Abdominal Pain
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Try one of these related symptoms.
Stomachache
I have lower abdominal pain
I have left lower abdominal pain
Pain in the lower right stomach
Upper left abdominal pain
Upper right abdominal pain
Have periodic abdominal pain
Have pelvic pain
Sharp abdominal pain
Stomach pain with diarrhea
Localized abdominal pain
Flank pain
About the Symptom
Abdominal pain is a painful sensation in the abdominal area. The abdominal area is the part between the chest and pelvis, often called the belly, tummy, stomach. The pain may be pressing, aching, cramping, sharp or dull in nature.
When to See a Doctor
Seek professional care if you experience any of the following symptoms
- Intermenstrual bleeding
- Jaundice
- Fever
- Sensation of incomplete voiding
- Melena (black stools)
- Edema
- Recent weight loss
- Constipation
Possible Causes
Generally, Abdominal pain can be related to:
- Ovulation Bleeding
Ovulation is the process when the ovary releases an egg as part of the normal female reproductive cycle. It typically happens in the middle of a menstrual cycle (about 2 weeks after the end of the period). At the time of ovulation, some women may feel some cramping or lower abdominal pain that resolves by itself. This is called mid-cycle pain (mittelschmerz), and it can occasionally cause some mild bleeding or spotting along with it. If there is no other cause for the pain or bleeding, this is not considered to be harmful.
- Cholelithiasis
Gallbladder stones or pieces of solid material that form in the gallbladder. Many people have gallbladder stones without any symptoms for their entire lives. Severe cases may require surgery.
Related Serious Diseases
Sometimes, Abdominal pain may be related to these serious diseases:
- Intestinal Perforation
Intestinal perforation is a hole in the intestinal wall. It's a serious, painful condition that can cause fatal complications. Causes include twisted intestines, inflammation, ulcers, or injury to the intestinal walls. Elderly people, those who recently had abdominal surgery, and those with a history of cancer or gastrointestinal problems are at higher risk.
- Acute Appendicitis
- Torsion of Ovarian Cyst
- Ischemic Enteritis
- Peritonitis
- Ovarian Hemorrhage
- Ectopic Pregnancy
- Pseudomembranous Colitis
Doctor's Diagnostic Questions
Your doctor may ask these questions to check for this symptom:
- Do you have any stomach or abdominal pain?
- When did you first notice your stomach or abdominal pain?
- Which of the following best describes how your stomach or abdominal pain began?
- How often do you experience stomach or abdominal pain?
- On a scale of 1 to 10, how severe was your stomach or abdominal pain at its worst?
Reviewed By:
Samantha Nazareth, MD (Gastroenterology)
Board-certified gastroenterologist. Experience managing gastrointestinal conditions (GERD, IBS, ulcerative colitis, Crohn’s, celiac disease, NASH) within healthcare organizations (three ambulatory surgical centers, single-specialty practice, multi-specialty practice and solo practice).
Aiko Yoshioka, MD (Gastroenterology)
Dr. Yoshioka graduated from the Niigata University School of Medicine. He worked as a gastroenterologist at Saiseikai Niigata Hospital and Niigata University Medical & Dental Hospital before serving as the Deputy Chief of Gastroenterology at Tsubame Rosai Hospital and Nagaoka Red Cross Hospital. Dr. Yoshioka joined Saitama Saiseikai Kawaguchi General Hospital as Chief of Gastroenterology in April 2018.
Content updated on Feb 6, 2025
Following the Medical Content Editorial Policy
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- Pit of the stomach has burning sensation
- Stomach discomfort and grouchiness comes and goes with fussiness / grouchiness
- Child starts crying or pushes me away if I try to massage the stomachache area
- I ate something in the previous 3 days that might be causing symptoms
- Child can't move around much because it makes the stomach pain worse
- Lower stomach pain that goes away after having a bowel movement
- Stomach looks swollen and bloated up whenever the pain occurs
- Stomach pain when standing on tiptoe then dropping to heels
- Standing on tiptoes then dropping heels causes stomach pain
- Stomach pain is worse when letting go than when pressing
- Pain spreading from the stomach to the surrounding area
- Pushing lightly on the stomach cause muscles to stiffen
- Cannot take a deep breath because of stomach pain pain
- Sharp or stabbing stomach pain exacerbated by walking
- Frequent bowel movements associated with stomach pain
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FAQs
Q.
Abdominal Pain? Why Your Rectus Abdominis is Failing & Medical Next Steps
A.
Abdominal pain from your rectus abdominis can stem from strain, diastasis recti, sports hernia, or even a rectus sheath hematoma, often causing sharp, localized pain that worsens with movement, coughing, or sit-ups. Next steps range from rest and targeted physical therapy to medical evaluation and imaging, with urgent care needed for severe or worsening pain, fever, persistent vomiting, bruising or a firm mass, dizziness, or a rigid abdomen. There are several factors to consider; see complete details below to learn the key signs, safer strengthening options, and when to seek care so you do not miss something important.
