This information is intended only to provide general guidance. It does not provide definitive medical advice. It is important that you consult your doctor about your specific condition.
Pain in the abdomen (also called a "stomach ache") is common and may be due to many causes, some serious and most not serious. The abdominal pain may originate in the internal organs, the abdominal wall, or from sites outside the abdominal cavity, such as the chest, the back, or the pelvis.
What causes abdominal pain?
This table lists some of the more common causes of abdominal pain:
INFLAMMATORY DISEASES OF THE UPPER ABDOMEN:
- Gastritis
- Duodenal or gastric ulcers
- Esophagitis (usually due to gastroesophageal reflux disease)
- Pancreatitis
- Cholecystitis (inflammation of the gallbladder)
- Choledocholithiasis (gallstones blocking the bile ducts)
- Gallstones
INFLAMMATORY DISEASES OF THE MID-ABDOMEN AND LOWER ABDOMEN
- Diverticulitis (inflammation of pouches protruding from the colon)
- Appendicitis
- Colitis
- Crohn's disease
- Infections of the small bowel
FUNCTIONAL CONDITIONS
- Irritable bowel syndrome
- Nonulcer dyspepsia (discomfort related to eating that is not due to ulcers or gastritis)
- Biliary dyskinesia (spasm of the bile duct or valve)
- Functional abdominal pain (without a clear cause)
- Intestinal gas
- Lactose intolerance
ABDOMINAL OR CHEST WALL PAIN
- Shingles (herpes zoster infection)
- Costochondritis (inflammation of the rib joints)
- Injury (due to a pulled muscle or trauma)
- Neuropathy (irritation of a nerve)
- Hernias (protrusion of internal structures through a gap in the abdominal wall)
INTESTINAL OBSTRUCTION
- Adhesions (scar tissue that forms after abdominal surgery or inflammation)
- Tumors
- Inflammation (including Crohn's disease)
- Colon cancer
VASCULAR DISEASES
- Abdominal aortic aneurysm
- Mesenteric vascular insufficiency (blockage of abdominal arteries or veins)
ABDOMINAL CANCERS
- Pancreatic cancer
- Stomach cancer
- Liver cancer
- Bile duct or gallbladder cancer
- Colon cancer
- Lymphoma
URINARY TRACT DISEASES
- Kidney stones
- Urinary tract infections
- Tumors of the kidney or bladder
GYNECOLOGIC PROBLEMS
- Ectopic pregnancy
- Endometriosis
- Ovarian cysts
- Ovarian cancer
- Infection of the fallopian tubes (salpingitis)
- Uterine fibroid tumors
- Adhesions (scar tissue)
- Cancer of the uterus or cervix
NON-ABDOMINAL CAUSES
- Pneumonia
- Myocardial infarction (heart attack)
- Pleurisy (inflammation or infection of the lining around the lungs)
- Pulmonary embolism (blood clot in the lungs)
When should your doctor be contacted when you have abdominal pain?
When the abdominal pain is severe and lasts more than one hour or comes and goes on for more than 24 hours, you should contact your doctor as soon as possible. In addition, if your abdominal pain is accompanied by any of the following symptoms, you should contact your doctor immediately:
- Vomiting blood
- Bloody stools
- Difficulty breathing
- The abdomen is tender to the touch
- Fever greater than 101°
- Jaundice (yellow skin or eyes)
- Painful or frequent urination
- A recent fall or injury
- Severe or persistent pain during pregnancy
Other symptoms that should cause concern and lead to a doctor visit include:
- Abdominal swelling
- Inability to eat for over 24 hours
- The pain lasts several days
- Loss of weight or loss of appetite
Diagnosis of the cause of the abdominal pain
The history you give your doctor is the most important information for the doctor to determine the cause of the abdominal pain. Dr. Harary, in his New York City office, will ask you such details as:
- The character of the abdominal pain (burning, crampy, sharp, dull, twisting)
- The location of the abdominal pain and whether it spreads (radiates) elsewhere.
- Relationship to eating or bowel movements.
- The duration of the abdominal pain.
- What makes the abdominal pain better or worse.
- Whether there is more than one type or location of the abdominal pain.
Dr. Harary will examine your abdomen to look for areas of tenderness, the presence or absence of abdominal distention and bowel sounds, enlargement of the liver or spleen, and masses. He may do a rectal examination to check for blood in the stool.
The combination of the history and physical examination often provides a clear idea of the cause of the abdominal pain. Sometimes tests are required, such as blood tests, urine and stool tests, x-rays, ultrasound examinations (using sound waves to visualize the organs), CT scans(computerized tomography), MRI scans (magnetic resonance imaging), and endoscopy (tubes to look inside the stomach or intestine: See the web pages on EGD and colonoscopy under the Services section of this website). With this approach - a careful history and physical examination supplemented if necessary by selected additional tests - the cause of the abdominal pain can usually be discovered. You can read more about some of the specific conditions that cause abdominal pain in the Conditions We Treat section of this website.
How is abdominal pain treated?
Depending on the cause, abdominal pain can be treated with medications (for example, to decrease acid production, stimulate or relax the muscles of the intestine, or decrease inflammation). Sometimes surgery is necessary (for example, to remove the gallbladder if it is inflamed, for appendicitis, or to repair hernias). Altering the diet can sometimes help abdominal pain.
Aspirin and nonsteroidal anti-inflammatory drugs (ibuprofen, Motrin, Advil, Aleve, naproxen, etc.) should not be used for abdominal pain, because they can cause or worsen other problems, such as ulcers. Narcotic drugs are sometimes used for abdominal pain, but they must be used very carefully, because they can cause constipation, nausea, dependency, and other side effects and can perpetuate the chronic abdominal pain problem even as they provide temporary pain relief. Chamomile tea and over-the-counter medications containing peppermint oil can help mild abdominal pain by relaxing the muscles of the stomach and intestine.
To learn more about the treatment of abdominal pain offered by Dr. Harary, please contact our New York City office today.
