawing and comes and goes when the stomach is empty. Ulcers are usually caused by H. pylori infection or regular use of NSAIDs. Diagnosis often involves endoscopy and biopsy. Treatment includes antibiotic therapy if H. pylori is present, stopping NSAIDs, acid suppression medication, and medications to protect stomach lining.
Gallstones
Gallstones are hardened deposits of digestive fluid that can form in the gallbladder. Symptoms include sharp, cramping pain in the upper right or middle abdomen, nausea, vomiting, fatty food intolerance, gas, and bloating. Gallstones can block bile ducts, causing more severe pain and jaundice. Diagnosis uses ultrasound, CT scan, or MRI. Most gallstones do not require treatment. Those causing complications may be treated by surgically removing the gallbladder. Medications can help dissolve some small stones.
Irritable Bowel Syndrome (IBS)
IBS is a chronic disorder of how the brain and gut interact, causing abdominal pain, bloating, and changes in bowel habits. It affects 10-15% of people. Symptoms tend to flare up during stress. Tests are done to rule out other conditions. Treatment focuses on dietary changes, stress management, exercise, and sometimes medication for pain, constipation or diarrhea. Antidepressants in low doses can also help reduce IBS symptoms. IBS is usually managed with lifestyle modifications.
When to See a Doctor
Red Flag Symptoms
See a doctor promptly or visit urgent care or the ER if abdominal pain is severe or you have:
- Diffuse pain not localized to one area
- Fever over 101°F (38°C)
- Uncontrolled nausea and vomiting
- Blood in vomit or stool
- Signs of shock like excessive sweating, skin cold to touch, lightheadedness
- Inability to pass gas or stool
- Pain that persists for more than 4-6 hours
These red flag symptoms can indicate a serious medical issue requiring emergency care, like appendicitis, bowel obstruction, ulcer perforation, diverticulitis, or cholecystitis. Better to be safe when severe or concerning symptoms accompany abdominal pain.
Persisting Symptoms
See your doctor if abdominal pain lasts more than a few days and is not improving with home treatment or is interfering with daily activities. Also make an appointment if you experience bothersome abdominal symptoms more than 3 times per week or if symptoms recur. Recurrent or persistent symptoms may indicate an underlying chronic digestive disorder that needs medical diagnosis and management.
Pain with Vomiting, Diarrhea, Constipation
Unexplained abdominal pain that occurs with vomiting, diarrhea, or constipation may require medical evaluation. Causes could include gastroenteritis, IBS, Crohn’s disease, ulcerative colitis, blockages, and cancers. Testing like bloodwork, stool analysis, endoscopy, colonoscopy, ultrasound, CT scan or MRI may be needed to check for these conditions. Treatment depends on the cause but may include medication, diet changes, or surgery.
Sudden and Severe Pain
Abdominal pain that comes on suddenly and is severe could be due to trauma, appendicitis, kidney stones, diverticulitis, gallstones, pancreatitis, ulcer perforation, bowel obstruction or aneurysm. Seek prompt medical attention, as some of these can rapidly deteriorate and even become life threatening if not treated urgently. Evaluation typically includes imaging tests and possibly surgery. Don’t wait with sudden, extreme abdominal pain that leaves you doubled over.
Pain After 50 Years Old
The likelihood of developing serious medical conditions rises as we age, so unexplained abdominal pain after age 50 needs medical assessment. Concerning causes include cancer, pancreatitis, diverticulitis, gallstones, ulcers, IBS, and infections like viral gastroenteritis. Blood in the stool, unintentional weight loss, or anemia are also warning signs. Evaluation often includes colonoscopy, endoscopy, CT scans, and testing for anemia.
Diagnostic Tests
Some common diagnostic tests used to evaluate abdominal pain include:
Blood Tests
Blood tests can check for inflammation, infection, celiac disease, liver issues, and anemia. Blood levels of lipase and amylase can help diagnose pancreatitis. Specific conditions may require other bloodwork.
Stool Studies
Stool cultures can check for infections from bacteria, viruses or parasites. A fecal occult blood test (FOBT) screens for blood in the stool that could indicate ulcers, hemorrhoids, polyps or cancer.
Breath Tests
Special breath tests can detect H. pylori infection which can cause gastritis and ulcers if left untreated. Lactose breath tests can help diagnose lactose intolerance.
Endoscopy and Colonoscopy
A tiny camera on a flexible tube is inserted down the throat into the stomach (endoscopy) or up the rectum into the colon (colonoscopy). This allows direct visualization of the digestive tract to check for ulcers, cancers, hemorrhoids, polyps, inflammation and more. Biopsies can also be taken.
Imaging Tests
Imaging techniques like x-rays, CT scans, MRIs and ultrasounds help visualize abdominal organs and tissues. They can detect gallstones, kidney stones, tumors, abscesses, and intestinal blockages requiring surgery.
Liver and Pancreatic Function Tests
Blood tests, specialized scans, and biopsy may be used to evaluate liver enzymes, drainage systems, and pancreatic structure and function when these organs are suspected.