References:
* Pimentel M, Lembo AJ. Anterior Abdominal Wall Pain: Abdominal Cutaneous Nerve Entrapment Syndrome. Gastroenterol Clin North Am. 2020 Jun;49(2):339-354. doi: 10.1016/j.gtc.2020.02.007. Epub 2020 Apr 16. PMID: 32308006.
* Emanuelsson P, et al. Diastasis Recti Abdominis: A Review of Treatment Options and a Proposal for an Algorithm. Front Surg. 2022 Mar 22;9:848941. doi: 10.3389/fsurg.2022.848941. PMID: 35392686; PMCID: PMC8982422.
* Walker P, et al. The Role of Physical Therapy in the Management of Abdominal Wall Pain. Gastroenterol Clin North Am. 2020 Jun;49(2):373-388. doi: 10.1016/j.gtc.2020.02.008. Epub 2020 Apr 16. PMID: 32308005.
* Kapan M, et al. Rectus Sheath Hematoma: A Literature Review and Case Report. Cureus. 2021 May 26;13(5):e15243. doi: 10.7759/cureus.15243. PMID: 34187042; PMCID: PMC8236166.
* El-Hawary R, et al. Rectus Abdominis Muscle Injuries in Athletes: A Review of Anatomy, Biomechanics, Diagnosis, and Management. PM R. 2014 Dec;6(12):1122-8. doi: 10.1016/j.pmrj.2014.07.001. Epub 2014 Aug 16. PMID: 25484809.
Q.
NG Tube Pain? The Medical Reality & Medically-Approved Next Steps
A.
NG tubes can be briefly painful during placement and may leave mild nasal or throat irritation, but strong or worsening pain, breathing difficulty, heavy bleeding, or new severe chest or abdominal pain are not normal and warrant urgent evaluation. There are several factors to consider and clear, medically approved next steps like telling your clinician, confirming tube position, using pain relief, and never adjusting or removing the tube yourself; see below for important details, comfort strategies, and red flags that could change what you should do next.
References:
* Wang L, Chen B, Zhang Y, et al. Effect of Topical Anesthetics on Pain during Nasogastric Tube Insertion: A Systematic Review and Meta-Analysis. Pain Res Manag. 2019 Jan 16;2019:9358319. doi: 10.1155/2019/9358319. PMID: 30678602; PMCID: PMC6350796.
* Gholizadeh H, Gholizadeh S, Mohseni K, Pourmirza M. Effect of lidocaine gel on pain during nasogastric tube insertion: a randomized controlled trial. Minerva Anestesiol. 2018 Sep;84(9):1043-1049. doi: 10.23736/S0375-9393.17.12328-5. Epub 2018 Jan 12. PMID: 29329068.
* Alizadeh K, Hatamabadi HR, Vafaee F, Kariman H, Emami H. Topical Lidocaine Spray for Reducing Pain During Nasogastric Tube Insertion in Patients Admitted to the Emergency Department: A Randomized Clinical Trial. Anesth Pain Med. 2015 Sep 21;5(5):e28989. doi: 10.5812/aapm.28989. PMID: 26622437; PMCID: PMC4655459.
* Metheny NA, Meert KL. Complications of nasogastric tube insertion and their prevention: a narrative review. Crit Care Nurs Q. 2016 Apr-Jun;39(2):168-75. doi: 10.1097/CNQ.0000000000000109. PMID: 27040985.
* Sorokina M, Bushara A, Ii Z, Singh P. Prevention and Management of Nasogastric Tube Complications. 2023 Feb 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 33496033.
Q.
Pain After Prone Bone? Why Your Pelvis Hurts & Medically Approved Next Steps
A.
Pelvic pain after "prone bone" is most often due to muscle strain, pelvic floor tension, or sacroiliac or pubic bone irritation, and mild soreness that eases within 1 to 3 days is usually normal; severe, worsening, or persistent pain, or red flags like fever, heavy bleeding, nausea, urinary pain, or trouble walking need medical evaluation. For medically approved next steps, see below, including short rest with light movement, ice then heat, gentle stretching, appropriate OTC pain relief, pelvic floor relaxation, prevention tips, and the specific situations when you should see a doctor or seek urgent care, with important details that can change your best next step.
References:
* Nardos R, Ma S, Rapkin R, Ackerman AL. Pelvic Floor Dysfunction and Pain: A Narrative Review. Curr Sex Health Rep. 2020 Dec;12(4):252-261. doi: 10.1007/s11930-020-00293-x. PMID: 33424424; PMCID: PMC7778235.
