Abdominal Pain in Adults: Causes, Symptoms & When to Seek Care

What Does "The Abdomen" Actually Mean?

The term "abdomen" or "stomach" is used to describe many different areas and organs. It can refer to the actual stomach organ, the entire gastrointestinal tract including liver, pancreas, and intestines, or other organs located between the pelvis and lungs such as the bladder, kidneys, prostate, uterus, and ovaries.

When people complain of "stomach pain" or "abdominal pain," they may be referring to discomfort in any part of this large region of the body. Understanding the anatomy helps both patients and healthcare providers communicate more effectively about symptoms. The abdominal cavity contains numerous vital organs, and pain can originate from any of them or from the muscles and tissues of the abdominal wall itself.

The gastrointestinal tract, which processes food from ingestion to elimination, includes the esophagus, stomach, small intestine, large intestine (colon), rectum, and associated organs like the liver, gallbladder, and pancreas. Each of these can be a source of abdominal pain when affected by disease, inflammation, or dysfunction. Additionally, organs outside the digestive system – such as the kidneys, bladder, uterus, and ovaries – are located within or near the abdominal cavity and can cause pain that feels like it's coming from the "stomach."

The nervous system in the gut is remarkably complex, sometimes called the "second brain" or enteric nervous system. This explains why emotional states like stress, anxiety, and depression can directly affect digestive function and cause real physical symptoms in the abdomen.

What Can I Do Myself to Relieve Stomach Pain?

Try to identify the cause of your stomach pain by reviewing your diet, stress levels, and lifestyle. Keeping a food diary, eating smaller meals, avoiding trigger foods, reducing stress, staying physically active, and getting adequate sleep can all help relieve or prevent abdominal pain.

Before seeking medical care for mild or recurring abdominal pain, there are several self-care strategies that can help identify the cause and provide relief. Many cases of stomach discomfort are related to dietary habits, stress, or lifestyle factors that can be modified without medical intervention. Taking a systematic approach to identifying triggers is often the first step toward finding relief.

Review Your Eating Habits

Start by examining what you eat and drink. Many digestive problems are directly related to diet. Consider whether your stomach pain might be connected to specific foods or eating patterns. Try eliminating foods you suspect might be causing problems and observe whether your symptoms improve.

Keeping a food diary is one of the most effective ways to identify dietary triggers. Write down everything you eat and drink, along with when you eat and how your symptoms respond. Over time, patterns often emerge that reveal connections between specific foods and digestive discomfort. Note not just what you eat but also the circumstances – are you eating quickly, while stressed, or late at night?

Common foods that can trigger digestive problems include:

• Fatty and fried foods – these slow digestion and can cause bloating and discomfort
• Spicy foods – can irritate the stomach lining and cause heartburn
• Coffee and caffeinated beverages – stimulate acid production and can worsen reflux
• Alcohol – irritates the digestive tract and affects gut bacteria
• Dairy products – problematic for those with lactose intolerance
• Foods high in refined flour – like pasta and white bread can cause bloating
• Acidic foods – such as citrus and vinegar can aggravate some conditions

Fiber: Important but Potentially Problematic

Dietary fiber is essential for healthy digestive function, but some people experience diarrhea and gas from too much fiber, especially if it's increased suddenly. Pay attention to how your body responds to high-fiber foods and increase fiber intake gradually if needed. Remember to drink more fluids when eating fiber-rich foods to prevent constipation.

Good sources of fiber include whole grain products, beans and lentils, root vegetables and potatoes, and fruits and vegetables. While fruits and vegetables contain soluble fiber that's generally easier to digest, some vegetables like onions, cabbage, and bell peppers can produce gas in the intestines. Experiment with different foods to see what your digestive system tolerates best.

Managing Stress-Related Stomach Pain

Stomach pain is frequently connected to stress and anxiety. The gut and brain are intimately connected through the gut-brain axis, and emotional distress can directly affect digestive function. If you're experiencing stress-related stomach issues, consider what might be causing your stress and whether changes are possible.

