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Published on: 2/10/2026

Abdominal Pain in Women 65+: When to Worry and Common Causes

Abdominal pain in women 65+ is common but should be taken seriously; frequent causes include constipation, gas and bloating, indigestion or GERD, medication irritation, gallbladder disease, urinary tract infections, diverticulitis or other bowel issues, and less often gynecologic problems. Symptoms can be subtle with age. Seek prompt care for severe, persistent, or worsening pain or if there is fever, vomiting, blood or black stools, unexplained weight loss, chest pain, shortness of breath, confusion, or pain after injury. There are several factors to consider that can change what to do next, so see the complete guidance below.

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Explanation

Abdominal Pain in Women 65+: When to Worry and Common Causes

Abdominal pain is common at any age, but in women aged 65 and older it deserves special attention. As we get older, the body changes in ways that can make abdominal pain more complex. Pain may feel different, develop more slowly, or be caused by conditions that are more serious than they first appear. At the same time, many causes are still minor and treatable.

This guide explains common causes of abdominal pain in women 65+, when to monitor symptoms at home, and when it is important to speak to a doctor. The goal is to help you stay informed without creating unnecessary fear.


Why Abdominal Pain Is Different After Age 65

Several age-related factors affect how abdominal pain shows up and what it means:

  • Pain sensitivity may decrease, so serious problems may not feel severe
  • Long-term conditions (diabetes, heart disease) can affect digestion
  • Multiple medications can irritate the stomach or intestines
  • The risk of certain diseases increases with age

Because symptoms may be subtle, abdominal pain in older women should never be ignored, especially if it is new, persistent, or worsening.


Common Causes of Abdominal Pain in Women Over 65

Many cases of abdominal pain are not dangerous. Below are common causes doctors see in women aged 65 and older.

1. Digestive Issues

Digestive problems remain the most frequent cause of abdominal pain.

  • Constipation
    Very common due to slower digestion, dehydration, low fiber intake, or medications.
  • Gas and bloating
    Can cause cramping or pressure, especially after meals.
  • Indigestion (dyspepsia)
    Burning or discomfort in the upper abdomen, often after eating.
  • Acid reflux (GERD)
    May cause upper abdominal pain, chest discomfort, or nausea.

These conditions are usually manageable with diet changes, hydration, and guidance from a healthcare provider.


2. Medication-Related Abdominal Pain

Many women over 65 take several medications daily. Some drugs can irritate the digestive tract.

Common examples include:

  • Pain relievers like NSAIDs (ibuprofen, naproxen)
  • Certain antibiotics
  • Iron supplements
  • Some heart and blood pressure medications

Medication-related abdominal pain may improve when doses are adjusted or medications are changed—always under medical supervision.


3. Gallbladder Problems

Gallbladder disease becomes more common with age.

Typical signs include:

  • Pain in the upper right abdomen
  • Pain after fatty meals
  • Nausea or vomiting
  • Pain that spreads to the back or right shoulder

Gallstones are common and may require medical treatment if they cause symptoms.


4. Urinary Tract Issues

Urinary tract infections (UTIs) are common in older women and may not cause classic burning with urination.

Symptoms can include:

  • Lower abdominal pain or pressure
  • Confusion or fatigue
  • Urgency or frequent urination
  • Fever (sometimes mild or absent)

Untreated UTIs can lead to more serious infections, so early evaluation is important.


5. Gynecologic Causes (Even After Menopause)

Although less common after menopause, gynecologic issues can still cause abdominal pain.

These include:

  • Ovarian cysts
  • Uterine fibroids
  • Pelvic organ prolapse
  • Rarely, gynecologic cancers

Persistent pelvic or lower abdominal pain should always be discussed with a doctor.


