Call it a bellyache, stomach pain, or abdominal cramps, most of us have experienced the excruciating agony of abdominal pain some time or the other in our life. In fact, the very term 'bellyache', meaning to complain, gripe, or grouse, has been derived from it. Abdominal pain can be mild or severe, and it may be continuous or come and go. Abdominal pain can be short-lived (acute) or occur over weeks and months (chronic).
In medical terms, abdominal pain is defined as a pain that is felt in any part of the region between the chest and the groin, which is usually referred to as the belly or stomach. Other terms used to describe abdominal pain are stomachache, tummy ache and gut ache.
Abdominal pain has many potential causes. Many causes aren't serious, such as gas pains or a pulled muscle.
Call your doctor right away if you have abdominal pain so severe that you can't move without causing more pain or you can't sit still or find a comfortable position. Also seek immediate medical help if pain is accompanied by other worrisome signs and symptoms, such as bloody diarrhea or chest pain.
The intensity of an abdominal pain can range from a mild ache in the stomach region to acutely severe pain. To make matters worse, it is usually nonspecific and a number of conditions could be the cause for its occurrence. The location and type of stomach pain can the doctor diagnose the cause. The duration and intensity of the pain is also taken into consideration when the doctor makes the diagnosis. Given below are a few characteristics of stomach pain:
Abdominal pain may last just for a few minutes, or continue for many hours, or even longer. Sometimes it may occur strongly initially and then diminish in intensity for some time.
Abdominal pain may be acute, twisting, cramp-like, stabbing, or dull. There are many other types.
The intensity of abdominal pain can result in the affected person wanting to remain without moving in one place, or it could cause great restlessness, making the person pace about, seeking to find some position that will provide relief.
Sometimes the abdominal pain could be so acute that it can cause vomiting, without any abatement in the pain. At other times, the vomiting does provide relief.
As is quite well-known, the abdominal cavity contains a number of organs, and abdominal pain could be caused by any of these, such as: organs related to the digestive system, such as the stomach, the esophagus, the intestines, the pancreas, the gall bladder, and the liver. The appendix, which occurs in the lower right side of the abdomen, can also be the cause. The kidneys, ovaries, or the bladder could also cause abdominal pain. Generally, abdominal pain is caused by a problem in the digestive system, for instance food poisoning, cramping due to diarrhea, or appendicitis.
The intensity level of the abdominal pain often does not reflect how serious the condition that is causing it may be. For instance, relatively mild conditions like the cramping caused by viral gastroenteritis or just the formation of gas in the intestinal tract can cause acute pain. Whereas, a comparatively mild pain could be caused due to a potentially life-threatening condition like appendicitis, or colon cancer.
Some of the causes of abdominal pain are:
Intolerance to milk and milk products, also known as lactose intolerance
Irritable Bowel Syndrome, recurrent abdominal pain accompanied with alternating periods of diarrhea and constipation
Gastroesophageal reflux
An inflamed appendix, or appendicitis
Ulcers
Infections of the urinary tract
Diverticulitis, an inflamed diverticulum in the intestinal tract, especially in the colon
Kidney stones
Cholecystitis, an inflammation of the gallbladder, with or without gallstones
Pancreatitis, inflammation of the pancreas
Obstruction of the bowels, apart from pain, this also causes bloating, nausea, vomiting, and the inability to eliminate stool or gas
Food poisoning, due to bacteria like shigella and salmonella
Food allergy
Hernia
Inflammatory bowel diseases like ulcerative colitis and Crohn's disease
Infants often experience colic, resulting in prolonged crying, which usually subsides on passing gas or stool. Menstrual cramps are also a common cause of abdominal pain in women. Sometimes, pain in the abdomen could actually be due to an organ located in the chest, like the heart, because of heart disease, or the lungs, because of pneumonia. Or, it could be caused by strain in the abdominal muscles.
Stomach cramps are often due to trapped gas and bloating. This is an extremely common problem that can be embarrassing but is easily dealt with - your chemist will be able to recommend a product, such as charcoal tablets, which can be bought over the counter to relieve the gas.
If your stomach cramps have started recently and you also have diarrhea, the cause is probably a tummy bug (gastroenteritis). This means you have a viral or bacterial infection of the stomach and bowel, which your immune system will usually fight off after a few days. A common cause of gastroenteritis is a norovirus.
