Abdominal pain is one of the most common complaints that lead people to see a doctor. Almost all of us have experienced it at some point in our lives, whether it’s a simple upset stomach or a sign of a more serious illness. Although it is often harmless and goes away on its own, it is important to know when to take it seriously and seek professional help. This article will help you understand the possible causes, types and associated symptoms of abdominal pain, so that you can make an informed decision about when to seek medical help. The Endomedix Gastroenterology Centre Our doctors are committed to providing accurate diagnoses and effective treatment so that you can regain your health as soon as possible.
Abdominal pain can take many different forms: it may be sharp, cramp-like, dull, stabbing or a burning sensation. It may be felt only at a specific point, or it may spread across the entire abdominal cavity. Sometimes it is linked to eating, whilst at other times it strikes completely out of the blue. The nature and location of the pain, along with any accompanying symptoms, all provide important clues as to the underlying causes. This is precisely why it is essential to pay attention to the signals our body sends us.
In this detailed guide, we review the most common causes of abdominal pain, ranging from simple digestive disorders to more serious conditions requiring immediate medical attention. We will examine the diagnostic procedures available for establishing an accurate diagnosis, and we will also discuss which symptoms mean you should not delay seeking medical attention.
Types and characteristics of abdominal pain
An accurate description of abdominal pain is crucial for making a diagnosis. Detailed information provided to the doctor can help narrow down the range of possible causes. When describing the pain, it is worth bearing the following points in mind.
The location of the pain
Pain felt in different areas of the abdominal cavity may indicate problems with different organs.
- Pain in the upper right abdomen: It often indicates a condition affecting the gallbladder (e.g. gallstones, cholecystitis) or the liver. Biliary colic typically occurs beneath the right rib cage and may radiate into the back, towards the right shoulder blade.
- Epigastric (stomach area) pain: Pain felt in the area below the breastbone may indicate problems with the stomach (e.g. stomach ulcer, reflux), the oesophagus or the pancreas. Pancreatitis is typically characterised by a band-like pain that radiates into the back.
- Pain in the left upper abdomen: This may involve the stomach, the pancreas or the spleen.
- Pain around the navel: Problems with the small intestine, such as an obstruction or inflammation, can cause pain in this area. Appendicitis also often begins with pain around the navel before moving to the lower right abdomen.
- Pain in the lower right abdomen: The classic cause is appendicitis. In women, it can also be caused by problems with the ovaries or the urinary tract.
- Pain in the lower left abdomen: Typically, it is diseases of the large intestine, particularly diverticulitis (inflammation of the pouches in the intestinal wall), that cause symptoms here.
- Diffuse pain affecting the entire abdomen: In such cases, gastroenteritis, peritonitis or an intestinal obstruction may be suspected.
The nature of the pain
- Cramp-like pain: Intense pain that comes in waves, often indicating bowel problems (e.g. irritable bowel syndrome – IBS, bowel obstruction, diarrhoea) or gallstones or kidney stones.
- A sharp, stabbing pain: Sudden, intense pain, which may indicate organ perforation or a ruptured artery.
- A dull, aching pain: Prolonged, less intense pain, which may indicate chronic inflammatory conditions (e.g. chronic pancreatitis) or cancer.
- Burning sensation: These are often symptoms of problems related to stomach acid, such as reflux (GERD) or a stomach ulcer.
The temporal course of pain and its triggering factors
- Relationship to meals: Pain from a stomach ulcer may be relieved by eating, whilst pain from a duodenal ulcer typically occurs 1–3 hours after a meal. Biliary colic is often triggered by eating fatty, heavy meals.
- Relationship to defecation: In irritable bowel syndrome (IBS), pain is often accompanied by changes in the consistency and frequency of stools, and a bowel movement may provide relief from the symptoms.
- Relationship to body position: The pain associated with pancreatitis worsens when lying on your back, whilst it may ease when you bend forwards.
- Sudden-onset pain vs. pain that gradually worsens: Sudden, lightning-like pain requires immediate medical attention. Pain that gradually gets worse may indicate an inflammatory condition, such as appendicitis.
Possible causes of abdominal pain
Abdominal pain can be caused by a number of conditions, ranging from digestive problems to urinary tract or gynaecological disorders.
Common causes relating to the digestive system
- Gastroenteritis (inflammation of the stomach and intestines): Inflammation caused by a viral or bacterial infection, often accompanied by nausea, vomiting, diarrhoea and fever.
- Irritable bowel syndrome (IBS): A functional bowel disorder characterised by abdominal pain, cramps, bloating, and either diarrhoea or constipation. The symptoms can be exacerbated by stress and certain foods.
- Gastro-oesophageal reflux disease (GERD): The backflow of stomach acid into the oesophagus can cause a burning pain in the chest and upper abdomen (heartburn).
- Stomach and duodenal ulcers: Ulcers that develop on the lining of the stomach or duodenum, often caused by the bacterium _Helicobacter pylori_ or long-term use of non-steroidal anti-inflammatory drugs (NSAIDs).
- Inflammatory bowel diseases (IBD): Chronic autoimmune diseases, such as Crohn’s disease and ulcerative colitis. These may be accompanied by severe abdominal pain, bloody diarrhoea, weight loss and fever.
- Diverticulitis: Inflammation of small pouches (diverticula) in the wall of the large bowel, which typically causes pain in the lower left abdomen, fever and changes in bowel habits.
- Gallstones and cholecystitis: Stones forming in the gallbladder can cause cramp-like pain in the right upper abdomen, particularly after eating fatty foods. If a stone blocks the duct leading out of the gallbladder, inflammation may develop, accompanied by constant pain and a fever.