* Ramsden C, Ammar T, Ammar A. Pudendal neuralgia and pudendal nerve entrapment: a comprehensive review. Expert Rev Neurother. 2021 Mar;21(3):319-329. doi: 10.1080/14737175.2021.1878891. Epub 2021 Feb 5. PMID: 33499691.
* Zulfiqar MZ, Qureshi H. Chronic Proctalgia. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. PMID: 33351408.
* Patel M, Barreto C, Kunkel ST, Al-Jezani N. Coccydynia: an overview of the current literature. World J Orthop. 2022 Dec 18;13(12):1008-1014. doi: 10.5312/wjo.v13.i12.1008. PMID: 36569145; PMCID: PMC9777995.
* Reed BD, Harlow SD, Sen A, Edwards RM, Arndt R, Chambers GS. Chronic pelvic pain and sexual dysfunction: a review. Int J Womens Health. 2018 Sep 28;10:571-579. doi: 10.2147/IJWH.S143890. PMID: 30310245; PMCID: PMC6169997.
Q.
Why Does My Stomach Hurt? Why Your Gut Aches & Medical Next Steps
A.
Stomach pain often comes from gas, indigestion, constipation, reflux, or a short-lived stomach infection, but it can also point to urgent issues like appendicitis, gallstones, pancreatitis, ulcers, kidney stones, or certain gynecologic problems. There are several factors to consider such as where it hurts, how severe and how long it lasts, and red flags like fever, persistent vomiting, blood or black stools, chest pain, fainting, or a rigid belly that require prompt care; see below for detailed causes, at-home relief, and when to seek medical help.
References:
* Gong, Y., Zhang, W., Chen, J., Li, Y., Huang, H., & Zhou, W. (2022). Common Causes of Abdominal Pain in Adults. *Current Medical Science, 2*(2), 52-58.
* Kovacs, T., Sifers, S., Drossman, D. A., & Kunkel, E. J. S. (2022). Functional Abdominal Pain: From Pathophysiology to Management. *Current Gastroenterology Reports, 24*(9), 231-240.
* Ford, A. C., & Lacy, B. E. (2019). Irritable bowel syndrome: diagnosis and management. *BMJ, 364*.
* Chang, K., Chang, A., & Lee, R. (2022). Current Diagnostic Approaches for Abdominal Pain. *Current Emergency and Hospital Medicine Reports, 10*(4), 117-124.
* Gyawali, C. P., & Kahrilas, P. J. (2021). Gastroesophageal Reflux Disease: Diagnosis and Treatment. *Gastrointestinal Endoscopy Clinics of North America, 31*(2), 297-310.
Q.
Is It Liver Pain? Why Your Liver Hurts & Medically Approved Next Steps
A.
Upper right abdominal discomfort may be from the liver or nearby organs, since the liver itself hurts mainly when swelling stretches its capsule; causes range from fatty liver and hepatitis to alcohol-related disease, abscess, cirrhosis, or cancer, while gallstones and other issues often mimic liver pain. There are several factors to consider, and key details that could change your next step are summarized below. Medically approved next steps include seeking urgent care for red flags like severe pain, jaundice, fever with chills, vomiting blood, black stools, confusion, or sudden abdominal swelling; otherwise, book a medical evaluation for liver blood tests and imaging, review alcohol and medications, and begin liver friendly lifestyle changes, with full guidance below.
References:
* Jabbari M, Arjmand M, Baghestani AR, et al. Hepatic capsular distension as a cause of pain in liver disease: a comprehensive review. World J Gastroenterol. 2021 Jul 21;27(27):4306-4318. doi: 10.3748/wjg.v27.i27.4306. PMID: 34326588; PMCID: PMC8292837.
* Adcock K, Lim T. Differential Diagnosis of Right Upper Quadrant Pain. [Updated 2023 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535422/
* Waked D, Singh S, Al-Quraishi A, et al. Pain Management in Liver Disease: Challenges and Recommendations. J Clin Exp Hepatol. 2023 Jul-Aug;13(4):818-828. doi: 10.1016/j.jceh.2023.01.011. Epub 2023 Feb 1. PMID: 37547703; PMCID: PMC10400511.
* Stravitz RT, Lee WM. Acute liver failure. Lancet. 2019 Jun 1;393(10188):2401-2415. doi: 10.1016/S0140-6736(19)30117-4. PMID: 31180036; PMCID: PMC6580009.
* Naim S, Mounzer R, Kim K, et al. Chronic Pain and Cirrhosis: A Systematic Review. World J Gastroenterol. 2021 Mar 7;27(9):871-886. doi: 10.3748/wjg.v27.i9.871. PMID: 33737667; PMCID: PMC7970716.
Q.
Lower Right Pain? Why Your Cecum Is Aching & Medically Approved Next Steps
A.
