Abdominal pain — sometimes dull, sometimes sharp, and often confusing. We’ve all felt it at some point. But when should you worry? And what could it mean? Let’s break it down in simple terms.
What is Abdominal Pain?
Abdominal pain refers to discomfort in the area between your chest and pelvis. It can feel like cramps, a dull ache, or a sharp stab. It might last a few hours or linger for days.
This symptom is one of the most common reasons people visit the emergency room or clinic. In fact, studies show that up to 15-20% of people will experience significant abdominal pain at some point in a year.
Abdominal pain isn’t a disease — it’s a signal. The cause could be something as simple as gas or as serious as appendicitis. So, listening to what your belly is saying is crucial.
How Does Abdominal Pain Happen?
Imagine your abdomen like a busy neighbourhood. There are different ‘houses’ (organs) — the stomach, liver, intestines, kidneys, and more — all packed in a small space.
When one of these structures gets irritated, inflamed, stretched, or blocked, the body responds with pain. Sometimes, the pain is from the organ itself. Other times, it might come from muscles, blood vessels, or even nerves nearby.
For example:
- If gas builds up in your intestines, it stretches the bowel wall — kind of like overfilling a balloon. That stretching causes cramping.
- If there’s inflammation (like in gastritis or appendicitis), it irritates the nerves, causing sharper, localized pain.
What Causes Abdominal Pain?
Abdominal pain has many faces and even more causes. Here are the top ones:
- Indigestion and Gas: Overeating or eating too fast can lead to bloating and discomfort. Think of that “ugh” feeling after a heavy meal.
- Constipation: When waste builds up, the pressure in the intestines can cause dull, crampy pain.
- Stomach flu (gastroenteritis): Often caused by a virus or bacteria, this brings cramping pain, nausea, and sometimes diarrhoea.
- Appendicitis: Starts near the belly button, then shifts to the lower right side. It’s a medical emergency.
- Gallstones: These can block the bile duct, leading to sudden pain in the upper right abdomen.
- Urinary tract infections: Can cause lower abdominal pain, especially during urination.
- Acid reflux or GERD: Causes upper abdominal burning pain or discomfort after meals.
- Irritable Bowel Syndrome (IBS): Causes cramping, bloating, and changes in bowel habits. It affects up to 10-15% of people globally.
Some studies suggest that:
- Gastroenteritis accounts for up to 20-25% of acute abdominal pain cases.
- Appendicitis is responsible for around 5-10%, especially in younger patients.
- Constipation and gas-related issues make up roughly 20-30%, particularly in children and older adults.
Who’s at Risk? (Risk Factors)
Abdominal pain can affect anyone — but certain people are more likely to suffer from it. Here’s a quick guide:
- Children: More prone to gas, constipation, and infections.
- Women: More likely to have pain related to menstruation, ovarian cysts, or urinary infections.
- Elderly: At higher risk for serious causes like bowel obstruction or diverticulitis.
- Stress-prone individuals: Stress can worsen IBS or even cause stomach discomfort directly.
- People with poor diets: Lack of fibre can cause constipation; too much fatty food may trigger gallbladder issues.
Other Symptoms That May Come With Abdominal Pain
Pain is rarely alone. It usually brings a few friends — and they offer clues.
Common symptoms:
- Bloating and gas
- Nausea or vomiting
- Diarrhoea or constipation
- Fever
- Loss of appetite
If the condition gets worse, you might see:
- Severe, sharp pain that won’t go away
- Bloody stools or vomit
- Weight loss
- Yellowing of the skin (jaundice)
- Pain when touching the belly (rebound tenderness)
These red flags need urgent attention.
Tests to Identify the Cause
The most important tool is a thorough history and physical exam. Doctors often ask where the pain is, what it feels like, and what makes it better or worse.
Gold standard tests depend on what the doctor suspects. These may include:
- Blood tests: To check for infection, inflammation, or liver/kidney issues.
- Urine tests: To rule out urinary infections or kidney stones.
- Ultrasound: Especially useful for gallstones, ovarian cysts, or appendicitis.
- CT scan: Offers detailed imaging of organs and is often used for emergencies.
- Endoscopy: To see inside the stomach or intestines for ulcers or inflammation.
For example:
- If appendicitis is suspected, a CT scan or ultrasound is the go-to test.
- If the pain is high up and reflux is suspected, endoscopy may be recommended.
Treatment for Abdominal Pain
The treatment depends entirely on the cause — there’s no one-size-fits-all solution.
Mainstream Treatments (Gold Standard):
- Appendicitis: Needs surgical removal of the appendix (appendectomy).
- Gastritis or ulcers: Treated with acid reducers (PPIs) and antibiotics if H. pylori is involved.
- Gallstones: Often need surgery (cholecystectomy) if painful or recurrent.
- UTI: Requires antibiotics.
- Gastroenteritis: Usually gets better on its own — rest and fluids are key.
- IBS: Managed through dietary changes (low FODMAP), stress reduction, and sometimes medication.
Other Supportive Options:
- Pain relievers (paracetamol or antispasmodics)
- Heating pads for cramps
- Hydration and electrolyte replacement
- Probiotics for gut balance
- Diet changes like more fibre or cutting down on dairy, depending on the cause
Always remember: Never ignore sudden or severe pain, especially if it wakes you from sleep or doesn’t improve.
References
- “Abdominal Pain”, Mayo Clinic, 2023. https://www.mayoclinic.org/symptoms/abdominal-pain/basics/definition/sym-20050728
- “Evaluation of Acute Abdominal Pain”, American Family Physician, 2020. https://www.aafp.org/pubs/afp/issues/2020/0215/p233.html
- “Irritable Bowel Syndrome”, NHS UK, 2024. https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/
- “Acute Appendicitis”, National Institute of Health (NIH), 2022. https://www.ncbi.nlm.nih.gov/books/NBK493193/