What are the Causes of Abdominal Pain?
Abdominal Pain is a very common complaint and can be observed in many medical conditions. Pain in abdomen can be commonly experienced by people of all ages and can affect both the genders equally. Causes of abdominal pain can be many and the complaint of abdominal pain can be a part of many medical disorders. In fact, abdominal pain is simply a symptom, and causes of abdominal pain usually depend on the underlying medical condition.
Here are some of the common causes of abdominal pain.
Common Conditions That Can Cause Abdominal Pain
Causes of abdominal pain may be related to the commonest conditions that people experience very often. For example-
Abdominal Pain Caused Due to Indigestion1– Overeating, improper digestion or changes in regular dietary habits can often cause abdominal pain. It may sometimes be associated with abdominal bloating and feeling of fullness, which may be relieved by having light meals and allowing the digestive system to rest. Abdominal pain, caused by indigestion and dietary disturbances may also be a result of eating outside food, consumption of certain food substances which are difficult to digest or which the body may not tolerate well.
Abdominal Pain Caused Due to Food Allergies – People having food allergiesmay face trouble on consumption of those foods, resulting in abdominal pain, cramping, bloating, nausea, vomiting or loose motions. Abdominal pain is a common occurrence with intake of allergy causing food substances like sea foods, milk products, dairy, peanuts, certain vegetables and lentils. It is important to identify such substances and avoid them in the diet to prevent abdominal pain from food allergies. Food allergy causes infiltration of eosinophils in gastrointestinal tract.
Milk Intolerance – Milk intolerance is another common cause of abdominal pain, resulting in vomiting, improper digestion of milk and pain in abdomen. This occurs due to the lack of ability to digest the sugar (lactose) present in milk and the result is gastric disturbance and abdominal pain.
Gastric & Intestinal Infections That Can Cause Abdominal Pain
Contaminated food and water is commonly the main cause of gastric infections causing abdominal pain. Most infections and digestive problems related to food and water contaminated with bacteria, viruses and other organisms, result in conditions that cause abdominal pain. These include-
Viral Infections - Viral infections are a common cause of abdominal pain. Viral infections commonly occur during change of weather and usually present with flu-like symptoms. Common cold, cough, fever, stomach ache or abdominal pain, which may be associated with bloating, nausea, vomiting and bowel changes. While some viral infections clear off on their own, after running their natural course, some may need medical treatment. It is advisable to seek medical opinion and follow the treatment.
Food Poisoning – Food poisoning, often a medical emergency, can be an important cause of abdominal pain. It results from consumption of food contaminated with disease causing organisms, commonly found in street food or leftover and stale food. In this case, abdominal pain is often accompanied with vomiting, diarrhea and gastric disturbances. It is better to get the case evaluated immediately and take the necessary medical treatment.
Gastroenteritis – Gastroenteritis, commonly occurring due to bacterial or sometimes viral agents, can be a common cause of abdominal pain. This conditions usually results from poor hygiene and affects the gastric system, by causing inflammation in the stomach and intestines. This leads to excessive gas formation, vomiting and loose motions with crampy abdominal pain. It requires appropriate medical treatment and oral or intravenous rehydration to maintain body fluids.
Typhoid3– Typhoid fever or enteric fever is an infection caused by a bacteria called Salmonella typhi. Typhoid spreads through contaminated food or water and causes fever, headache, abdominal pain and gastric upset. Typhoid is also one of the common causes of abdominal pain. Diagnosis of typhoid is based on clinical examination and laboratory tests, which also include detecting the presence of the causative organism. It is treated with antibiotics and other medications depending on the condition.
Hepatitis4– Hepatitis is a viral infection, mainly affecting the liver and can cause abdominal pain. This is usually contracted through contaminated food and water, but has other modes of transmission too, depending on the type of hepatitis like hepatitis A, B, C, D and E. There are non-viral types of hepatitis like those caused due to alcohol or due an autoimmune disease. As the liver is involved in the function of clearing off toxins from the body, inflammation of the liver in hepatitis can cause disturbance in the digestive function. It presents with nausea, vomiting, abdominal pain, may be more on the right side, loss of appetite and weight loss. All types of hepatitis are causes of abdominal pain. The characteristic feature of hepatitis is jaundice or yellowish discoloration of the skin, eyes, which can be noted on the sclera or the white part of the eyes. Diagnosis is often made by physical examination, investigations like liver enzyme tests and imaging studies of liver, which may reveal elevated levels and swelling or enlargement of the liver. Viral antibody testing may be done to detect the specific type of hepatitis. Treatment depends on the type and the infection can be prevented by avoiding contaminated food and water and maintaining food and personal hygiene. Vaccines are also available to prevent certain types of hepatitis.
