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Alternative names

Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps

Definition   

Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.

Considerations   

There are many organs in the abdomen. Pain in the abdomen can originate from any one of them, including:

• Organs related to digestion — the stomach, the end of the esophagus, the small and large intestines, the liver, the gallbladder, and the pancreas.
• The aorta — a large blood vessel that runs straight down the inside of the abdomen.
• The appendix — an organ in the lower right abdomen that no longer serves much function.
• The kidneys — two bean shaped organs that lie deep within the abdominal cavity.

However, the pain may originate from somewhere else — like your chest or pelvic region. You may also have a generalized infection affecting many parts of your body, like the flu or strep throat.

The intensity of the pain does not always reflect the seriousness of the condition causing the pain. Severe abdominal pain can be from mild conditions, such as gas or the cramping of viral gastroenteritis. On the other hand, relatively mild pain or no pain may be present with life-threatening conditions, such as cancer of the colon or early appendicitis.

Common Causes   

Many different conditions can cause abdominal pain. The key is to know when you must seek medical care right away. In many cases you can simply wait, use home care remedies, and call your doctor at a later time only if the symptoms persist.

Possible causes include:

• Excessive gas
• Chronic constipation - Constipation refers to infrequent or hard stools, or difficulty passing stools. Constipation may involve pain during the passage of a bowel movement, inability to pass a bowel movement after straining or pushing for more than 10 minutes, or no bowel movements after more than 3 days. Infants who are still exclusively breastfed may go 7 days without a stool.
• Lactose intolerance (milk intolerance)
• Viral gastroenteritis (stomach flu) - Viral gastroenteritis is inflammation of the stomach and intestines caused by a virus. The infection can lead to diarrhea and vomiting. It is sometimes called the “stomach flu.”
• Irritable bowel syndrome (sensitive stomach with intermittent episodes of diarrhea and constipation) - Irritable bowel syndrome (IBS) refers to a complex disorder of the lower intestinal tract. It is mainly characterized by a pattern of symptoms that is often worsened by emotional stress.
• Heartburn - Heartburn is a painful burning sensation in the esophagus, just below or behind the breastbone. The pain often rises in your chest and may radiate to your neck or throat.
• indigestion - Indigestion is a vague feeling of abdominal discomfort — possibly including belching, a feeling of fullness, bloating, and nausea.
• Gastroesophageal reflux - Gastroesophageal reflux is the movement of stomach contents up the esophagus toward the mouth, rather than down through the digestive system (peristalsis).
• Ulcers - An ulcer is a crater-like lesion on the skin or mucous membrane caused by an inflammatory, infectious, or malignant condition.
• Cholecystitis (inflammation of the gallbladder) with or without gallstones - Acute cholecystitis is a sudden inflammation of the gallbladder that causes severe abdominal pain.
• Appendicitis (inflammation of the appendix)
• Diverticular disease, including inflammation of small pouches that form in the large intestines (diverticulitis) - Diverticulitis is inflammation of an abnormal pouch (diverticulum) in the intestinal wall. These pouches are usually found in the large intestine (colon). The presence of the pouches themselves is called diverticulosis.
• Bowel obstruction — in addition to pain, this causes nausea, bloating, vomiting, and inability to pass gas or stool - Intestinal obstruction involves a partial or complete blockage of the bowel that results in the failure of the intestinal contents to pass through.
• Food allergy
• Food poisoning (salmonella, shigella)
• Hernia - A groin lump is localized swelling in the groin area. It may be firm or soft, tender or not painful at all.
• Kidney stones - A kidney stone is a solid mass that consists of a collection of tiny crystals. There can be one or more stones present at the same time in the kidney or in the ureter. (See also cystinuria.)
• Urinary tract infections
• Pancreatitis (inflammation of the pancreas)
• Intussusception (telescoping intestines) — while uncommon, this is a serious possible cause of pain in an infant who may be drawing his or knees to the chest and crying to indicate the pain - Intussusception involves a telescoping of one portion of the intestine into another, which results in decreased blood supply of the involved segment.
• Dissecting abdominal aortic aneurysm — bleeding into the wall of the aorta - Aortic dissection is a potentially life-threatening condition in which there is bleeding into and along the wall of the aorta, the major artery leaving the heart.
• Parasite infections (Giardia)
• Sickle cell crisis - Sickle cell anemia is an inherited disease in which the red blood cells, normally disc-shaped, become crescent shaped. As a result, they function abnormally and cause small blood clots. These clots give rise to recurrent painful episodes called “sickle cell pain crises.”
• Crohn’s disease - Crohn’s disease is a form of inflammatory bowel disease (IBD), which involves ongoing (chronic) inflammation of the gastrointestinal tract. Crohn’s-related inflammation usually affects the intestines, but may occur anywhere from the mouth to the anus (the end of the rectum).
• ulcerative colitis - Ulcerative colitis is a chronic, episodic, inflammatory disease of the large intestine and rectum characterized by bloody diarrhea.
• (Crohn’s disease and ulcerative colitis are two different types of inflammatory bowel disease)

When an inflamed organ in the abdomen ruptures or leaks fluid, you not only have excruciating pain, your abdomen will be very stiff (board-like) and you will likely have a fever. This occurs when you have peritonitis due to an infection spreading in the abdominal cavity from the ruptured organ, like the appendix. This is a medical emergency.

In infants, prolonged unexplained crying (often called “colic”) may be caused by abdominal pain that may end with the passage of gas or stool. Colic is often worse in the evening. Cuddling and rocking the child may bring some relief.

Abdominal pain that occurs during menstruation may be from menstrual cramps or it may indicate a problem in a reproductive organ. This includes conditions such as endometriosis (when tissue from the uterus is displaced to somewhere else like the pelvic wall or ovaries), uterine fibroids (thick bands of muscular and fibrous tissue in the uterus), ovarian cysts, ovarian cancer (rare), or pelvic inflammatory disease (PID) — infection of the reproductive organs, usually from a sexually transmitted disease.

Abdominal pain may actually be caused by an organ in the chest, like the lungs (for example, pneumonia) or the heart (like a heart attack). Or, it may stem from a muscle strain in the abdominal muscles.

Cancer of the colon, stomach, or pancreas are serious but uncommon causes of abdominal pain.

Other more unusual causes of abdominal pain include a type of emotional upset called somatization disorder, reflected as physical discomfort (including recurrent abdominal pain). Strep throat in children can cause abdominal pain.