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Underlying causes of abdominal pain

14-minute read

If you have a sudden, severe, incapacitating pain in your abdomen, go immediately to your nearest hospital emergency department or call triple zero (000) and ask for an ambulance.

Key facts

  • Abdominal pain can have many different underlying causes.
  • Sudden and severe abdominal pain is a medical emergency and you requires immediate help.
  • Mild to moderate abdominal pain may only last for a few hours or a few days and can clear up without the need for treatment.
  • Children often experience stomach or abdominal pain, which may not have a physical cause.
  • Older people are more likely to have abdominal pain with atypical symptoms.

What causes abdominal pain?

There are many underlying causes of abdominal pain. Some of these are short-term (acute) causes that aren’t serious — the symptoms may last only hours or days, and may clear up by themselves. Others are longer lasting and may be more serious.

There are also causes of abdominal pain that require urgent medical attention and may be life-threatening.

Some causes of abdominal pain are more common — or less likely — in certain age groups or genders.

Children often get stomach or abdominal pain. Some of the most common causes are gastroenteritis, wind or indigestion. Some causes of abdominal pain apply mainly to children, such as colic, intussusception, and testicular torsion. For more information on these, see abdominal pain in children.

Women may experience abdominal pain associated with their periods, pregnancy or problems with their urinary or reproductive system.

Older people are more likely than younger people to have abdominal pain due to heart or lung problems, bowel obstruction, or conditions such as diverticulitis or gallstones.

CHECK YOUR SYMPTOMS — Use the abdominal pain Symptom Checker and find out if you need to seek medical help.

What causes sudden and severe abdominal pain?

Sudden and severe abdominal pain should never be ignored. Steadily worsening abdominal pain may also be a sign of a serious condition.

If you have these symptoms, go immediately to your nearest hospital emergency department or call triple zero (000) and ask for an ambulance.

Some of the causes of serious abdominal pain include:

Appendicitis

Appendicitis causes a dull pain that starts around the belly button area. It normally travels to the lower right of the abdomen where it is felt as a sharp pain. Other symptoms of appendicitis include a loss of appetite, nausea, vomiting, fever and chills.

If left untreated the appendix can become swollen and infected and then it may burst. Urgent surgery is usually the treatment required for appendicitis.

Bowel obstruction

Bowel obstruction can be partial or complete. Most bowel obstructions are in the small bowel, the section between your stomach and your large intestine.

Bowel obstructions cause bloating and abdominal pain. The pain may be cramping or colicky, so it starts suddenly and comes and goes in waves. You may not be able to poo or fart (pass gas/wind). If the blockage is only partial, you may have diarrhoea. You may also feel sick (nausea) and have lost your appetite.

You might need surgery, depending on your situation.

Gallstones

If gallstones block a bile duct they can cause pain known as biliary colic.

Biliary colic pain is felt on the upper right side of the abdomen, under the ribs. The pain is often severe and comes in waves that usually last between 30 minutes and 2 hours. It is often accompanied by nausea.

You may need to have your gallbladder removed surgically. This operation is called a cholecystectomy and is often done using keyhole surgery (laparoscopic surgery).

Kidney stones

Many small kidney stones are passed to the bladder without any problems. But large kidney stones may become stuck in the ureter, causing a blockage that stops the flow of urine out of the kidney. This can cause a sudden pain called renal colic, which starts as a gripping pain in your back, just below your ribs. The pain may move around to your abdomen at the front of your body, or to your groin. The pain may come and go in waves.

You may also have fever or shivers, an urge to urinate, or blood in your urine. Kidney stones are more common in older people.

Abdominal aortic aneurysm (AAA)

An aneurysm is an abnormal enlarged area in a blood vessel, where the walls of the blood vessel have become weak and allowed it to bulge out. If the aneurysm ruptures it causes sudden, severe and persistent abdominal or back pain. This is a life-threatening emergency. These aneurysms happen mostly in older people.

Other symptoms of AAA are feeling faint, nausea and vomiting.

Heart attack

In addition to chest and arm pain radiating to the jaw or back, heart attacks can also cause indigestion, nausea and abdominal pain. Women, especially, may experience these other symptoms.

Pregnancy problems

Severe abdominal pain in pregnancy could be due to one of the causes above, or it could be connected to your pregnancy, as with the following:

  • Pre-eclampsia — This is a complication of pregnancy that causes dangerously high blood pressure and can be fatal, both for the mother and baby. There may not be any symptoms, but severe upper right abdominal pain and vomiting may occur.
  • Ectopic pregnancy — This refers to when an embryo implants outside the womb. It can cause one-sided abdominal pain or severe pain in the lower abdomen.
  • Pre-term labour — This is defined as going into labour before 37 weeks of pregnancy. It causes painful contractions and cramping for the woman.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

What causes long-term or recurrent abdominal pain?

Long-term abdominal pain may be present all the time or it may come and go. Pain that has been present for 3 months or more and that comes and goes in episodes is known as recurrent pain. It may worsen over time or stay the same in intensity.

Common causes of long-term or recurrent abdominal pain include:

GORD

Acid reflux (gastro-oesophageal reflux disease, or GORD) causes discomfort and pain in the upper abdomen, commonly known as heartburn. Other symptoms include belching, sore throat and bad breath. Symptoms may flare up after eating certain foods or large meals.