Giardiasis – Giardiasis is a parasitic infection, mainly affecting the small intestine. It usually spreads through contaminated water, drink and sometimes food, coming in contact with infected person and also through pets. It presents with nausea, vomiting, diarrhea, abdominal pain, bloating and cramps. It may also be accompanied with gas formation, headache and loss of appetite.
Most gastric infections present with abdominal pain and show gastric symptoms. The precise way to diagnose the condition is to get a stool examination done, which often reveals the organism responsible for causing the infection and pain in the abdomen. For some conditions, additional investigations like imaging studies or visualization of a particular area in endoscopy maybe done, if found appropriate. Treatment is based on the cause, infective organism and other findings in the investigations. Gastric infections can be prevented by maintaining proper personal and community hygiene, practicing proper hand washing techniques and implementing appropriate food handling measures.
Gastric and Intestinal Conditions That Can Cause Abdominal Pain
Constipation – Constipation is a very common cause of abdominal pain and can affect adults as well as children. Straining to pass stools, hard stools and painful passage of stools in constipation can cause pain and discomfort in the anal region and abdominal pain. This is often treated with laxatives, but proper diet, exercise and lifestyle changes can help to a great extent, however, medical advice should be followed. Any other underlying conditions causing constipation and abdominal pain must be ruled out.
Gastroesophageal Reflux Disease (GERD) – Conditions resulting in hyperacidity and reflux disease often cause abdominal pain. The acid or digestive juices in the stomach get refluxed reaching to the esophagus, which often causes burning pain in stomach and esophagus, felt under the breastbone. This is accompanied by irritation in throat, nausea, abdominal pain and sometimes even vomiting. Diagnosis can be made with proper history, imaging studies and endoscopy. This condition needs to be treated with appropriate antacids, antibiotics and other medicines that improve digestion.
Peptic Ulcers – Peptic ulcers, which include gastric and duodenal ulcers often cause abdominal pain. The location and type of abdominal pain in peptic ulcers may be different from that in other causes of abdominal pain. Peptic ulcers may cause burning type of pain, the location may be specific that can be pointed with a finger in the region of stomach, on the left side or around the duodenum, on the right side of the umbilicus. The abdominal pain caused by peptic ulcer can be associated with nausea, vomiting, regurgitation of food, burning in throat and burning pain under the breastbone. The pain is related to food intake and is usually felt on empty stomach or after eating food and there are specific triggers too. Peptic ulcers are treated with antacids, antibiotics and changes in dietary habits may be suggested.
Diverticulitis – Diverticulitis is the inflammation of the pouches formed in the wall of the colon, which leads to abdominal pain, may be more on the left side. It can be caused by an infection or a low fiber diet may add to the problems. Diverticulitis can cause abdominal pain, which may be aggravated on movement and may be accompanied with indigestion, feeling of fullness, abdominal bloating and changes in bowel, constipation or diarrhea. The condition can be diagnosed with the help of personal history, blood tests to check for infection or abdominal scans to detect the structural changes and inflammation causing abdominal pain.
Appendicitis – Appendicitis is a condition, resulting from inflammation of the appendix, which can cause abdominal pain. It is often caused by accumulation of feces due to constipation, injury, tumors or conditions causing obstruction in the area. The condition can be chronic in nature or can be acute, which may require immediate medical attention. Abdominal pain is accompanied with nausea, vomiting, constipation or diarrhea, difficulty in passing stools, swelling in abdomen and sometimes even fever.
Appendicitis can be diagnosed with imaging studies, X-rays and CT scans, which can also help to rule out other possible conditions with similar complaints. Treatment usually depends on the severity of the condition, abdominal pain and associated complications. Antibiotics to treat infection, drainage of abscess or surgical removal of appendix (appendectomy) may be considered as appropriate.
Pancreatitis – Pancreatitis is inflammation of the pancreas, which maybe of acute or chronic type. Pancreatitis can cause abdominal pain, more in the middle and towards the left in the abdomen. It is associated with abdominal bloating, nausea, vomiting and other gastric symptoms. There are several complications of pancreatitis, which may appear if timely treatment is not done. Treatment involves medications to relieve inflammation, surgery, special diet and other specific treatment depending on the severity of the condition.
Inflammatory Bowel Disease – Inflammatory bowel disease, which includes Crohn’s disease and ulcerative colitis is a common cause of abdominal pain. It also involves passing loose motions, fatigue, weight loss and inability to digest food effectively, resulting in abdominal pain and discomfort. Ulcerative colitis causes ulcers in large intestine and rectal lining, while Crohn’s disease results in inflammation of the lining of the intestines, both of these conditions can cause considerable abdominal pain. The condition is diagnosed with the help of colonoscopy and other specialized endoscopies. Treatment of abdominal pain caused due to IBD includes anti-inflammatory medicines, antibiotics, steroids or immunosuppressant medicines depending on the cause, type and severity.
