Fifteen possible causes of abdominal pain

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Abdominal pain refers to discomfort in the space between the chest and pelvis. Most cases of abdominal pain are mild and have a variety of common causes, such as indigestion or muscle strain.

Symptoms often resolve quickly on their own or with basic treatment. Abdominal pain, especially with severe or chronic symptoms, can also be a sign of more serious underlying medical conditions, including cancer or organ failure.

Sudden and severe or long-lasting abdominal pain may require immediate medical treatment.

Fast facts on abdominal pain:

  • Digestive problems are considered the most common cause of abdominal pain.
  • Most cases resolve on their own without medical attention.
  • Sudden or intense pain requires immediate medical attention.
  • Over-the-counter medication can alleviate symptoms of mild abdominal pain.

What is abdominal pain?

Lady in bed holding her stomach

Nausea, vomiting, and a loose stool may accompany abdominal pain if the cause is gastroenteritis.
Digestive problems are considered the most common cause of abdominal pain. Discomfort or irregularities in any organ or part of the abdomen can cause pain that radiates throughout the entire area.

Many people refer to abdominal pain simply as a stomachache. However, the abdomen contains many vital organs, muscles, blood vessels, and connective tissues that include:

  • stomach
  • kidneys
  • liver
  • small and large intestines
  • the appendix
  • pancreas
  • gallbladder
  • spleen

The main artery of the heart (aorta) and another heart vein (inferior vena cava) pass through the abdomen too. The abdomen is also home to the core muscles, the four groups of abdominal muscles that give the trunk stability and keep organs in place and protected.

Because there are a lot of areas that can be affected, abdominal pain may have many causes.

Abdominal pain is a common complaint and can be caused or complicated by a variety of factors.

Common causes include:

1. Gastroenteritis (stomach flu)

lady holding stomach in discomfort

Abdominal pain may be caused by constipation, which puts pressure on the colon.

In this case, the abdominal pain is often accompanied by nausea, vomiting, and loose, fluid-filled stools that occur much sooner and more frequently than normal after eating.

Bacteria or viruses cause most cases, and symptoms usually resolve within a few days. Symptoms that last longer than 2 days may be a sign of more serious health problems, such as infection or inflammatory conditions, such as inflammatory bowel disease.

Common symptoms include:

  • nausea
  • vomiting
  • fever
  • abdominal cramping
  • bloating
  • gas

2. Gas

Gas occurs when bacteria in the small intestine break down foods that the body finds intolerant. An increased pressure of gas in the intestine can cause sharp pain. Gas can also cause tightness or restriction in the abdomen and flatulence or belching.

3. Irritable bowel syndrome (IBS)

For unknown reasons, those with IBS are less able to digest certain foods or types of foods.

Abdominal pain is the primary symptom for many people with IBS and is often relieved after a bowel movement. Other common symptoms include gas, nausea, cramping, and bloating.

4. Acid reflux

Occasionally stomach acids travel backward, moving up into the throat. This reflux almost always causes a burning sensation and accompanying pain. Acid reflux also causes abdominal symptoms, such as bloating or cramps.

5. Vomiting

Vomiting often causes abdominal pain as stomach acids travel backward through the digestive tract, irritating tissues along the way. The physical act of vomiting also may cause abdominal muscles to become sore.

6. Gastritis

When the stomach lining becomes inflamed or swollen, pain may occur. Nausea, vomiting, gas, and bloating are other common symptoms of gastritis.

7. Food intolerances

When the body is unable to digest food materials, they are broken down by intestinal and stomach bacteria, which release gas in the process. When large amounts of undigested materials are present, a lot of gas is produced, causing pressure and pain.

Nausea, vomiting, bloating, diarrhea, and abdominal pain are other symptoms.

8. Constipation

When the bowel becomes backed up with waste, the pressure on the colon is increased, which may cause pain.

9. Gastroesophageal reflux disease (GERD)

GERD can cause abdominal pain as well as heartburn and nausea.

10. Stomach or peptic ulcers

Ulcers or wounds that will not heal tend to cause severe and persistent abdominal pain.

The most common causes of stomach and peptic ulcers are the bacteria H. pylori and the overuse or continued use of non-steroidal anti-inflammatory medications (NSAIDS).

11. Crohn’s disease

Crohn’s causes inflammation of the digestive tract lining, which results in pain, gas, diarrhea, nausea, vomiting, and bloating. Given its chronic nature, the condition may lead to malnutrition, causing weight loss and exhaustion.

12. Celiac disease

An allergy to gluten, a protein found in many grains, such as wheat and barley, causes inflammation in the small intestine, resulting in pain.

Diarrhea and bloating are also common symptoms. Over time, malnutrition can occur, resulting in weight loss and exhaustion.

13. Pulled or strained muscles

Because many daily activities require the use of the abdominal muscles, injury or strain is common. Many people also focus heavily on abdominal exercises, increasing the risk of damage.

14. Menstrual cramps or endometriosis

Menstruation can cause inflammation and pain in the abdomen. Bloating, gas, cramping, and constipation can also occur during menstruation, causing abdominal discomfort.

Women who have endometriosis may experience more severe or chronic inflammation and pain.

15. Urinary tract and bladder infections

Urinary tract infections are most often caused by bacteria, primarily E.coli species, that colonize the urethra and bladder, causing a bladder infection or cystitis.

Symptoms include pain, pressure, and bloating in the lower abdominal area. Most infections also cause painful urination and cloudy, strong-smelling urine.

Uncommon causes

In some cases, abdominal pain is a sign of a medical condition that can be fatal without immediate medical care.

Less common causes of abdominal pain include:

  • appendicitis (ruptured appendix) or any other ruptured abdominal organ
  • kidney infection, disease, or stones
  • hepatitis (inflammation of the liver)
  • gallbladder stones (hard deposits in the gallbladder)
  • food poisoning
  • parasitic infections
  • abdominal organ infection or infarction (when the organ dies due to lack of blood supply)
  • cardiac conditions, such as atypical angina or congestive heart failure
  • organ cancer, notably stomach, pancreatic, or bowel cancer
  • hiatal hernia
  • cysts that have become invasive or compromise organ space or function

When to see a doctor

Most cases of abdominal pain are not serious, and symptoms resolve with basic home care, such as rest and hydration, within hours to days.

Many over-the-counter medications, such as antacids and gas medications, also help reduce and manage symptoms.

Antacids

Over-the-counter antacids may help to manage symptoms of abdominal pain.

Acute (sudden and severe) or chronic (long-lasting) abdominal pain, however, are often signs of conditions that do require medical attention and treatment.

Symptoms that require medical attention include:

  • unexplained weight loss
  • unexplained exhaustion
  • changes or disturbances in bowel movements, such as chronic constipation or diarrhea, that do not resolve within a few hours or days
  • minor rectal (anal) bleeding or blood in stool
  • unusual vaginal discharge
  • chronic pain that continues after taking over-the-counter medications or returns after stopping prescribed medication
  • signs of urinary tract infection

Symptoms that require emergency care include:

  • sudden, severe pain, especially if accompanied by a fever over 102°F
  • severe pain that is very concentrated
  • bloody or black stool that may be sticky
  • uncontrollable vomiting, especially if vomit includes blood
  • the abdomen is extremely painful and sensitive to the touch
  • being unable to urinate
  • fainting or becoming unconscious
  • pain that gets dramatically worse quickly
  • pain in the chest, especially around the ribs, extending into the abdomen
  • severe abdominal pain that improves with lying very still

Though rare, it is important for people experiencing these symptoms to seek emergency medical attention.