Strategies for reducing stress-related stomach symptoms include:

• Identifying and addressing sources of stress when possible
• Lowering expectations and reducing overcommitment
• Practicing relaxation techniques like deep breathing or meditation
• Getting regular physical exercise
• Ensuring adequate sleep
• Seeking support from friends, family, or a mental health professional

Additional Self-Care Tips

Beyond diet and stress management, other lifestyle factors can affect digestive health:

• Stay physically active – regular movement helps maintain healthy bowel function and prevents constipation
• Don't smoke – smoking increases the risk of many digestive problems
• Get adequate sleep – poor sleep can worsen digestive symptoms
• Wear loose clothing – tight clothes around the abdomen can increase discomfort
• Review your medications – some medications can cause stomach problems; discuss concerns with your doctor

When Should I Seek Medical Care for Stomach Pain?

Most stomach pain doesn't require medical care and resolves on its own. However, seek immediate care for sudden severe pain, pain with fever, bloody vomit or stool, pain after abdominal trauma, or if you feel faint. Contact a healthcare provider for recurring or persistent pain lasting more than a few days.

The vast majority of people who experience stomach pain don't need to seek medical care. The discomfort typically resolves on its own within a day or two. However, certain symptoms indicate potentially serious conditions that require prompt medical attention. Learning to distinguish between minor and serious symptoms can help you make appropriate decisions about seeking care.

Contact a healthcare provider promptly if you have recurring or long-lasting abdominal symptoms. Many clinics offer online consultations that can help determine whether you need an in-person visit. Seek same-day care at an urgent care clinic or emergency department if you experience:

• Sudden onset of severe abdominal pain
• Stomach pain accompanied by fever
• Vomit that looks like coffee grounds or contains blood
• Black, tarry, or bloody stool
• Pain following trauma or injury to the abdomen

How Is the Cause of Abdominal Pain Diagnosed?

Diagnosis involves a detailed description of your symptoms, physical examination including palpation and auscultation, and often laboratory tests (blood, urine, stool) and imaging studies (ultrasound, CT scan, endoscopy). The location, type, and timing of pain provide important diagnostic clues.

When you visit a healthcare provider for abdominal pain, providing a detailed and accurate description of your symptoms is crucial for reaching a correct diagnosis. The more specific information you can provide, the easier it is for your doctor to identify the underlying cause. Be prepared to describe not just where it hurts but how it hurts, when the pain started, and what makes it better or worse.

Questions Your Doctor May Ask About Your Symptoms

Your healthcare provider will likely ask detailed questions about the nature of your pain:

• Location: Where exactly in your abdomen is the pain? Be as specific as possible
• Character: How would you describe the pain? (dull, aching, burning, sharp, stabbing, cramping)
• Radiation: Does the pain spread or radiate to other areas like your back, shoulder, or groin?
• Timing: Is the pain constant or does it come and go? When did it start?
• Progression: Has the pain gotten better, worse, or stayed the same?
• Associated symptoms: Do you have nausea, vomiting, changes in bowel habits, or other symptoms?

You'll also be asked about your habits and medical history:

• Your eating habits and any recent dietary changes
• When you last had a bowel movement
• Whether certain foods trigger or worsen symptoms
• Your stress levels and emotional state
• Medications you're taking, including over-the-counter drugs
• What makes the pain better or worse
• For women: menstrual history and when your last period occurred

Physical Examination

The doctor will examine your abdomen by feeling (palpating) different areas while you try to relax your abdominal muscles. Tell the doctor how it feels when they press on different locations. They may also tap on your abdomen to check for unusual sounds or listen with a stethoscope to assess bowel sounds and detect any abnormalities. A rectal examination may be performed to check for abnormalities and test for blood in the stool.

Laboratory Tests

No single test can diagnose all causes of abdominal pain, so multiple tests may be needed. Common tests include:

• Blood tests: Complete blood count, liver function tests, pancreatic enzymes, inflammatory markers
• Urine tests: To check for urinary tract infection or kidney problems
• Stool tests: To check for blood, infection, or other abnormalities

Imaging and Endoscopic Studies

Depending on your symptoms and initial findings, additional tests may be ordered:

• Gastroscopy: A thin tube with a camera is passed through the mouth to examine the esophagus, stomach, and upper small intestine
• Colonoscopy: A camera examines the large intestine through the rectum
• Rectoscopy/Proctoscopy: Examination of the rectum and lower colon
• Ultrasound: Particularly useful for examining the liver, gallbladder, and kidneys
• CT scan: Detailed imaging that can reveal many abdominal abnormalities
• MRI: Sometimes used for specific diagnostic questions
• Gynecological examination: For women, to evaluate uterus, ovaries, and related structures

How Is Abdominal Pain Treated?