6. Bowel Conditions

Several bowel-related conditions are more likely with age:

  • Diverticulosis and diverticulitis
    Small pouches in the colon can become inflamed and cause steady pain, often on the left side.
  • Irritable bowel syndrome (IBS)
    Can continue into older age, causing cramping, bloating, and changes in bowel habits.
  • Bowel obstruction
    Can cause severe pain, bloating, vomiting, and inability to pass stool or gas.

Some bowel conditions require urgent medical care.


When Abdominal Pain Is More Concerning

While many causes of abdominal pain are mild, some symptoms suggest a serious or life-threatening condition. Do not wait to seek care if abdominal pain is accompanied by:

  • Severe or worsening pain
  • Pain lasting more than a few days
  • Fever or chills
  • Persistent vomiting
  • Blood in stool or black, tarry stools
  • Unexplained weight loss
  • Chest pain or shortness of breath
  • Confusion or fainting

These symptoms may point to infections, internal bleeding, bowel problems, or other serious conditions. Speak to a doctor immediately or seek emergency care if these occur.


Abdominal Pain That Should Not Be Ignored in Older Women

Some types of abdominal pain are especially important to evaluate in women over 65:

  • Sudden abdominal pain with no clear cause
  • Pain that wakes you from sleep
  • Pain with a history of heart disease or vascular problems
  • Abdominal pain after a fall or injury
  • Pain combined with changes in bowel habits lasting more than a few weeks

Even if pain feels mild, its cause may not be.


How Doctors Evaluate Abdominal Pain in Women 65+

A doctor may use several tools to understand abdominal pain:

  • Review of symptoms and medical history
  • Physical exam of the abdomen
  • Blood and urine tests
  • Imaging tests (such as ultrasound or CT scan)
  • Review of medications

Early evaluation often leads to simpler and more effective treatment.


What You Can Do Right Now

If you are experiencing abdominal pain, consider these steps:

  • Note where the pain is and how long it lasts
  • Track what makes it better or worse
  • Review recent diet changes or new medications
  • Stay hydrated unless advised otherwise
  • Avoid self-treating severe or ongoing pain

If you're unsure what might be causing your symptoms, you can use a free Abdominal pain symptom checker to help identify possible causes and understand when to seek care—though this should never replace professional medical advice.


Reducing Future Episodes of Abdominal Pain

While not all abdominal pain is preventable, healthy habits can lower risk:

  • Eat a balanced diet with enough fiber
  • Drink adequate fluids
  • Stay physically active
  • Take medications only as prescribed
  • Keep regular medical checkups
  • Report new or unusual symptoms early

The Bottom Line

Abdominal pain in women 65+ is common, but it should always be taken seriously. Many causes are mild and treatable, but some can be serious even when pain feels manageable. Paying attention to changes, knowing warning signs, and acting early can make a significant difference.

If abdominal pain is severe, persistent, or accompanied by concerning symptoms, speak to a doctor right away. Prompt care can protect your health and provide peace of mind.

(References)

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  • * Nagurney JT, Aljohani K. Acute Abdominal Pain in Elderly Patients. J Am Osteopath Assoc. 2020 Feb 1;120(2):114-121. doi: 10.1515/j.jaoa.2019.014. PMID: 32092288.

  • * Lemaire MT, Reijnders MRMN, Kessels RMMRSFH. Abdominal pain in the older adult. Best Pract Res Clin Gastroenterol. 2018 Oct-Dec;32(5-6):415-423. doi: 10.1016/j.bpg.2018.09.006. Epub 2018 Nov 1. PMID: 29424888.

  • * Buggenhout E, Vakalopoulos D, Meuris T. Abdominal Pain in Elderly Patients: A Review. Curr Geriatr Rep. 2018 Sep;11(3):200-207. doi: 10.1007/s13670-018-0263-x. PMID: 30163901.

  • * Liu D, Yang W. Acute Cholecystitis in Elderly Patients: A Review. Front Surg. 2021 Dec 6;8:786026. doi: 10.3389/fsurg.2021.786026. PMID: 34882772; PMCID: PMC8688461.

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