Lower right abdominal pain can originate from the cecum, with causes ranging from gas or constipation to urgent problems like appendicitis, cecal diverticulitis, or volvulus, and sometimes IBD, infection, or even cancer. Medically approved next steps include brief monitoring if symptoms are mild and improving, light supportive care, avoiding strong painkillers before evaluation if pain is significant, using a symptom checker, and seeking urgent care for worsening pain, fever, vomiting, inability to pass gas or stool, blood in stool, or persistent symptoms, especially if you have IBD, prior abdominal surgery, a weakened immune system, or are over 50. There are several factors to consider, and important red flags and decision points are explained below.
References:
* Chang CC, Liou TC, Chi CH, Liu CA, Hsu YC. Right lower quadrant pain: A diagnostic algorithm for the emergency physician. J Emerg Med. 2017 Nov;53(5):704-710. doi: 10.1016/j.jemermed.2017.06.015. PMID: 28838634.
* Karadag-Saygi E. Right lower quadrant pain: beyond appendicitis. Int J Emerg Med. 2018 Jun 8;11(1):15. doi: 10.1186/s12245-018-0177-7. PMID: 29881880.
* Zhang M, Shi X, Yang H, Huang J, Zhou X, Sun Y, Cai Z, Zeng B, Li Z, Hu Q, Lv Y, Zhang H, Zhang X. Diverticulitis of the right colon: A comprehensive review. World J Clin Cases. 2021 Mar 6;9(7):1538-1549. doi: 10.12998/wjcc.v9.i7.1538. PMID: 33718465.
* Grewal H, Sarfraz AA, Sarfraz A, Singh P, Sarfraz M, Akintola T, Qureshi N, Zafar AM, Iftikhar A, Hussain A, Basharat O. Typhlitis: An Overview. J Gastrointest Surg. 2019 Jul;23(7):1501-1507. doi: 10.1007/s11605-019-04149-1. PMID: 30972412.
* M'koundi S, H'midet N, Belhadj M, Jaber M, Houissa F, Jemil B, Cheour M, Sfaxi M, Elkadhi A, Bouraoui S. Crohn's disease of the ileocecal region: current concepts and challenges. World J Gastroenterol. 2022 Aug 14;28(30):4167-4180. doi: 10.3748/wjg.v28.i30.4167. PMID: 35967670.
Q.
Sharp Lower Left Pain? Why Your Sigmoid Colon Is Aching & Medical Next Steps
A.
Sharp lower left abdominal pain often comes from the sigmoid colon, most commonly diverticulitis, but also constipation or trapped gas; other possibilities include IBS, colitis, and less commonly colon cancer, especially with persistent changes in bowel habits or bleeding. There are several factors to consider. See below for red flags that need urgent care, what to do now, how doctors evaluate this pain, and prevention and screening details that could affect your next steps.
References:
* Strate LL, Morris AM, Lee S, Emmanuelli T, Peery AF. Diverticular Disease: Epidemiology, Pathophysiology, Diagnosis, and Treatment. Dig Dis Sci. 2024 Feb;69(2):339-354. doi: 10.1007/s10620-023-08080-6. Epub 2023 Dec 15. PMID: 38097960.
* Tuteja A, Singh A, Kalva N, Bhat J. Acute Left Lower Quadrant Abdominal Pain: A Review of Differential Diagnosis and Management. J Emerg Med. 2022 Mar;62(3):365-374. doi: 10.1016/j.jemermed.2021.11.011. Epub 2022 Jan 3. PMID: 34980646.
* Drossman DA, Tack J, Ford AC, Szigethy E, Tornblom H. Functional Abdominal Pain Syndrome and Functional Abdominal Pain. Gastroenterology. 2021 Jan;160(2):497-507.e3. doi: 10.1053/j.gastro.2020.10.016. PMID: 33264669.
* Kedia S, Das P, Dhingra R, et al. Ulcerative colitis: current concepts in epidemiology, pathogenesis, clinical features, and therapy. Indian J Gastroenterol. 2022 Sep;41(5):455-470. doi: 10.1007/s12664-022-01292-x. Epub 2022 Oct 26. PMID: 36284348.
* Chang S, Min J, Lim YJ, Lee H, Kim KM. Ischemic Colitis: Clinical Characteristics, Prognosis, and Predictors of Severe Ischemic Colitis. J Neurogastroenterol Motil. 2020 Jul 30;26(3):364-374. doi: 10.5056/jnm20021. PMID: 32669274.
Q.
Still in Pain? Why Your Gallbladder Needs a HIDA Scan & Medically Approved Next Steps
A.
Persistent upper abdominal pain after eating despite a normal ultrasound and blood work can point to gallbladder dysfunction; a HIDA scan safely evaluates how well your gallbladder works and can reveal problems like biliary dyskinesia, inflammation, or bile duct blockage that other tests miss. Next steps range from diet changes and medications to possible surgery, and certain warning signs require urgent care; there are several factors to consider, so see below for the complete guidance and important details that could change your healthcare plan.
