Abdominal pain

What is abdominal pain?

Abdominal pain is pain that is felt in the abdomen. The abdomen is that part of your body which is below your ribs and above your hips. Some people call it the stomach, tummy, trunk, or gut.

When you have a pain in that area, doctors will call it abdominal pain.

However, other popular terms for abdominal pain include:

• Tummy pain.

• Tummy ache.

• Stomach ache.

• Stomach pain.

• Belly ache.

Usually, pain that you feel here will be caused by a problem in your gut. Sometimes it can be caused by problems in other organs.

This leaflet is about abdominal pain in adults. For children, see the leaflet called Abdominal pain in children.

Where can abdominal pain be felt?

Abdominal pain can be felt anywhere between the chest and the pelvis. Common areas include:

• Upper left quadrant (above the belly button to the left).

• Lower left quadrant (below the belly button to the right).

• Upper right quadrant (above the belly button to the right).

• Lower left quadrant (below the belly button to the left).

What does abdominal pain feel like?

Abdominal pain may feel:

• Sharp or stabbing - sudden and intense.

• Dull or aching - persistent, mild discomfort.

• Cramping or colicky - comes and goes in waves.

• Burning sensation.

• Pressure or fullness - bloating or swelling.

• Tenderness – pain when the area is touched.

Doctors may also be interested in where the pain is and whether the pain seems to be travelling (radiating) in a certain direction. Having this information and putting it together with other information, such as whether you have been being sick (vomiting) or have had diarrhoea, will help the doctor work out what is wrong.

Pain that comes on suddenly may be called acute. Longer-standing pain is called chronic.

What causes abdominal pain?

There are many causes of abdominal pain. These include:

Digestive issues

• Indigestion - can cause pain in your upper abdomen or behind your breastbone. This usually happens after eating certain types of food. The foods might be fatty or very rich.

• Trapped wind - can causes crampy pains after eating. Your stomach may also feel swollen or bloated. The pain usually goes after pooing or farting.

• Constipation - causes crampy pains in the lower abdomen. The pain usually goes after you poo.

• Irritable bowel syndrome (IBS) - causes stomach pain that comes and goes in waves. Can also cause wind, bloating, and sometimes bouts of diarrhoea and/or constipation.

Infection

• Urine infection - causes lower stomach pain. There may also be a sharp stinging when you pee.

• Food poisoning or gastroenteritis - causes crampy pains in your stomach. Pains may ease for a while each time you pass some diarrhoea.

• Appendicitis - causes pain that usually starts in the middle of the abdomen but over time seems to move towards the right hip. The pain gradually worsens over 6-24 hours.

• Hepatitis - many people have no symptoms when they initially contract hepatitis (infection in the liver) but some will have pain in the upper right side of the abdomen.

Inflammation

• Pelvic inflammatory disease (PID) in women - causes pain in the lower abdomen (pelvic area). It can range from mild to severe. Pain during sex can also occur.

• Inflammatory bowel disease (IBD) - symptoms vary, depending on the part of the gut affected, but can include abdominal pain.

• Gastritis - may cause upper abdominal pain (just below your breastbone). The pain is often described as a burning feeling.

• Diverticulosis - can causes ongoing lower abdominal ache. It can also cause flares of more severe pain

Organ issues

• Kidney stones - causes pain that starts in your back and seems to travel around the side of your abdomen to your groin. The pain is severe and comes and goes.

• Gallstones - causes severe pain in the upper right side of the abdomen. The pain is usually worst to the right-hand side, just below the ribs.

Reproductive issues

• Period pain - causes lower abdominal pain during periods (menstruation). The pain is often mild but for some women, the pain is severe enough to affect day-to-day activities.

• Endometriosis - causes severe abdominal pain, usually around the time of a period.

• Ovarian cysts - this pain is usually felt only on one side. A cyst is not always painful but can be so if it twists, in which case the pain may get worse and then better as the cyst twists and then untwists.

• Ectopic pregnancy - this pain is usually on one side and may be accompanied by vaginal bleeding. The woman may know that she is pregnant, or her period may be late but she doesn't yet know that she is pregnant.