Treatment depends entirely on the underlying cause. Most mild cases respond to lifestyle modifications and over-the-counter medications. Some conditions require prescription medications like antibiotics, acid-reducing drugs, or antispasmodics. Certain causes, such as appendicitis, gallstones, or bowel obstruction, may require surgical intervention.

Because abdominal pain has so many possible causes, treatment varies widely depending on the diagnosis. For many common conditions, self-care measures and lifestyle modifications are the primary treatment. More serious conditions may require prescription medications or surgical intervention. Your healthcare provider will recommend treatment based on the identified cause of your symptoms.

Over-the-Counter Medications

For certain types of stomach discomfort, over-the-counter medications can provide relief:

• Antacids: For heartburn and acid reflux symptoms
• H2 blockers and proton pump inhibitors: For more persistent acid-related problems
• Antispasmodics: For cramping pain associated with IBS or menstrual cramps
• Laxatives: For constipation (use as directed, not for long-term use)
• Anti-diarrheal medications: For acute diarrhea (not for use with bloody diarrhea or fever)

Prescription Medications

Depending on the diagnosed condition, your doctor may prescribe:

• Antibiotics: For bacterial infections like pelvic inflammatory disease or urinary tract infections
• Stronger acid suppressants: For peptic ulcers, gastritis, or severe reflux
• Medications for IBS: Including antispasmodics, low-dose antidepressants, or newer IBS-specific drugs
• Anti-inflammatory medications: For inflammatory bowel disease
• Pain medications: For conditions like kidney stones or gallstones

Surgical Treatment

Some conditions causing abdominal pain require surgical intervention:

• Appendicitis: Removal of the inflamed appendix
• Gallstones: Removal of the gallbladder when medications don't help
• Kidney stones: Removal or breaking up of large stones
• Bowel obstruction: Emergency surgery to remove the blockage
• Perforated ulcer: Emergency repair of the stomach or intestinal wall
• Ectopic pregnancy: Surgical treatment of pregnancy outside the uterus
• Cancer: Surgical removal as part of cancer treatment
• Hernias: Repair of incarcerated or symptomatic hernias

What Can Cause Sudden Abdominal Pain?

Sudden abdominal pain can be caused by many conditions including constipation, gastroenteritis (stomach flu), appendicitis, kidney stones, gallstones, perforated ulcer, pancreatitis, bowel obstruction, or abdominal aortic aneurysm. The nature and location of pain helps identify the cause.

Sudden onset of abdominal pain can range from minor conditions that resolve quickly to medical emergencies requiring immediate treatment. Understanding the common causes and their characteristic features can help you assess the seriousness of your symptoms and decide when to seek care.

Constipation

Constipation is a common cause of both sudden and chronic abdominal pain. When you're constipated, you have difficulty passing stool, and the stool may be hard and dry. Along with pain, you may feel bloated and nauseous. Constipation can cause both sudden and more prolonged symptoms depending on severity.

Gastroenteritis (Stomach Flu)

Most people experience gastroenteritis at least once in their lives. When you have a stomach bug, you feel nauseous and have stomach pain. Vomiting and diarrhea are common, and you may also have fever and muscle aches. While very unpleasant, symptoms typically improve within one to two days.

Appendicitis

Appendicitis typically begins with nausea and decreased appetite. You may feel vague discomfort and pain around the belly button. After several hours, the pattern usually changes – you develop severe pain in the lower right part of the abdomen. Fever may develop within a day or so. Appendicitis requires surgical treatment and should be evaluated promptly.

Kidney Stones

Kidney stones can cause intense, wave-like pain in the side or back when a stone becomes lodged in the urinary tract and blocks urine flow. The pain fluctuates between mild and severe and may radiate to the back or groin. Nausea, bloating, and sometimes blood in the urine are common. Movement may provide some relief.

Gallstones

Gallstone pain typically causes intense, cutting pain under the right ribs that occurs in waves, often after eating, especially fatty meals. The pain may radiate to the back and right shoulder. Nausea and vomiting are common. If the gallbladder becomes inflamed, you may develop a dull ache, tenderness over the right ribs, chills, and fever.