Allergy Testing
Allergy testing either through skin or blood tests can help identify if intolerances to certain foods like gluten, dairy or others may be causing symptoms. This can guide elimination diets.
Most Common Causes By Age
Children
– Viral gastroenteritis
– Gas pain
– Constipation
– Food poisoning
– Lactose intolerance
– Trauma
– Urinary tract infections
– Appendicitis
Teens
– Viral gastroenteritis
– Gas pain
– Constipation
– Food poisoning
– Lactose intolerance
– Irritable bowel syndrome
– Gastroesophageal reflux disease
– Appendicitis
– Gynecological disorders like ovarian cysts
Young Adults
– Gas pain
– Constipation
– Food poisoning
– Gastroesophageal reflux disease
– Irritable bowel syndrome
– Ulcers
– Kidney stones
– Diverticulitis
– Appendicitis
– Inflammatory bowel disease
– Muscle strain
Middle Age
– Gas pain
– Constipation
– Gastroesophageal reflux disease
– Ulcers
– Irritable bowel syndrome
– Diverticulitis
– Gallstones
– Kidney stones
– Abdominal aneurysms
– Inflammatory bowel diseases
– Cancers
Elderly
– Gas pain
– Constipation
– Diverticulitis
– Irritable bowel syndrome
– Gallstones
– Gastroesophageal reflux disease
– Peptic ulcers
– Colorectal cancer
– Pancreatitis
– Bowel obstructions
– Aortic aneurysm
Treatment Options
Home Care
Mild or temporary abdominal pain often improves with little or no treatment with:
– Rest
– Applying heat pads or taking warm baths
– OTC pain relievers like acetaminophen, ibuprofen or naproxen
– Gas relief medications like simethicone
– Laxatives for constipation
– Antacids or acid reducers for indigestion
– Avoiding aggravating foods
– Staying hydrated
– Light exercise
Prescription Medications
If symptoms persist, prescription medications that may help include:
– Muscle relaxants
– Antispasmodics for bowel cramping
– Low dose tricyclic antidepressants
– Prescription acid reducers, antacids, H2 blockers or PPIs for ulcers and GERD
– Laxatives or stool softeners for constipation
– Antibiotics for diverticulitis or H. pylori infection
– Immunosuppressants for inflammatory bowel disease
Dietary Changes
Dietary modifications tailored to specific conditions can help minimize symptoms:
– Low fiber, low residue diet for diverticulitis
– Dairy-free diet for lactose intolerance
– Eliminating foods causing intolerance, sensitivities or allergies
– Small, frequent, bland meals for ulcers or indigestion
– High fiber diet with plenty of fluids for constipation
– Low fat meals for gallbladder disease
Surgery
Abdominal pain caused by certain conditions may require surgery:
– Appendicitis – Appendectomy
– Bowel obstructions or perforations – Bowel resection
– Severe diverticulitis – Partial colonectomy
– Gallstones – Cholecystectomy
– Large kidney stones – Lithotripsy, laser stone breakup, basket stone removal
– Abdominal aortic aneurysm repair – Grafting or stent placement
– Severe ulcer disease – Antrectomy
– Cancer – Tumor removal
Prevention
Some ways to help prevent abdominal pain include:
– Drink plenty of fluids
– Eat a high fiber diet with probiotics
– Exercise regularly
– Avoid smoking and limit alcohol
– Maintain a healthy weight
– Manage stress levels
– Avoid trigger/high fat foods if you have GERD, gallstones or IBS
– Take NSAIDs with food and limit use if you have a history of ulcers
– Prevent foodborne illness by properly handling, preparing and storing foods
When to Seek Emergency Treatment
Seek prompt emergency care for abdominal pain if you experience:
– Severe constant pain or sharp pains that come in waves
– Fever over 101° F (38° C)
– Vomiting blood or passing bloody stool
– Chest pain with abdominal discomfort
– Pain with shoulder, neck or rectal pain
– Difficulty breathing
– Abdominal rigidity or tightness
– Signs of shock like fainting, excessive sweating, rapid heart rate
These can indicate a serious problem like appendicitis, perforated ulcer, pancreatitis, gallstone attack or abdominal aortic aneurysm dissection. Anyone with sudden, severe abdominal pain needs rapid medical evaluation, as delaying treatment can be dangerous. Don’t hesitate to call 911 or have someone drive you to the emergency room if very concerning symptoms arise.
Conclusion
Abdominal pain has many potential causes, ranging from mild indigestion to emergent conditions like appendicitis. The most common reasons for abdominal pain are gas, constipation, food poisoning, gastroesophageal reflux disease, irritable bowel syndrome, diverticulitis, kidney stones, abdominal muscle strains, ulcers and gallstones. More serious causes like appendicitis, bowel obstructions and aneurysms require prompt medical treatment. Mild pain often improves with rest, diet changes and over-the-counter medications. If severe or accompanied by vomiting, fever or bloody stools, seek emergency care. Paying attention to associated symptoms and risk factors can help determine when abdominal pain is likely to be minor or require further evaluation. If in doubt, consult a medical professional.