Severe stomach cramps and diarrhea that make you feel very ill (for example, causing chills or a fever) could be due to a more serious infection, such as food poisoning. This also usually gets better on its own without treatment.
If your stomach cramps and diarrhea continue, you may have a long-term condition, such as irritable bowel syndrome (see below).
If you have sudden, agonizing pain in a particular area of your stomach, call your doctor immediately or go to your nearest hospital accident and emergency department. It may be a sign of a serious illness that will rapidly get worse without treatment.
The most common causes of sudden, severe abdominal pain include:
a perforated peptic ulcer – an open sore that develops on the inside lining of your stomach or duodenum (upper small intestine) that has broken through the lining
gallstones – small stones that form in the gallbladder (the gallbladder may need to be removed)
appendicitis, which is a medical emergency – the pain will be agonizing and your appendix will need to be removed
an infection of the stomach and bowel (gastroenteritis) – most people get better without treatment after a few days
kidney stones – small stones may be passed out in your urine, but larger stones may block the kidney tubes and you will need to go to hospital to have these broken up
diverticulitis - inflammation of the small pouches that are part of the bowel
If your doctor suspects that you have appendicitis, they will refer you to hospital immediately.
Adults who have persistent or repeated episodes of abdominal pain should see their doctor. However, there is no need to panic as the cause is often not serious and can be easily managed.
Common causes in adults include:
irritable bowel syndrome – a common condition where the muscle in the bowel wall tends to go into spasm (tightens); pain is often relieved when you go to the toilet
a urinary tract infection that keeps returning (you will usually feel a burning sensation when you urinate)
a long-term peptic ulcer – an open sore that develops on the inside lining of your stomach or duodenum (upper small intestine)
constipation
heartburn and acid reflux – stomach acid leaks from the stomach and up into the esophagus, the tube that runs from the mouth to the stomach
There is an even wider range of possible causes in children. The most common include:
periodic syndrome (similar to irritable bowel syndrome in adults) - children have recurring episodes of tummy pain
constipation
a urinary tract infection that keeps returning
anxiety and depression
heartburn and acid reflux
Some abdominal pain isn't focused in one area of the abdomen. This type of pain can be caused by:
Appendicitis
Crohn's disease
Diabetic ketoacidosis (high levels of ketones in the blood)
Diverticulitis
Injury
Intestinal obstruction
Intussusception (in children)
Irritable bowel syndrome
Lead poisoning
Mesenteric lymphadenitis (swollen lymph nodes in the folds of membrane that hold the abdominal organs in place)
Pancreatitis (pancreas inflammation)
Pelvic inflammatory disease (PID) (infection of the female reproductive organs)
Peritonitis (infection of the abdominal lining)
Sickle cell anemia
Strained or pulled abdominal muscle
Thoracic aortic aneurysm
Ulcerative colitis
Uremia (buildup of waste products in your blood)
Urinary tract infection
Viral gastroenteritis (stomach flu) (stomach inflammation)
Causes of lower abdominal pain, sometimes described as pelvic pain, include:
Appendicitis
Cystitis (bladder inflammation)
Diverticulitis
Ectopic pregnancy
Endometriosis
Intestinal obstruction
Mittelschmerz (pain associated with ovulation)
Ovarian cysts
Pelvic inflammatory disease (PID) (infection of the female reproductive organs)
Salpingitis (inflammation of the fallopian tubes)
Causes of upper abdominal pain include:
Angina (reduced blood flow to the heart)
Appendicitis
Cholangitis (bile duct inflammation)
Cholecystitis (gallbladder inflammation)
Duodenitis (inflammation of the initial portion of the small intestine)
Gallstones
GERD (gastroesophageal reflux disease)
Heart attack
Hepatitis (liver inflammation)
Intestinal obstruction
Mesenteric ischemia (decreased blood flow to the intestines)
Non-Hodgkin's lymphoma
Nonulcer stomach pain
Pancreatitis (pancreas inflammation)
Peptic ulcer
Pericarditis (inflammation of the tissue around the heart)
Pleurisy (inflammation of the membrane surrounding the lungs)
Pneumonia
Pneumothorax (lung collapse caused by air that leaks inside chest wall)
Pyloric stenosis (in infants)
Thoracic aortic aneurysm
Causes of pain in the center of the abdomen include:
Appendicitis