Perforated Ulcer

A peptic ulcer is a sore in the stomach or duodenal lining. While uncommon, an ulcer can perforate (break through) the wall, causing sudden severe pain in the upper abdomen with tenderness to touch. The pain is constant and may radiate to the back. This is a medical emergency. A perforated ulcer may occur without prior warning symptoms, though many people have had some discomfort beforehand.

Acute Pancreatitis

The pancreas sits deep in the abdomen in front of the spine. Acute pancreatitis causes severe pain high in the middle of the abdomen that often radiates to the back between the shoulder blades. Fever may be present. Symptoms can range from mild to severe enough to cause pale, clammy skin and sweating. Nausea, vomiting, and abdominal swelling are common.

Bowel Obstruction

There are two types of bowel obstruction: mechanical obstruction and paralytic ileus. Mechanical obstruction occurs when something physically blocks the intestine. Pain increases as the bowel tries to push contents past the blockage. Nausea and vomiting are common – vomit may have a fecal odor. In paralytic ileus, bowel movements stop, causing the abdomen to become distended with gas.

Abdominal Aortic Aneurysm

An abdominal aortic aneurysm is a bulging of the main artery in the abdomen. You may have an aneurysm without symptoms for years. However, if it ruptures, you experience sudden severe pain and significant internal bleeding. Pain often starts on the left side and radiates to the back. Due to blood loss, you may go into shock – becoming pale, sweaty, with low blood pressure and rapid pulse. You may faint. This is a life-threatening emergency. Abdominal aortic aneurysm can be hereditary.

Blood Clot in Intestinal Blood Vessels

A blood clot in the intestinal blood vessels causes severe pain felt throughout the abdomen. You become nauseous, bloated, and may have diarrhea that's sometimes bloody. You may have experienced mild pain before the acute event, particularly after eating.

What Can Cause Long-Term Abdominal Pain?

Chronic or recurring abdominal pain can result from stress, food intolerances (lactose, gluten), irritable bowel syndrome (IBS), functional dyspepsia, gastritis, peptic ulcers, inflammatory bowel disease (Crohn's, ulcerative colitis), diverticulitis, or medications. Sometimes no specific cause can be identified despite testing.

Abdominal pain lasting weeks or occurring repeatedly over time requires different consideration than acute pain. Many causes of chronic abdominal pain don't show up on standard tests – conditions like IBS and functional dyspepsia are diagnosed based on symptoms rather than abnormal test results. This doesn't mean the pain isn't real; it reflects the complex nature of digestive symptoms and the gut-brain connection.

Stress-Related Stomach Pain

It's very common to experience digestive symptoms when stressed or anxious. The gut contains millions of nerve cells that communicate constantly with the brain. During stressful situations or periods of emotional difficulty, this communication can trigger real physical symptoms including pain, cramping, diarrhea, or constipation. The symptoms are caused by the stress itself, not by physical damage to the digestive organs. Smoking, alcohol, and certain medications can worsen stress-related symptoms.

Functional Dyspepsia (Sensitive Stomach)

Functional dyspepsia means you have a sensitive stomach that causes pain or burning in the upper abdomen, feelings of tension or bloating, and early fullness when eating. Many people use the term "gastritis" to describe these symptoms, though gastritis technically refers to inflammation visible on examination. Symptoms often worsen with certain foods or drinks and during times of stress. Lifestyle changes frequently help improve symptoms.

Gastritis

True gastritis involves inflammation of the stomach lining. Symptoms resemble those of functional dyspepsia or peptic ulcers – gnawing or aching pain in the middle upper abdomen. Nausea and a burning sensation behind the breastbone are common. Gastritis can be caused by infection with H. pylori bacteria, excessive alcohol, or certain medications including NSAIDs.

Peptic Ulcers

Peptic ulcers are sores in the lining of the stomach or duodenum. Symptoms vary between individuals – some feel worse when eating while others feel better. Common features include pain in a specific location in the upper abdomen, pain that comes and goes in cycles, nausea, and early satiety. Many ulcers are caused by H. pylori infection and can be cured with antibiotic treatment.