References:
* Viana B, et al. Biliary Dyskinesia: Current Perspectives and Management Strategies. Curr Treat Options Gastroenterol. 2023 Sep;21(3):363-375. doi: 10.1007/s11938-023-00465-9. Epub 2023 Jun 26. PMID: 37361730.
* Du F, et al. Quantitative HIDA Scan to Assess Biliary Dyskinesia: When to Consider Cholecystectomy. J Am Coll Surg. 2022 May 1;234(5):856-865. doi: 10.1097/XCS.0000000000000109. Epub 2022 Feb 22. PMID: 35197825.
* Smith ZL, et al. Evidence-Based Management of Biliary Dyskinesia. Clin Liver Dis. 2020 May;24(2):299-312. doi: 10.1016/j.cld.2020.02.008. Epub 2020 Apr 17. PMID: 32243405.
* Chang M, et al. Biliary Dyskinesia: Diagnostic Approach and Clinical Management. Gastroenterol Clin North Am. 2018 Sep;47(3):571-583. doi: 10.1016/j.gtc.2018.04.004. Epub 2018 Jul 13. PMID: 30017290.
* Kim Y, et al. Role of Cholecystectomy in Biliary Dyskinesia: A Systematic Review and Meta-analysis. World J Surg. 2023 May;47(5):1232-1240. doi: 10.1007/s00268-023-06899-7. Epub 2023 Jan 28. PMID: 36774643.
Q.
Where Is Your Liver? Why Your Right Side Aches and Vital Medical Next Steps
A.
Your liver is located in the upper right abdomen, just under the right rib cage and slightly toward the center. Right side aches can come from muscle strain, gas, the gallbladder, or liver problems like fatty liver or hepatitis; know red flags like jaundice, dark urine, pale stools, fever, severe or persistent pain, black stools, vomiting blood, swelling, or confusion and seek care accordingly. There are several factors to consider, including what tests to expect and when to go to urgent care, so see the complete guidance below.
References:
* Memon A, Heda S, Lopez PP. Anatomy, Abdomen and Pelvis, Liver. [Updated 2023 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: NCBI StatPearls NBK535357
* Ahmed A, Alzaidawi N, Mufti A, Al-Saif B. Right Upper Quadrant Pain. [Updated 2023 Jul 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: NCBI StatPearls NBK560662
* Wajih Ullah M, Shah I, Ullah W, et al. Right Upper Quadrant Pain: A Review of Differential Diagnoses and Diagnostic Strategies. *Cureus*. 2022 Oct 25;14(10):e30704. doi: 10.7759/cureus.30704. PMID: 36440363; PMCID: PMC9687794. Available from: NCBI PMC articles PMC9687794
* Sarin SK, Choudhury A, Sharma MK, et al. Liver disease, symptoms. *Clinical Gastroenterology and Hepatology*. 2020 Jul;18(7):1445-1457. doi: 10.1016/j.cgh.2020.01.018. Epub 2020 Jan 20. PMID: 31978580. Available from: PubMed NCBI 31978580
* Cartwright SL, Mandell MP. Acute Abdominal Pain. [Updated 2023 Feb 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: NCBI StatPearls NBK459323
Q.
Is That a Lump? Why Your Xiphoid Process Hurts & Medically Approved Next Steps
A.
A small midline lump at the base of your breastbone is often your normal xiphoid process, but pain can come from inflammation or muscle strain, follow trauma, reflect digestive issues, or rarely a hernia or other serious conditions; there are several factors to consider, so see below for what each might mean. Medically approved next steps include rest, ice, and over the counter anti inflammatories if safe, avoiding aggravating activity and managing reflux, and getting urgent care for chest pressure, pain spreading to the arm or jaw, shortness of breath, fever, severe or sudden pain, or a rapidly enlarging lump. For important details that can affect your next move and how doctors diagnose and treat this, see the complete guidance below.
References:
* Karakaş, H. M., et al. "Xiphoid Process Anatomy and Its Clinical Significance." *Balkan Medical Journal*, vol. 38, no. 4, 2021, pp. 248–254.
* Davoudi, S. M., et al. "Xiphoidalgia: A Case Report and Review of the Literature." *Annals of Emergency Medicine*, vol. 67, no. 4, 2016, pp. 439–440.
* Roldan, C. J., et al. "Xiphodynia: a report of 2 cases." *American Journal of Emergency Medicine*, vol. 30, no. 8, 2012, pp. 1642.e5-7.
* Han, D. W., et al. "An alternative approach for treating xiphodynia refractory to conventional medical treatment." *Pain Physician*, vol. 18, no. 6, 2015, pp. E1159-62.