Diabetic ketoacidosis (high levels of ketones in the blood)
Injury
Intestinal obstruction
Mesenteric thrombosis (blood clot in a vein carrying blood away from your intestines)
Pancreatitis (pancreas inflammation)
Thoracic aortic aneurysm
Uremia (buildup of waste products in your blood)
Causes of lower left abdominal pain include:
Appendicitis
Cancer
Crohn's disease
Diverticulitis
Ectopic pregnancy
Endometriosis
Inguinal hernia
Injury
Intestinal obstruction
Kidney infection
Kidney stones
Mittelschmerz (pain associated with ovulation)
Ovarian cysts
Seminal vesiculitis (inflammation of the seminal vesicles)
Thoracic aortic aneurysm
Torn colon
Tuboovarian abscess (pus-filled pocket involving a fallopian tube and an ovary)
Ulcerative colitis
Causes of upper left abdominal pain include:
Angina (reduced blood flow to the heart)
Cancer
Diverticulitis
Empyema (infection of the lining around the lungs)
Enlarged spleen (splenomegaly)
Fecal impaction (hardened stool that can't be eliminated)
Gastritis (inflammation of the stomach lining)
Heart attack
Hiatal hernia
Injury
Kidney infection
Kidney stones
Pancreatitis (pancreas inflammation)
Pneumonia
Pulmonary infarction (loss of blood flow to the lungs)
Pyloric stenosis (in infants)
Ruptured spleen
Shingles
Spleen infection
Splenic abscess (pus-filled pocket in the spleen)
Thoracic aortic aneurysm
Torn colon
Causes of lower right abdominal pain include:
Appendicitis
Cancer
Cholecystitis (gallbladder inflammation)
Diverticulitis
Ectopic pregnancy
Endometriosis
Inguinal hernia
Injury
Intestinal obstruction
Kidney infection
Kidney stones
Mittelschmerz (pain associated with ovulation)
Ovarian cysts
Salpingitis (inflammation of the fallopian tubes)
Seminal vesiculitis (inflammation of the seminal vesicles)
Thoracic aortic aneurysm
Tuboovarian abscess (pus-filled pocket involving a fallopian tube and an ovary)
Viral gastroenteritis (stomach flu) (stomach inflammation)
Causes of upper right abdominal pain include:
Appendicitis
Cholangitis (bile duct inflammation)
Diverticulitis
Fecal impaction (hardened stool that can't be eliminated)
Gallbladder cancer
Gallstones
Gastritis (inflammation of the stomach lining)
Hepatitis (liver inflammation)
Hiatal hernia
Injury
Intestinal obstruction
Kidney cancer
Kidney infection
Kidney stones
Liver abscess (pus-filled pocket in the liver)
Liver cancer
Liver hemangioma
Pancreatic cancer
Pancreatitis (pancreas inflammation)
Peptic ulcer
Pericarditis (inflammation of the tissue around the heart)
Pleurisy (inflammation of the membrane surrounding your lungs)
Pneumonia
Pulmonary infarction (loss of blood flow to the lungs)
Pyloric stenosis (in infants)
Shingles
Stomach cancer
Call or see a health care practitioner if the affected person has any of the following:
Abdominal pain that lasts more than six hours or continues to worsen
Pain that stops the person from eating
Pain accompanied by vomiting more than three or four times
Pain that worsens when the person tries to move around
Pain that starts all over, but settles into one area, especially the right lower abdomen
Pain that wakes the person up at night
Pain with vaginal bleeding or pregnancy, even if the person only thinks she might be pregnant
Pain accompanied by fever over 101 F (38 C)
Pain along with inability to urinate, move the bowels, or pass gas
Any other pain that feels different from a simple stomach ache
Any other pain that alarms the person, or concerns them in any way
Call 911 or emergency medical assistance
If the person has any of the following, or cannot reach their health care practitioner, go to a hospital emergency department or call 911:
The "worst pain of your life" or very severe pain
Pain so bad the affected person passes out or almost passes out
Pain so bad the affected person cannot move
Pain and vomiting blood, or any vomiting that lasts more than six hours
Pain and no bowel movement for more than three days
Pain the person thinks might be in their chest, but they aren't sure
Pain that seems to come from the person's testicles
Seek help if your abdominal pain is severe and is associated with:
Trauma, such as an accident or injury
Pressure or pain in your chest
Seek
immediate medical attention
Have
someone drive you to urgent care or the emergency room if:
Pain is so severe that you can't sit still or need to curl into a ball to find relief
Pain is accompanied by bloody stools, persistent nausea and vomiting, skin that appears yellow, severe tenderness when you touch your abdomen or swelling of the abdomen
Schedule
a doctor's visit
Make an
appointment with your doctor if your abdominal pain worries you or
lasts more than a few days.