Irritable Bowel Syndrome – This condition is very common and affects the digestive system at the functional level but usually does not cause damage to the inner lining of the intestines. Irritable bowel syndrome causes crampy abdominal pain, changes in bowel patterns, difficult digestion. It may also be associated with other symptoms like headache, irritability, disturbed sleep, body pain, etc.
Gall Bladder Conditions – Gall bladder conditions, those that cause inflammation (cholecystitis) and those, which can get triggered like gall stones (cholelithiasis) can cause severe abdominal pain. Gall bladder related abdominal pain is felt more in the right upper part of the abdomen and under the ribs. It is associated with nausea, vomiting, fever, chills and jaundice. An episodic pain may subside but if the condition is severe, surgical removal of gall bladder (cholecystectomy) may be considered.
Other Causes of Abdominal Pain – Along with the commonest causes of abdominal pain, almost any condition affecting the digestive system, can cause abdominal pain. Some of the other conditions causing abdominal pain include worms, hernia, peritonitis, intussusception, intestinal obstruction, etc.
Other Medical Conditions That Can Cause Abdominal Pain
It is common for gastric causes to result in abdominal pain, however, there are other conditions that can cause abdominal pain. These include-
Kidney Related Causes of Abdominal Pain – Kidney related conditions like urinary tract infections, renal stones and other conditions can cause pain in the back often also extending in the front resulting in abdominal pain. Such pain in abdomen due to renal causes often presents with other renal symptoms like pain when urinating, burning urination, increased or decreased urination.
Muscular Causes – Muscular causes, muscular rigidity or spasms, too can cause abdominal pain.
Gynecological Reasons for Abdominal Pain – Women may experience abdominal pain during their menstrual cycle. Menstrual pain or dysmenorrhea, pain during ovulation, pregnancy, ectopic pregnancy or gynecological conditions like endometriosis, pelvic inflammatory disease or infections can cause abdominal pain.
Others – Other conditions affecting other areas like pneumonia, pulmonary infarction, pleurisy, pericarditis, etc. can cause abdominal pain. Problems with related organs like conditions affecting the prostate gland, diabetic ketoacidosis, aortic aneurysms can cause abdominal pain. Injury in or around the abdomen, uremia, sickle cell anemia, etc. too can cause abdominal pain. Tumors, certain types of cancers or diseases spreading to the abdominal areas can also cause abdominal pain.
The Following Could Also Cause Abdominal Pain or Stomach Ache
- Trauma- Stomach, bowel, spleen, liver and kidney.
- Inflammatory- Appendicitis, cholecystitis, pancreatitis, pyelonephritis, pelvic inflammatory disease, hepatitis, mesenteric adenitis, subdiaphragmatic abscess.
- Perforation of Gut- Peptic ulcer, diverticulum, appendix, caecum.
- Complications- Crohn's disease, ulcerative colitis.
- Mechanical- Small bowel obstruction, colorectal cancer, inflammatory bowel disease, volvulus, fecal impaction, hernia.
- Vascular- Occlusive intestinal ischemia.
When Should I Consult A Doctor?
One should see a physician or visit ER physician when abdominal pain lasts for 8 to 12 hours and pain does not respond to over the counter medication. Most symptoms caused by food poisoning or food allergies subside after 8 to 12 hours. If the abdominal pain, nausea, vomiting and diarrhea continues after 12 hours then it is important to find out the cause of abdominal pain. The conditions like perforation of ulcer, intestinal obstruction and abdominal bleeding can cause further complication or turn into life threatening condition because of severe bleeding. Such condition may need emergency surgery.
Food and functional dyspepsia- a systematic review.
Eosinophilic Gastrointestinal Disorders.
Enteric fever imported to the Czech Republic- epidemiology, clinical characteristics and antimicrobial susceptibility.
Trojánek M1, Dědičová D, Žemličková H, Jakubů V, Malíková E, Reisingerová M, Gabrielová A, Papagiannitsis CC, Hrabák J, Horová B, Urbášková P, Marešová V, Stejskal F., Folia Microbiol (Praha). 2015 May;60(3)-217-24.
Quality of life in adolescents with hepatitis C treated with sofosbuvir and ribavirin.
Clinical and diagnostic features and treatment of giardiasis.
- Abdominal Pain: What Can Cause Pain in the Stomach?
- What are the Causes of Abdominal Pain?
- Treatment Options for Abdominal Pain or Stomach Ache
- 19 Safe and Natural Home Remedies for Abdominal Pain or Stomach Ache
- Abdominal Pain or Stomach Ache in Children: Causes, Signs, Treatment
- What Can Cause Abdominal Pain or Stomach Ache During Pregnancy?
- Abdominal Pain When Coughing