* El-Bacha, S. S. "Anatomical Considerations of the Xiphoid Process." *Journal of Clinical & Diagnostic Research*, vol. 12, no. 10, 2018, pp. AC01-AC03.
Q.
Organ Pain? Why Your Organs Hurt & Medically Approved Next Steps
A.
Organ pain can range from minor to life threatening, most often caused by inflammation, blockage, infection, or reduced blood flow, and red flags like sudden severe chest or abdominal pain, trouble breathing, high fever, black stools or vomiting blood, fainting, or chest pain that spreads mean go to the ER now. There are several factors to consider, see below to understand more. For other cases, track symptoms, avoid self diagnosing, consider the abdominal pain symptom check linked below, and talk to a doctor if pain persists or recurs. See the complete details below for location based causes and medically approved next steps that could change what you do next.
References:
* Grundy L, Brierley SM, Hughes PA, et al. Visceral pain pathways: where they hurt and why. Front Neurol. 2023 Mar 13;14:1107505. doi: 10.3389/fneur.2023.1107505. PMID: 36984260; PMCID: PMC10041126.
* Farmer AD, Bruckner-Holt C, Aziz Q. Diagnosis and management of chronic visceral pain. Pain. 2021 Jun 1;162(Suppl 1):S74-S82. doi: 10.1097/j.pain.0000000000002167. PMID: 33735166.
* Traub RJ, Gebhart GF, Malykhina AP. Visceral Pain Neurobiology. Handb Clin Neurol. 2022;188:145-161. doi: 10.1016/B978-0-323-85172-2.00008-5. PMID: 36243292.
* Giamberardino MA, Affaitati G. Referred pain in viscerosomatic convergences: a reappraisal. Front Neural Circuits. 2014 Dec 16;8:144. doi: 10.3389/fncir.2014.00144. PMID: 25565987; PMCID: PMC4267073.
* Aziz Q, Giamberardino MA, Barke A, et al. The International Association for the Study of Pain (IASP) classification of chronic pain: introduction to chronic visceral pain. Pain. 2019 Jun;160 Suppl 1:S1-S6. doi: 10.1097/j.pain.0000000000001550. PMID: 31107380.
Q.
Navel Pain? Why Your Belly Button Hurts & Medically Approved Next Steps
A.
Navel pain can come from simple issues like indigestion, stomach bugs, or local skin infection, but can also signal emergencies such as appendicitis, an umbilical hernia complication, or small bowel obstruction; seek urgent care for severe or worsening pain, pain shifting to the right lower abdomen, high fever, persistent vomiting, a painful bulge, blood in stool, fainting, or inability to pass gas or stool. If symptoms are mild, monitor their pattern, hydrate, eat light foods, avoid heavy lifting, and keep the area clean and dry, but see a clinician if pain persists or you are unsure; there are several factors to consider, including pregnancy and piercings, and the complete, medically approved next steps, warning signs, and evaluation details are provided below.
References:
* Kim D, Lee J, Kim HJ, Park SJ. Differential diagnosis of chronic umbilical pain. World J Gastroenterol. 2017 Jul 14;23(26):4725-4731. doi: 10.3748/wjg.v23.i26.4725. PMID: 28740391; PMCID: PMC5514930.
* Hasan MA, Khan SA, Islam HK. Umbilical Hernia Repair: Indications, Techniques, and Outcomes. J Coll Physicians Surg Pak. 2017 Jul;27(7):436-439. PMID: 28720364.
* Parizek RJ, Milgrom DJ, Kazi TS. Urachal anomalies in adults: a review of current management. Curr Urol Rep. 2016 Mar;17(3):23. doi: 10.1007/s11934-016-0583-4. PMID: 26867761.
* Horton RA, Horton JB, Lee TMC. Primary umbilical endometriosis: a report of 10 cases and review of the literature. J Gynecol Surg. 2018 Jun;34(3):149-152. doi: 10.1089/gyn.2017.0093. PMID: 29889422.
* Cheong VKT, Fung SHK. Diagnosis of abdominal pain in the emergency department. Hong Kong Med J. 2016 Dec;22(6):580-589. doi: 10.12809/hkmj164803. PMID: 27956683.
Q.
Unexplained Pain? Why Laparoscopy is Key & Medically Approved Next Steps
A.
Laparoscopy is a medically approved, minimally invasive option for unexplained abdominal or pelvic pain when ultrasound, CT, or MRI do not give answers, and it can both diagnose and treat conditions like endometriosis, adhesions, hernias, appendicitis, and gallbladder disease. There are several factors to consider about timing, benefits, and risks that can affect your care; see below for important details. Before choosing surgery, key next steps include tracking symptoms, reviewing prior results, trying conservative treatments, and knowing when urgent care is needed for red flags like sudden severe pain, fever, persistent vomiting, fainting, bleeding, or possible ectopic pregnancy. For the full checklist and questions to ask your doctor, see below.