Hiatus hernia

Hiatus hernia — where part of the stomach protrudes from the abdomen into the chest — can lead to symptoms of GORD.

Irritable bowel syndrome

Irritable bowel syndrome (IBS) causes cramping abdominal pain, bloating and episodes of constipation or diarrhoea. The cramping pain is often relieved by passing wind or going to the toilet.

Crohn's disease and ulcerative colitis

Crohn’s disease and ulcerative colitis are known together as inflammatory bowel disease. Symptoms include crampy abdominal pain, diarrhoea, and a feeling of urgently needing to pass a poo. Blood, mucus or pus may be seen in your poo.

Diverticulitis

Diverticulitis occurs when small abnormal pockets in the wall of the bowel become inflamed or infected, which can cause left-sided abdominal pain and bloating. Passing wind or going to the toilet may relieve symptoms, although a mild attack may last for a few days. Eating sufficient fibre is recommended to soften stools and prevent constipation. Flare-ups are rare, but some people will have a recurrence of diverticulitis. The condition becomes more common with increasing age.

Peptic ulcers

Peptic ulcers, such as stomach ulcers and duodenal ulcers, can cause dull abdominal pain that comes and goes. The condition may develop a few hours after eating or during the night. Taking antacids or eating some food may relieve it.

If you experience a sudden sharp stomach pain, however, or start vomiting blood or pass blood in your poo, you should seek urgent medical attention. You may have a bleeding perforated ulcer — one that has made a hole through the wall of your stomach.

Coeliac disease

Coeliac disease can cause ongoing abdominal pain and other gastrointestinal symptoms, such as cramping, diarrhoea, constipation, bloating and flatulence.

Cancer

Bowel cancer, stomach cancer and liver cancer can all cause abdominal pain that may steadily worsen over time. In their early stages, these diseases often don’t cause any symptoms, which is why it’s important to take advantage of any screening programs that are available.

Functional dyspepsia

Functional dyspepsia is a condition with multiple recurring symptoms in the upper abdomen but no obvious physical cause. These symptoms may include abdominal pain, a feeling of fullness, burning pain, and problems with muscle function on the gut.

Period pain

Throbbing, cramping pain in the lower abdomen that follows a monthly menstrual cycle is known as period pain.

Urinary tract infections

Recurrent urinary tract infections (UTIs) may cause lower abdominal pain when you are passing urine.

What causes mild to moderate abdominal pain?

Most Australians will experience mild or moderate abdominal pain from time to time. Often these episodes last only a few hours or days. They may clear up without the need for treatment. However, you may be more comfortable managing the symptoms with medicines from your pharmacy or doctor.

Some of the causes of short-term abdominal pain are:

Flatulence

Flatulence (farting or trapped wind or gas) is normal, but sometimes the amount of gas is excessive and causes bloating, wind pain or discomfort. Most people will experience this from time to time. The pain is usually relieved when you pass the gas.

Indigestion

Indigestion refers to discomfort in the upper abdomen — some people call it tummy pain or an upset stomach. It feels like you are full before you have finished eating. You may also have heartburn, a burning feeling rising up from your chest. If you are middle-aged or older, it’s important to know the symptoms of heart attack. They can be similar to those of indigestion.

Constipation

Constipation is common both in adults and children, and increases with age. Some people have a bowel movement (poo) more frequently than others, but constipation is generally understood to mean having fewer than 3 bowel movements in a week. Stools may also be lumpy or hard and difficult to pass.

As well as abdominal pain, constipation can also lead to stomach wind being trapped.

Pregnancy and some medicines can cause constipation too.

Diarrhoea

Diarrhoea is very common in all age groups. If the person with diarrhoea is a baby, child or older person they should see a doctor. However — regardless of your age — if you are experiencing severe diarrhoea, or diarrhoea that has lasted for more than a few days, then you should seek medical advice. You should also seek medical advice if you have both diarrhoea and:

  • fever
  • blood or mucus in your stool
  • diarrhoea at night
  • signs of dehydration — including feeling tired, urinating less frequently, feeling thirsty with a dry mouth

Gastroenteritis

Gastroenteritis is an infection of the digestive system that can cause stomach cramps and diarrhoea. The symptoms may take a couple of days to appear, then last a couple of days.

Food poisoning

Food poisoning usually causes an upleasant illness, but it lasts for only a few days. It is more serious for the very young and for older people since they are more at risk of dehydration.

Gastritis

Gstritis is inflammation of the stomach lining due to infection, medicines or alcohol. Gastritis causes pain under the ribs. It may also cause indigestion and nausea.

Lactose intolerance

Lactose intolerance is the inability to digest lactose (a sugar in milk) and can cause bloating, wind, diarrhoea and cramps.

Which medicines can cause abdominal?

Some medicines can cause abdominal pain as a side effect. Common examples include:

If you, or someone you are caring for, has an episode of abdominal pain that you think may be related to a medicine, talk to your pharmacist or doctor. There may be an alternative medicine that is better for you.

ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.

Resources and support

If you have abdominal pain and you need advice, call healthdirect on 1800 022 222 (known as NURSE-ON-CALL in Victoria) to speak with a registered nurse, 24 hours, 7 days a week.

For more information and support, try these resources:

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Last reviewed: June 2021


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