Heartburn and Gastroesophageal Reflux

When stomach acid flows back into the esophagus, it causes burning pain behind the breastbone (heartburn) and sometimes pain in the upper middle abdomen. Acid reflux often causes sour taste or regurgitation. Symptoms typically worsen when lying down and improve when sitting or standing. Avoiding trigger foods, eating smaller meals, and elevating the head of the bed can help.

Irritable Bowel Syndrome (IBS)

IBS is one of the most common causes of chronic abdominal pain, affecting 10-15% of adults worldwide. IBS causes various digestive symptoms including abdominal pain that typically improves after having a bowel movement, alternating constipation and diarrhea, and excessive gas. While IBS isn't dangerous, it can significantly impact quality of life. Treatment focuses on identifying triggers, dietary modifications (like the low-FODMAP diet), stress management, and medications to manage specific symptoms.

Inflammatory Bowel Disease

Crohn's disease and ulcerative colitis are inflammatory conditions affecting the intestines. Common symptoms include abdominal pain, diarrhea, blood in stool, mucus in stool, weight loss, and fatigue. Symptoms typically come and go in flares. These conditions require medical management with anti-inflammatory medications and sometimes immunosuppressants.

Diverticulitis

Diverticulitis is inflammation of small pouches that can form in the intestinal wall. It commonly causes pain in the lower left abdomen, along with fever, abdominal tenderness, and sometimes diarrhea. Treatment typically involves antibiotics and dietary modifications.

Food Intolerances

Lactose intolerance: People with lactose intolerance lack sufficient lactase enzyme to digest milk sugar. Consuming dairy products causes gas, diarrhea, cramping, and bloating. Some people develop temporary lactose sensitivity after a stomach bug.

Celiac disease (gluten intolerance): Celiac disease is an autoimmune reaction to gluten found in wheat, rye, and barley. Symptoms include fatigue, diarrhea, gas, bloating, weight loss, mouth sores, and bone pain. Symptoms resolve when gluten is eliminated from the diet.

Medication-Related Stomach Pain

Both prescription and over-the-counter medications can cause stomach pain. Non-steroidal anti-inflammatory drugs (NSAIDs) are particularly common culprits. If you suspect your medications may be causing digestive symptoms, discuss this with your doctor or pharmacist.

Cancer

While less common than the conditions above, cancer affecting digestive organs can cause abdominal pain. Seek evaluation if you have persistent abdominal pain, especially if accompanied by unexplained fatigue, loss of appetite, or unintentional weight loss.

Can Gynecological Conditions Cause Abdominal Pain?

Yes, many gynecological conditions cause abdominal pain including menstrual cramps, endometriosis, pelvic inflammatory disease, uterine fibroids, ovarian cysts, and ectopic pregnancy. The pain is often felt in the lower abdomen and may be related to the menstrual cycle.

In women, abdominal pain can originate from the reproductive organs. These conditions typically cause lower abdominal or pelvic pain and may have a relationship to the menstrual cycle.

Menstrual Cramps

Menstrual cramps can cause significant pain in the lower abdomen or back, sometimes with dizziness and nausea. Pain typically begins just before or at the start of menstruation. Some women also experience pain at ovulation, which occurs mid-cycle.

Endometriosis

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus. It commonly causes severe menstrual pain, though pain can occur at other times as well. The pain often feels like a band across the pelvis and may radiate to the lower back or legs. Pain during sex, bowel movements, or urination is also common.

Pelvic Inflammatory Disease

Pelvic inflammatory disease is an infection of the female reproductive organs, often caused by sexually transmitted infections like gonorrhea or chlamydia. Symptoms include increased vaginal discharge, lower abdominal pain, pelvic heaviness, fever, and fatigue. Some infections cause minimal symptoms initially.

Uterine Fibroids

Fibroids are benign growths in the uterine muscle. They often cause heavy menstrual bleeding, pelvic heaviness, and severe menstrual pain.

Ovarian Cysts

Ovarian cysts are fluid-filled sacs that may cause no symptoms or may cause abdominal pain that's constant, related to activity, or sudden in onset.

Ectopic Pregnancy

An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, usually in a fallopian tube. Symptoms typically include vaginal bleeding around weeks 5-6 of pregnancy with severe lower abdominal pain, often on one side. If the fallopian tube ruptures, major internal bleeding occurs – this is life-threatening and requires immediate emergency care. Symptoms include severe pain, dizziness, cold sweats, and feeling faint.