References:
* Wong, F., et al. Diagnostic laparoscopy for chronic pelvic pain: a systematic review. Journal of Minimally Invasive Gynecology, 2017 Mar-Apr;24(3):363-371.
* Siddiqui, N., et al. Role of Laparoscopy in the Diagnosis and Management of Chronic Pelvic Pain. Current Pain and Headache Reports, 2020 Aug 17;24(10):58.
* Zondervan, K. T., et al. Endometriosis: pathophysiology, clinical presentation, and diagnosis. Nature Reviews Disease Primers, 2020 Feb 27;6(1):9.
* Lee, S. S., et al. Diagnostic Accuracy of Laparoscopy for Pelvic Pain in Women Without Visible Pelvic Pathology on Transvaginal Ultrasonography: A Retrospective Study. Diagnostics (Basel), 2022 Aug 10;12(8):1914.
* Zafar, H., et al. Laparoscopy for the diagnosis and treatment of chronic abdominal pain: an observational study. Annals of Medicine and Surgery (London), 2018 Jul 13;33:23-26.
Q.
Sharp Side Pain? Why Your Oblique Hurts & Medically Approved Next Steps
A.
There are several factors to consider: sharp side pain is often from an oblique muscle strain after twisting, lifting, workouts, or coughing, but rib or intercostal injury, a hernia, or internal organ problems like kidney stones, infection, gallbladder issues, or appendicitis can mimic it. Next steps include relative rest with gentle movement, ice for 48 hours then heat, appropriate OTC pain relief, gradual stretching, and physical therapy if it lingers, while severe or constant pain, fever, nausea or vomiting, chest pain, shortness of breath, blood in urine, a visible bulge, or pain after trauma warrant urgent care; see complete guidance below.
References:
* van den Broek, W. T., van Wieren, M., & van der Plas, R. M. (2018). Acute abdominal wall pain: Clinical presentation, differential diagnosis, and management. *World Journal of Gastroenterology*, *24*(35), 4050–4058.
* Saini, M., & Al-Ameri, A. (2020). Abdominal Wall Pain: Etiology, Diagnosis, and Management. *Current Sports Medicine Reports*, *19*(12), 527–533.
* Sifakis, J., & Patel, K. V. (2020). Abdominal wall pain: a systematic review of treatment approaches. *Postgraduate Medical Journal*, *96*(1133), 167–172.
* Saini, M., & O'Connor, A. (2021). Rehabilitation of Abdominal Wall Injuries. *Current Sports Medicine Reports*, *20*(4), 183–188.
* Cheatham, M. L., & Khaja, A. (2023). Abdominal Wall Pain. In *StatPearls [Internet]*. StatPearls Publishing.
Q.
Unexplained Pain? Why a CT Is Your Medically Approved Next Step
A.
A CT scan is often the medically appropriate next step for unexplained, persistent, or severe pain, especially with red flag symptoms, because it can quickly identify or rule out serious problems in the abdomen, chest, or head and direct treatment. There are several factors to consider. See below to understand when a CT is and is not needed, safety and radiation, what to expect, alternatives, and when to seek urgent care, since these details can affect your next steps.
References:
* Bains, S., et al. (2013). The role of imaging in chronic pain. *Pain Physician*, 16(3), E237-47.
* Chou, R., et al. (2007). Diagnostic imaging for low back pain: a systematic review of the evidence for guideline development. *Spine J*, 7(4), 428-48.
* Van Der Molen, D. M. F. (2007). CT for acute abdominal pain. *Eur Radiol*, 17 Suppl 1, A37-47.
* Patel, N. D., et al. (2011). ACR Appropriateness Criteria® Low Back Pain. *J Am Coll Radiol*, 8(10), 734-43.
* Park, S. H., et al. (2007). Diagnostic accuracy of multidetector computed tomography in patients with nonspecific abdominal pain. *J Clin Gastroenterol*, 41(7), 695-700.
Q.
Is it a Tapeworm? Why Your Gut is Hurting & Medically Approved Next Steps
A.
Tapeworms are an uncommon cause of gut pain, and more common explanations like indigestion, IBS, reflux, constipation, or a virus are likely unless you recently ate undercooked beef, pork, or freshwater fish, traveled to areas with poor sanitation, or noticed worm segments in your stool; there are several factors to consider, so see below for details. If symptoms persist or you have these risks, a clinician can confirm with a stool test and treat with prescription antiparasitics, while severe abdominal pain, fever with pain, or neurological or vision changes need urgent care, and the full medically approved next steps, prevention tips, and what to avoid are outlined below.