- Pancreatitis (inflammation of the pancreas): It can be acute or chronic. The acute form is characterised by sudden, severe, belt-like pain radiating to the back, often accompanied by nausea and vomiting. The most common causes are gallstones and excessive alcohol consumption.
- Appendicitis (appendicitis): Inflammation of the appendix. It typically begins with pain around the navel, which moves to the lower right abdomen within a few hours and gradually becomes more severe. It may be accompanied by loss of appetite, nausea, vomiting and a raised temperature or fever.
Other possible causes
- Urinary tract infection and kidney stones: A renal colic is characterised by extremely severe pain in the lower back that radiates to the side.
- Gynaecological problems: Ovarian cysts, endometriosis or pelvic inflammatory disease can also cause lower abdominal pain.
- Hernia: A weakening of the abdominal wall, through which internal organs – most commonly a section of the intestine – may protrude.
- Cancer: Tumours of the stomach, colon, pancreas or other abdominal organs can also cause persistent, dull pain, which is often accompanied by unexplained weight loss, loss of appetite and changes in bowel habits.
When should you see a doctor straight away?
There are certain „warning sign” symptoms where you must not wait, but must seek medical help immediately or call an ambulance. These symptoms may indicate a serious, even life-threatening, condition.
Symptoms requiring immediate medical attention:
- Sudden, unbearable, „knife-like” abdominal pain.
- A strong, rock-hard stomach.
- High fever, chills.
- Bloody vomit or vomit that looks like coffee grounds.
- Stool mixed with tar-coloured, black or fresh red blood.
- A cessation of bowel movements and flatulence, accompanied by bloating and vomiting.
- Jaundice (a yellowish discolouration of the skin and the whites of the eyes).
- Shortness of breath, chest pain.
- Significant weight loss of unknown cause over a short period of time.
- Fainting, confusion, severe weakness.
If the pain is less severe but lasts for more than a few days, gradually gets worse, or recurs regularly, it is also advisable to consult a gastroenterologist to determine the exact cause.
Diagnosis of abdominal pain
When you see a doctor about abdominal pain, the doctor will first ask you in detail about your symptoms and then carry out a physical examination. Further tests are often required to reach an accurate diagnosis. The Endomedix Gastroenterology Centre It offers patients access to modern diagnostic equipment.
- Physical examination: The doctor will examine, listen to and palpate the abdomen to assess the location of the pain, the tenderness of the abdomen, any abnormal sounds or palpable masses.
- Laboratory tests:
- Blood collection: A blood count may indicate inflammation (high white blood cell count, CRP) or anaemia. Liver and kidney function tests, as well as levels of pancreatic enzymes (amylase, lipase), provide important information about the condition of these organs.
- Stool analysis: It can help to detect hidden bleeding (faecal occult blood test), infections or markers of inflammation (calprotectin).
- Imaging studies:
- Abdominal ultrasound: One of the most common initial examinations, which is painless and involves no radiation exposure. It is well suited to examining abdominal organs such as the liver, gallbladder, bile ducts, pancreas and kidneys. It can be used to detect gallstones and kidney stones, cysts, tumours or collections of inflammatory fluid.
- CT (computed tomography) and MRI (magnetic resonance imaging): They provide a more detailed cross-sectional view of the abdominal organs. They are often used to diagnose tumours, inflammation (e.g. diverticulitis, pancreatitis), abscesses or bowel obstruction.
- Endoscopic examinations:
- Gastroscopy (gastroscopy): It is used to examine the upper digestive tract (oesophagus, stomach, duodenum). An endoscope is a thin, flexible tube with a camera at one end. During the examination, the doctor can detect signs of inflammation, ulcers, reflux or tumours, and it is also possible to take a tissue sample (biopsy), for example to detect an _Helicobacter pylori_ infection or coeliac disease (gluten intolerance).
- Colonoscopy (colonoscopy): It is suitable for examining the entire large intestine and the final section of the small intestine. It is essential for the diagnosis of inflammatory bowel diseases, diverticulosis, polyps and bowel cancer. Any polyps found during the examination can be removed, thereby preventing the development of tumours.
Treatment options and advice
Treatment always depends on the underlying cause. Whilst a simple case of indigestion may be managed with a change of diet and rest, a bacterial infection requires antibiotics, an ulcer requires antacids, and appendicitis requires surgery.
General advice for mild, temporary abdominal pain:
- Rest: Give your body time to recover.
- Hydration: Make sure you drink plenty of fluids, especially if you are suffering from vomiting or diarrhoea. Plain water and herbal teas (e.g. camomile, mint) are good choices.
- Diet: Avoid heavy, fatty and spicy foods, as well as alcohol and coffee. Eat easily digestible foods, such as toast, boiled potatoes and rice.
- Over-the-counter products: Antacids can provide temporary relief from heartburn, whilst antispasmodics can help with bloating, but their long-term use is no substitute for a medical examination. Among painkillers, paracetamol-based preparations are generally safer, as non-steroidal anti-inflammatory drugs (e.g. ibuprofen, diclofenac) can irritate the stomach.
Summary: The importance of mindful self-care
Abdominal pain is a complex symptom that can have countless underlying causes. In most cases, it is harmless, but certain signs may indicate a serious problem. The most important thing is to listen to your body and not to ignore persistent or unusually severe symptoms. Do not be afraid to seek medical help, as early diagnosis and appropriate treatment are key to recovery and to preventing more serious complications.
If you are also experiencing recurring or worrying abdominal pain, do not delay getting it checked out. The Endomedix Gastroenterology Centre With experienced specialists and state-of-the-art diagnostic facilities, we look forward to providing you with expert help in identifying and treating the cause of your symptoms. Take a step towards better health today!
