Abdominal Pain: Symptoms, Causes, Diagnosing

Abdominal pain is pain felt anywhere between the ribs and the pelvis. It is also called abdominal pain or stomachache. There are many organs in the abdomen, including the stomach, liver, pancreas, small and large intestines, and sexual organs. There are also large blood vessels in the abdomen.

Symptoms of Abdominal Pain in Adults

The type of pain can vary greatly. When abdominal pain occurs, it can:

• Stab, dull, stabbing, spasmodic, twisting, or many other ways
• Be short-term, come and go in waves, or be constant
• Make you throw up (vomit)
• Make you want to stay still or make you so restless that you pace back and forth trying to find “the right position.”
• Range from a minor problem to one that requires urgent surgery.

Causes of Abdominal Pain in Adults

Abdominal pain is often linked to issues within your digestive system, but it can also arise from problems in other organs, such as the kidneys or reproductive system.

Digestive Causes:

• Gastroenteritis or food poisoning
• Gastroesophageal reflux disease (GORD) or hiatus hernia
• Peptic ulcers
• Gallstones
• Pancreatitis
• Appendicitis

Bowel-Related Causes:

• Irritable bowel syndrome (IBS)
• Lactose intolerance
• Inflammatory bowel disease (IBD)
• Diverticulitis and diverticular disease
• Bowel obstruction

The duration of the pain can depend on the underlying cause.

Abdominal pain can also stem from problems outside the digestive system, such as:

• Menstrual pain
• Kidney stones
• Urinary tract infections
• Heart attacks

Certain medications can also trigger abdominal pain as a side effect, including:

• Anti-inflammatory drugs
• Aspirin
• Medications for dementia

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If you’re concerned that your medication might be causing abdominal pain, it’s important to consult with your doctor.

Diagnosing Abdominal Pain in Adults

To determine the cause of abdominal pain, doctors and healthcare professionals may ask questions such as:

Where is the pain?

Doctors and other health care professionals will first ask you where you feel the pain. Pain above the belly button but below the rib cage on the right side may be pain related to gallstones. Pain related to gallstones may spread (or radiate) to the right shoulder or back.

Pain caused by kidney stones is felt on the right or left side, in the back rather than the front of the abdomen and tends to radiate down to the groin on the same side.

Pain in the middle of the abdomen tends to come from the intestines, but in men, testicular pain can also be felt in the middle of the abdomen.

When did the pain start?

Abdominal pain is called “acute” if it lasts less than a day or two, “persistent” if it lasts more than a day or two, and “chronic” if it lasts more than two weeks.

How bad is the pain?

Healthcare professionals will usually ask you to rate the pain or give a pain rating out of 10. Mild pain may be rated as 3 to 4, noticeable and uncomfortable (like toothache) but not severe enough to interfere with usual activities.

Severe pain stops all other activities (such as labor pain during childbirth). The pain caused by gallstones or kidney stones is often severe.

Does the pain come and go?

Abdominal pain that comes and goes in waves is called colic and is caused by the contraction of a hollow organ such as the intestine, gallbladder, or urinary tract. Pain in other organs can be constant, as seen with stomach ulcers, pancreatitis, or abdominal infections.

Have you ever felt this pain?

Pain due to gallstones and kidney stones often recurs every few months.

Menstrual pain can be severe and indicate an underlying problem such as endometriosis or pelvic inflammatory disease, while pain in the middle of the menstrual cycle may be due to an ovarian follicle.

What events led to the pain?

This is an important question because it can shed light on the cause of the pain. For example, trauma such as a sports injury or car accident, recently taken medications such as anti-inflammatory drugs or antibiotics, or consuming more alcohol than usual, which can trigger pancreatitis.

Are there any associated features?

Blood in the urine as well as flank pain (pain between the pelvis and ribs) indicate kidney stones.

Vomiting accompanied by pain in the middle of the abdomen may indicate a small bowel obstruction. Severe constipation accompanied by pain in the side may indicate a large bowel obstruction.

Have you had surgery or radiation therapy on your abdomen in the past?

Recent surgery on the intestines or other abdominal organs can lead to complications such as infections that can cause abdominal pain.

Scarring of the tissue surrounding the intestines or adhesions can be caused by surgery or radiation therapy and can cause a blockage in the intestines.

Treating abdominal pain in adults

Your treatment will be based on the cause of your pain and may involve:

Pain relief: Painkillers may not make your pain go away completely, but they should improve it.

Fluids: You may be given fluids into a vein to replace fluid loss and soothe your intestines.

Medications: For example, you may be given something to stop vomiting.

Fasting: Your doctor might advise you to avoid eating or drinking until the cause of your pain is determined.

Take care of yourself at home

Most abdominal pain goes away without any treatment. Consult your doctor for advice, but there are some steps you can take to help ease the pain, including:

• Place a hot water bottle or a heated wheat bag on your abdomen for relief.
• Take a hot bath. Be careful not to scald yourself.
• Drink plenty of clear liquids such as water.
• Reduce your consumption of coffee, tea and alcohol as these can make the pain worse.
• When you can eat again, start with clear liquids and then move on to bland foods such as crackers, rice, bananas or toast. Your doctor might recommend avoiding specific foods.
• Get plenty of rest.
• Try over-the-counter antacids to help relieve certain types of pain.
• Take mild painkillers such as acetaminophen. Please check the appropriate dose on the package. Avoid aspirin or anti-inflammatory drugs unless recommended by a doctor. These drugs can make certain types of abdominal pain worse.

When to See a Doctor for Abdominal pain

See your doctor or the nearest hospital emergency room immediately if you experience any of the following symptoms:

• Severe pain
• Pain lasting several hours
• Vaginal pain or bleeding during pregnancy
• Pain in the scrotum in men
• Pain and vomiting or shortness of breath
• Pain and bloody vomit
• Blood in the stool or urine
• Pain that spreads to the chest, neck, or shoulder
• Fever and sweating
• Pallor and clammy feeling
• Inability to urinate
• Inability to pass stool or gas
• Other concerns

Reference

Department of Health & Human Services. (n.d.). Abdominal pain in adults. Better Health Channel. (https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/abdominal-pain-in-adults)