Most people experience abdominal pain from time to time, but working out what is causing it can be difficult. The abdomen is a large area, extending from the base of the ribs to the top of the hips. It contains the stomach and the large and small intestines, as well as major organs such as the liver, kidneys and pancreas. Problems with any of these can cause pain.
Abdominal pain can also be varied and can be felt as sharp, stabbing pains, cramping, dull aches or colicky pains that steadily get worse before easing off again.
Short-term mild to moderate abdominal pain
Most of the time abdominal pain or stomach ache that doesn't last more than a few days is nothing to worry about.
The most common cause is mild gastroenteritis, which is caused by a viral or bacterial infection. One of the most unpleasant is the norovirus (also known as stomach flu or winter vomiting virus). Mild food poisoning can also cause similar symptoms. Minor stomach bugs affect even the most hygiene-conscious people, causing a range of unpleasant symptoms such as diarrhoea, trapped wind, abdominal cramps and constipation. They may leave you feeling tired and lethargic, lacking in appetite and generally 'under the weather'.
Although these symptoms can cause moderate discomfort in the short term, they will usually pass of their own accord within a few days and there is no need to consult your GP or go to hospital.
Mild to moderate abdominal pain is also common in women at 'that time of the month'. Menstrual cramps are usually relieved by over-the-counter painkillers.
Sudden and severe abdominal pain
This is more worrying. If your abdominal pain comes on suddenly, is particularly severe and is accompanied by other symptoms, such as high temperature, bloody stools or persistent vomiting, you should seek urgent medical attention as this could be the sign of something more serious.
This type of abdominal pain may indicate a number of conditions, depending on the type, severity and location of the pain. A full examination and tests will be necessary to make a definite diagnosis, but possibilities include:
- Appendicitis: characterised by a severe abdominal pain that gets worse over the course of a day or so. The pain usually starts in the middle or to the left of the abdomen then moves to the lower right-hand side.
- Perforated ulcer: characterised by a sudden and severe upper abdominal pain that gets steadily worse. Urgent treatment is needed to avoid peritonitis (generalised infection of the abdominal cavity).
- Gallstones: characterised by severe colicky pain on the upper right of the abdomen, just under the ribs, which builds and eases periodically, and can also come on after eating.
- Pancreatitis: characterised by severe pain in the upper abdomen, or as a tight band, often radiating through to the back.
- Kidney stones: characterised by pain that starts in the back and moves to the lower abdomen or groin.
- Diverticulitis: characterised by intermittent pain in the lower abdomen, often associated with fevers and passing blood in the stool.
Long-term abdominal pain
Several conditions can cause long-term (chronic) or recurrent abdominal pain and require a long-term care plan with monitoring and maintenance treatment rather than urgent care or an emergency appointment. Sometimes, however, long-term bowel disorders such as Crohn's disease, can 'flare up' significantly causing severe symptoms that require urgent treatment:
- Irritable bowel syndrome (IBS): characterised by abdominal cramps caused by spasms or contractions in the bowel wall, associated with abnormal bowel habit (constipation or diarrhoea). Pain often improves after passing a stool.
- Heartburn and acid reflux: this leads to a burning pain or dull ache in the upper region of the abdomen or behind the breastbone.
- Peptic ulcer: typically causes a burning or gnawing pain in the upper abdomen.
- Crohn's disease: an inflammatory bowel disorder that causes abdominal cramping with loose stools/diarrhoea, often with blood.
- Ulcerative colitis: another inflammatory bowel disease that results in a general abdominal ache and is associated with diarrhoea that is often bloody.
- Diverticular disease: characterised by a niggling lower abdominal pain that comes and goes.
The Gastroenterology and Hepatology specialists at The Physicians' Clinic are able to offer expert diagnosis of any type of abdominal pain. We work closely as a team to cover the entire range of disorders that affect the digestive system (including the liver).