Cancer

Most people with abdominal pain do not have cancer. However, some cancers can cause abdominal pain. These include:

• Bowel cancer- can cause abdominal pain. It often also causes weight loss, a change in bowel habits and blood in the stools.

• Pancreatic cancer- can cause upper abdominal pain which goes through to the back, but more commonly starts with other symptoms such as jaundice.

• Stomach cancer - can cause upper abdominal pain similar to the symptoms of gastritis but it does not get better with simple remedies.

• Ovarian cancer - can cause pelvic or abdominal pain, abdominal bloating, a feeling of being full quickly whilst eating, and needing to wee more often than usual.

Other causes

• Stomach ulcer - causes pain in the upper abdomen but may also feel like it goes through into your back. The pain often comes at night and wakes you up.

• Food intolerance - can cause a cramping pain on eating the food to which you are intolerant.

The list does not include every condition that causes abdominal pain. These are just some of the most common causes.

How is abdominal pain diagnosed?

There are many different causes of abdominal pain. Your description of the pain, along with findings on clinical examination, should allow your doctor to narrow down the possible causes.

Sometimes, the diagnosis is clear, and no further tests are needed.

Other times, further tests are useful to help make a diagnosis. These vary depending on the situation, but might include:

• Blood tests.

• Urine tests.

• Stool tests.

• Scans, such as an ultrasound or CT scan.

• Endoscopy, such as a gastroscopy or a colonoscopy.

More details can be found in the individual condition leaflets, mentioned above.

How to treat abdominal pain

Treatment for abdominal pain depends on what the cause of your pain is. Some types of pain can be treated simply with over-the-counter remedies you can buy at the chemist. Others may need treatment at a hospital.

Home remedies for abdominal pain

• Eating and drinking small amounts often rather than large amounts in one go, and sticking to plain foods can be helpful.

• Pharmacists can advise on over the counter remedies to reduce spasm in the abdomen.

Follow the links to the individual condition leaflets in the causes section for more details on treating the underlying cause.

When to see a doctor for abdominal pain

You may recognise your type of pain from the descriptions here. However, if you have a pain that is not going away quickly (within a few hours) or that you cannot cope with, you should see a healthcare professional.

How can I prevent abdominal pain?

Eat plenty of fruit and vegetables

It is recommended that we eat at least five portions of a variety of fruit or vegetables each day. If you eat a lot of fruit and vegetables then your chances of developing heart disease, a stroke or bowel cancer are reduced. In addition, fruit and vegetables:

• Contain lots of fibre, which helps to keep your bowels healthy. Problems such as constipation and diverticular disease are less likely to develop.

• Contain plenty of vitamins and minerals, which are needed to keep you healthy.

• Are naturally low in fat.

• Are filling but are low in calories.

Eat plenty of fibre

Fibre is the part of food that is not digested. It is filling but has few calories. It helps your bowels to move regularly, which reduces constipation and other bowel problems. Fibre may also help to lower your cholesterol level.

Starchy foods, and fruit and vegetables contain the most fibre. So the tips above on starchy foods and fruit and vegetables will also increase fibre. If you switch to wholemeal rice and pasta and wholemeal bread, this can significantly increase your fibre intake. Pulses like lentils and beans are also full of fibre.

Have plenty to drink when you eat a high-fibre diet (at least 6-8 cups of fluid a day).

Frequently asked questions

Can stress cause stomach pain?

Stress can cause stomach pain and other symptoms such as bloating and diarrhoea. The pain is usually mild, temporary, and eases once the stress passes.

How do I tell if my abdominal pain is serious?

Most abdominal pain is not serious, but you should seek urgent medical help if it is sudden, severe, worsening, or comes with fever, vomiting blood, black poo, or breathing problems. Recurring pain should also be checked by a doctor.

Does constipation cause abdominal pain?

Yes, constipation can cause abdominal pain, as well as other symptoms such as bloating and feeling sick. The pain usually improves after pooing.