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You should be concerned about abdominal pain that is severe or is accompanied by fever, difficulty breathing, pale or bloody stools, vomiting blood, etc.
In most cases, abdominal pain is not a cause for concern. However, you should be concerned about abdominal pain that is severe or is accompanied by symptoms such as:
- Fever
- Difficulty breathing
- Pale stools
- Bloody stools
- Diarrhea with mucus in stools
- Blood in urine
- Burning sensation while passing urine
- Vomiting blood
- Two or more episodes of vomiting with loss of appetite
- Spotting or bleeding in between two menstrual periods
- Menorrhagia (excessive bleeding during a menstrual period)
- Tender to the touch
- Severe pain with pregnancy
- Pain so severe that it makes you pass out
- Pain that worsens or lasts for several days
- Pain after injury to the abdomen
- Unexplained or unintentional weight loss
- Jaundice
Seek medical attention if you notice the above symptoms in addition to abdominal pain, as they could indicate internal inflammation, infection, or bleeding. Less common causes include colorectal, ovarian, stomach, or pancreatic cancer.
When is abdominal pain a medical emergency?
Abdominal pain requires emergency medical help if:
- You are pregnant (can be due to ruptured ectopic pregnancy or miscarriage).
- Your pain starts or worsens within a week of abdominal surgery
- Your pain started within 1-2 days of abdominal trauma.
- Your abdomen is expanding or bloating.
Conditions that can cause sudden, extreme abdominal pain and are life-threatening include:
- Appendicitis
- Bowel obstruction caused by conditions such as:
- Hernia
- Scar tissue from previous abdominal surgery
- Swelling in the intestine caused by colon cancer
- Volvulus (twisting of the loops of the intestine)
- Intussusception (sliding of a section of the bowel into itself)
- Bowel perforation (hole in the intestine) due to ulcers, which can be due to inflammatory bowel disease
What are the most common causes of abdominal pain?
Because your abdomen is home to multiple organs, abdominal pain has multiple causes, such as inflammation, infection, or other problems. The most common causes include:
- Digestive issues
- Constipation
- Gas
- Food allergies
Less common causes of abdominal pain include:
- Appendicitis
- Food poisoning
- Food allergies
- Lactose intolerance
- Diverticulitis (infection or inflammation of pouches that can form in your intestines)
- Gallstones
- Cholecystitis (inflammation of the gallbladder)
- Gastroesophageal reflux disease
- Hernia
- Inflammatory bowel disease (such as Crohn’s disease)
- Kidney stones
- Gastroenteritis (stomach flu)
- Stomach ulcer
- Duodenal ulcer (ulcer in the first part of the intestine)
- Pancreatitis (inflammation of the pancreas)
- Hepatitis (infection of the liver)
- Alcoholic liver disease
- Fatty liver disease
- Endometriosis
- Menstrual cramps
- Ovarian cysts
- Pelvic inflammatory disease
- Urinary tract infections
- Pulmonary embolism
- Heart attack
How are causes of abdominal pain diagnosed?
To determine the cause of your abdominal pain, your doctor may ask about the following:
- Location and severity of your abdominal pain
- When the abdominal pain started
- Whether the abdominal pain started after consuming certain foods
- Whether sleeping in certain positions aggravates the pain
- Additional symptoms such as bloody stools or vomiting
Your doctor will take your medical history, including past surgeries, and examine your abdomen for tenderness or color changes.
To rule out serious causes of abdominal pain and confirm a diagnosis, your doctor may order one or more tests such as:
- Blood tests to test for infection, red blood cell count, liver and kidney function, and electrolytes
- Stool tests
- Urine tests
- Abdominal ultrasound
- Abdominal computed tomography scan
- Endoscopy (use of a flexible, tube-like camera to visualize the inside of the organs)
- Biopsy (surgical removal of a small piece of an organ to check for cancerous cells)