In the meantime, find ways to ease your pain. For instance, eat smaller meals if your pain is accompanied by indigestion. Avoid taking over-the-counter pain relievers such as aspirin or ibuprofen (Advil, Motrin, others) because these can cause stomach irritation that may worsen abdominal pain.
Since abdominal pain is caused by such diverse conditions, the treatment will depend on the diagnosis. Usually, remedies at home are enough to resolve the condition. However, if the symptoms do persist, then medical intervention is required.
The doctor will first try to find out what exactly is causing the abdominal pain. A physical examination will be done to determine whether the pain is diffuse or localized at a single area. The time pattern, and whether there are other symptoms such as nausea, vomiting, general feeling of illness, fatigue, fever, and changes in the stool, also help in the diagnosis and treatment of abdominal pain.
Abdominal pain without fever, vomiting, vaginal bleeding, passing out, chest pain, or other serious symptoms often get better without special treatment.
If the pain persists or if the person believes the pain may represent a serious problem, they should see a health care practitioner.
A heating pad or soaking in a tub of warm water may ease the person's pain.
Over-the-counter antacids, such as Tums, Maalox, or Pepto-Bismol, also can reduce some types of abdominal pain. Activated charcoal capsules also may help.
Acetaminophen (common brand names are Arthritis Foundation Pain Reliever, Aspirin Free Anacin, Panadol, Liquiprin, Tylenol) may help. This product should be avoided if liver disease is suspected. Try to avoid aspirin or ibuprofen (common brand names are Advil, Motrin, Midol, Nuprin, Pamprin IB) if stomach or ulcer disease is suspected. These drugs can make some types of stomach ache worse.
The patient's treatment will depend on what the doctor thinks is causing the abdominal pain.
The patient may be given IV (intravenous) fluids. The health care practitioner may ask the patient not to eat or drink anything until the cause of the pain is known. This is done to avoid worsening certain medical conditions (for example adding food to the stomach if there is a ruptured ulcer) or to prepare the patient in case they need to have surgery (an empty stomach is better when general anesthesia is needed).
The patient may be given pain medication.
For pain caused by bowel spasm, they may be given a shot in the hip, arm, or leg.
If the patient is not throwing up, they may receive a drink that has antacid in it or pain medication.
Although the patient's pain may not go away completely, they have the right to be comfortable and should ask for pain medicine until they are made comfortable.
Some types of abdominal pain require surgical treatment.
If the patient's pain comes from an infected internal organ, such as the appendix or gallbladder, they will be admitted to a hospital and will need surgery.
Bowel obstruction sometimes requires surgery, depending on what is causing the obstruction.
If the patient's pain comes from a ruptured or perforated organ, such as the bowel or stomach, they will need immediate surgery and will be taken directly to an operating room.
If the diagnosis is determined, the person should follow the instructions specific for that diagnosis.
If, for example, an ulcer causes the pain, the person must avoid nicotine, caffeine, and alcohol.
If it is caused by gallbladder disease, the person should avoid greasy, fatty, and fried foods.
If it's causes by a high fiber diet, the person should cut down on fiber intake. An intestinal blockage would be the worst side effect you could get from consuming too much fiber. This occurs when an individual eats too much fiber and does not consume enough water. Fiber can cause a blockage in the intestines, preventing any other foods to get past. Intestinal blockages can be serious health conditions and may require surgery.
To avoid these side effects, simply gradually increase your fiber intake over a few weeks. When increasing your fiber intake, make sure to also increase your fluid intake. It is recommended that you drink at least 8 glasses of water a day.