Lower
Abdominal Pain

What is Lower Abdominal Pain?

Abdominal or bowel pain is pain that occurs between the chest and pelvic regions. It can be crampy, achy, dull, intermittent or sharp, and is usually called a stomachache.

Inflammation or diseases that affect the organs in the abdomen can cause abdominal pain. Viral, bacterial, or parasitic infections that affect the stomach and intestines may also cause significant abdominal pain.

What causes abdominal pain?

Abdominal pain can be caused by many conditions. However, the main causes are infection, abnormal growths, inflammation, obstruction (blockage), and intestinal disorders.

Infections in the throat, intestines, and blood can cause bacteria to enter your digestive tract, resulting in abdominal pain. These infections may also cause changes in digestion, such as diarrhea or constipation.

Cramps associated with menstruation are also a potential source of lower abdominal pain, but these are more commonly known to cause pelvic pain.

Other common causes of abdominal pain include:

• constipation
• diarrhea
• gastroenteritis (stomach flu)
• acid reflux (when stomach contents leak backward into the esophagus, causing heartburn and other symptoms)
• vomiting
• stress

Diseases that affect the digestive system can also cause chronic abdominal pain. The most common are:

• gastroesophageal reflux disease (GERD)
• irritable bowel syndrome or spastic colon (a disorder that causes abdominal pain, cramping, and changes in bowel movements)
• Crohn’s disease (an inflammatory bowel disease)
• lactose intolerance (the inability to digest lactose, the sugar found in milk and milk products)

Causes of severe abdominal pain include:

• organ rupture or near-rupture (such as a burst appendix, or appendicitis)
• gallbladder stones (known as gallstones)
• kidney stones
• kidney infection

Types of abdominal pain

Abdominal pain can be described as localized, cramp-like, or colicky. Localized pain is limited to one area of the abdomen. This type of pain is often caused by problems in a particular organ. The most common cause of localized pain is stomach ulcers (open sores on the inner lining of the stomach).

Cramp-like pain may be associated with diarrhea, constipation, bloating, or flatulence. In women, it can be associated with menstruation, miscarriage, or reproductive complications. This pain comes and goes, and may go away on its own without treatment.

Colicky pain is a symptom of more severe conditions, such as gallstones or kidney stones. This pain occurs suddenly, and may feel like a severe muscle spasm.
Location of pain within the abdomen

The location of the pain within the abdomen may be a clue as to its cause. Pain that’s generalized throughout the abdomen (not in one specific area) may indicate:

• appendicitis (inflammation of the appendix)
• Crohn’s disease
• traumatic injury
• irritable bowel syndrome
• urinary tract infection
• the flu

In women, pain in the reproductive organs of the lower abdomen can be caused by:

• severe menstrual pain
• ovarian cysts
• miscarriage
• fibroids
• endometriosis
• pelvic inflammatory disease
• ectopic pregnancy

When to see the doctor

Mild abdominal pain may go away without treatment. However, in some cases, abdominal pain may warrant a trip to the doctor. Call 911 if your abdominal pain is severe and associated with trauma (from an accident or injury) or pressure or pain in your chest.

You should seek immediate medical care if the pain is so severe that you can’t sit still or need to curl into a ball to get comfortable, or if you have any of the following:

• bloody stools
• fever greater than 101°F (38.33°C)
• vomiting up blood (called hematemesis)
• persistent nausea or vomiting
• yellowing of the skin or eyes
• swelling or severe tenderness of the abdomen
• difficulty breathing

Make an appointment with your doctor if you experience any of the following symptoms:

• abdominal pain that lasts longer than 24 hours
• prolonged constipation
• vomiting
• a burning sensation when you urinate
• fever
• loss of appetite
• unexplained weight loss

Call your doctor if you’re pregnant or breastfeeding and you experience abdominal pain.

How is the cause of abdominal pain diagnosed?

The cause of abdominal pain can be diagnosed through a series of tests. Before ordering tests, your doctor will do a physical examination. This includes gently pressing on various areas of your abdomen to check for tenderness and swelling.

This information, combined with the severity of the pain and its location within the abdomen, will help your doctor determine which tests to order.

Imaging tests, such as MRI scans, ultrasounds, and X-rays, are used to view organs, tissues, and other structures in the abdomen in detail. These tests can help diagnose tumors, fractures, ruptures, and inflammation.

Other tests include:

• colonoscopy (to look inside the colon and intestines)
• endoscopy (to detect inflammation and abnormalities in the esophagus and stomach)
• upper GI (a special X-ray test that uses contrast dye to check for the presence of growths, ulcers, inflammation, blockages, and other abnormalities in the stomach)

Blood, urine, and stool samples may also be collected to look for evidence of bacterial, viral, and parasitic infections.