What causes abdominal pain?

There are many causes of abdominal pain. Some of these result in short-term pain, while others can cause ongoing (chronic) pain. Some types of abdominal pain may get better without treatment. But others need urgent medical attention, as they may be life-threatening.

Some causes of abdominal pain mainly affect children. For more information on these, see abdominal pain in children.

What can cause severe abdominal pain?

Sudden and severe abdominal pain should never be ignored. Abdominal pain that is getting worse may also be a sign of a serious condition.

If you have severe abdominal pain, go immediately to your nearest hospital emergency department or call triple zero (000) for an ambulance.

Some of the causes of severe abdominal pain include the following:

• abdominal aortic aneurysm
• appendicitis
• bowel obstruction
• diverticulitis
• ectopic pregnancy
• gallstones
• heart attack
• kidney stones

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. Aneurysms can affect your aorta — the large artery that carries blood from your heart to the rest of your body.

Aortic aneurysms can affect the part of the aorta in your abdomen (abdominal aortic aneurysm — AAA). These aneurysms can swell, causing abdominal pain. They can also burst — a burst AAA is a life-threatening emergency.

Symptoms of a burst AAA are:

• sudden, severe abdominal that goes through to your back, groin or legs
• feeling faint
• nausea and vomiting

Appendicitis

Appendicitis usually causes abdominal pain that starts around the belly button area but then travels to the lower right of your abdomen. It’s usually felt as a sharp pain that is worse with movement.

Other symptoms of appendicitis can include:

• loss of appetite
• nausea and vomiting
• fever
• diarrhoea

If left untreated, your appendix can become very swollen and infected, and may burst.

Urgent surgery is usually needed to treat appendicitis.

Bowel obstruction

A bowel obstruction can be partial or complete, and can affect your small or large bowel.

Symptoms of bowel obstruction are:

• abdominal pain that is cramping or colicky, so it comes and goes in waves
• bloating or swelling of the abdomen
• nausea and vomiting
• not being able to poo or fart (pass gas/wind)

You might need surgery, depending on your situation.

Diverticulitis

Diverticulitis occurs when small abnormal pockets in the wall of the bowel become inflamed or infected. Symptoms can include:

• left-sided abdominal pain
• fever
• loss of appetite
• nausea and vomiting
• constipation or diarrhoea

Diverticular disease becomes more common with increasing age.

Ectopic pregnancy

An ectopic pregnancy is when a pregnancy implants outside the womb (uterus). It can cause serious internal bleeding and be life-threatening. Symptoms can include:

• lower abdominal pain
• vaginal bleeding or spotting
• back pain
• shoulder tip pain
• nausea and vomiting
• feeling faint or light-headed

Gallstones

Gallstones can cause pain known as biliary colic.

Biliary colic pain is felt on the upper right side of your abdomen, under the ribs. It’s a constant pain that may last a few hours. The pain is often severe, and it can start after a meal, often at night. It’s often accompanied by nausea.

Gallstones can also cause pancreatitis (inflammation of the pancreas).

Heart attack

Heart attacks can cause chest pain that may radiate to your jaw, arms, neck or back. Other symptoms of heart attack can include:

• upper abdominal pain
• indigestion
• nausea or vomiting
• dizziness
• breathlessness
• tiredness

Females, especially, may experience symptoms other than chest pain.

Kidney stones

Kidney stones can cause a sudden pain called renal colic. It starts as a gripping pain in your back, just below your ribs. The pain may move around to your abdomen or groin. The pain may come and go in waves.

You may also have:

• fever
• nausea and vomiting
• an urge to urinate
• blood in your urine

Kidney stones are more common in older people.

What can cause ongoing abdominal pain?

Ongoing (chronic) abdominal pain is pain that lasts for at least 3 months. It may be present all the time or it may come and go.

Some of the causes of chronic abdominal pain are:

• coeliac disease
• GORD (reflux)
• inflammatory bowel disease
• irritable bowel disease
• lactose intolerance
• peptic ulcers
• period pain
• some types of cancer

Coeliac disease

Coeliac disease can cause ongoing abdominal pain and other gastrointestinal symptoms, such as:

• cramping
• diarrhoea
• bloating and flatulence
• weight loss

GORD (reflux)

Acid reflux (gastro-oesophageal reflux disease, or GORD) causes discomfort or burning pain in your upper abdomen. This is commonly known as heartburn. Other symptoms can include:

• belching (burping) and bloating
• chest pain
• indigestion
• tasting acid in your mouth

Your symptoms may flare up after eating certain foods or large meals. They may also be worse when you lie down.

Inflammatory bowel disease

Crohn’s disease and ulcerative colitis are types of inflammatory bowel disease.

Symptoms of inflammatory bowel disease can include:

• crampy abdominal pain
• diarrhoea
• a feeling of urgently needing to do a poo

You may see blood or mucus in your poo.

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 (farting) or a bowel motion (doing a poo).

Lactose intolerance

Lactose intolerance is when you can’t fully digest lactose (a sugar in milk). After eating or drinking dairy products, people with lactose intolerance can have:

• abdominal pain and cramps
• bloating
• flatulence (wind)
• diarrhoea

Peptic ulcers

Peptic ulcers, such as stomach ulcers and duodenal ulcers, can cause dull upper abdominal pain that comes and goes. The pain often comes on at night.

Taking antacids or eating food may relieve the pain. But sometimes, eating makes the pain worse.

Use of non-steroidal anti-inflammatory medicines (NSAIDs) and alcohol is associated with peptic ulcer disease.

Seek urgent medical attention if you:

• vomit blood
• have vomit that looks like coffee-grounds
• pass blood in your poo
• have black, tarry poo

These can be signs of a bleeding ulcer that needs urgent treatment.

Period pain

Cramping pain in your lower abdomen that comes on with your period is known as period pain.

Some types of cancer

Cancer affecting your abdominal organs can cause abdominal pain. Bowel cancer, stomach cancer and liver cancer can all cause abdominal pain that may steadily worsen over time.

What can cause short-term 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.

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

• gastroenteritis or food poisoning
• urinary tract infections
• gastritis

Gastroenteritis or food poisoning

Gastroenteritis is an infection of your digestive system. It’s usually caused by a virus.

Sometimes it is caused by food poisoning. Symptoms usually last for only a few days and include:

• crampy abdominal pain
• nausea and vomiting
• diarrhoea
• fever

Gastroenteritis and food poisoning are more serious for the very young and for older people since they are more at risk of dehydration.

Urinary tract infections

Urinary tract infections (UTIs) can cause abdominal pain:

• Cystitis (bladder infection) can cause dull lower abdominal pain.
• Pyelonephritis (kidney infection) can cause pain in your abdomen and flank (side), fever, nausea and vomiting.

Gastritis

Gastritis is inflammation of your stomach lining. It can be due to infection, medicines or alcohol.

Gastritis causes upper abdominal pain. It may also cause indigestion and nausea.

Which medicines can cause abdominal pain?

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

• non-steroidal anti-inflammatory drugs (known as NSAIDs), such as ibuprofen and
• ketoprofen
• aspirin
• medicines to help manage the symptoms of dementia or Alzheimer’s disease
• antibiotics

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.

Resources and support

For more information on what to do if you have abdominal pain, see:

• abdominal pain
• abdominal pain in children

For more information and support, try these resources:

• The Gut Foundation
• Gastroenterological Society of Australia (GESA)

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 w