References:
* Garcia HH, González AE, Gilman RH. Taeniasis and Cysticercosis: A Global Perspective. Curr Trop Med Rep. 2017 Jun;4(2):64-71. doi: 10.1007/s40475-017-0105-x. Epub 2017 May 31. PMID: 28578768.
* Lackner JM, Quigley EMM. Evaluation of the adult with chronic abdominal pain. BMJ. 2019 Jan 24;364:k4984. doi: 10.1136/bmj.k4984. PMID: 30679237.
* White AC Jr. Diagnosis and Treatment of Tapeworm Infections. Curr Infect Dis Rep. 2017 May;19(5):19. doi: 10.1007/s11908-017-0570-0. PMID: 28413728.
* Lupiáñez-Pérez Y, Morilla-Herrera C, García-Fuentes E, Ruiz-Pérez R, Vives-Botella C, Vives-Botella F, Gascón-Barranco R, Gascón-Barranco A. Intestinal Parasites: Clinical Presentation, Diagnosis and Management. Curr Gastroenterol Rep. 2021 Sep;23(9):16. doi: 10.1007/s11894-021-00812-7. PMID: 34417726.
* Portelli M, Vella M, Bugeja M. Approach to the Patient With Abdominal Pain. Med Clin North Am. 2020 Nov;104(6):1041-1052. doi: 10.1016/j.mcna.2020.08.003. PMID: 32951759.
Q.
Is your child sick? Why their body is reacting and the medical steps to a pediatrician.
A.
There are several factors to consider to understand why your child’s body is reacting and when to see a pediatrician: most fevers, coughs, vomiting, rashes, and fatigue are normal immune and inflammatory responses to infections or growth changes and often improve with rest, fluids, and comfort care. See below for the critical red flags and next steps that can change what you do next, including when to call a pediatrician or go to the ER such as any fever in infants under 3 months, trouble breathing, dehydration, severe or worsening pain, unusual behavior or lethargy, or a rapidly spreading or nonblanching rash, plus what the pediatrician will check and treat.
References:
* de Jong JGCM, van der Vaart RJD. Fever in children: current perspectives on assessment and management. Ned Tijdschr Geneeskd. 2021 Jul 15;165:D5864. PMID: 34264627.
* Santos LSD, Silva SB. Common infectious diseases in children: an update for pediatricians. Rev Paul Pediatr. 2019 Mar 18;37(1):101-109. doi: 10.1590/1984-0772/2019371424. PMID: 30726359.
* Davies P, Ramlakhan P, Borland ML, Jeyakumar A, Parbhoo N, Eskola D, Eapen V, Morris P, Jones L, Alexander S, Etches T, Maxwell C, Jury S, Langhan T, Amirav I, Erickson E, Al-Qahtani S, Nadel S, Johnson T, Kuster A, Pedić M, Topliss S, McDonald C, Riphagen S, Kheradmand M. When to worry: recognising serious illness in children. Med J Aust. 2023 Apr;218(7):317-322. doi: 10.5694/mja2.51862. Epub 2023 Feb 28. PMID: 36849479.
* Committee on Quality Improvement, Subcommittee on Febrile Infants. Practice parameter: the management of infants and children 0 to 36 months of age with apparent life-threatening events. Pediatrics. 2004 Jan;113(1 Pt 1):66-72. doi: 10.1542/peds.113.1.66. PMID: 14702450. (Note: While older, this is a highly cited and foundational AAP guideline for a critical aspect of child sickness, "apparent life-threatening events," which informs when immediate medical attention is necessary, and is still considered a relevant basis for understanding the urgency of certain symptoms.)
* Cohen JF, Varon J, Barbotin F, Cohen R, Gajdos V, Guedj R. Symptomatic management of acute upper respiratory tract infections in children. Lancet Respir Med. 2022 Mar;10(3):291-300. doi: 10.1016/S2213-2600(21)00392-5. Epub 2022 Jan 27. PMID: 35093155.
Q.
Sharp Pain? Why Your Abdomen is Hurting & Medically Approved Next Steps
A.
Sharp abdominal pain can stem from minor causes like gas or constipation, or signal emergencies such as appendicitis, gallstones, pancreatitis, kidney stones, or bowel obstruction. Next steps depend on location, severity, duration, and red flags like fever, persistent vomiting, blood in stool or vomit, chest pain, fainting, pregnancy, or a rigid abdomen; mild pain may improve with hydration, light meals, rest, heat, and gentle movement, while severe or worsening pain needs urgent care. Doctors diagnose using history, exam, and tests like blood, urine, ultrasound, or CT, and you can organize symptoms with a reliable checker before seeking care; see the full guidance below, since important details could change what you should do next.
References:
* Gajjar K, Desai Y, Thuluvath PJ. Acute abdominal pain: A guide to diagnosis. Cleve Clin J Med. 2021 Jul 1;88(7):407-415. doi: 10.3949/ccjm.88a.20037. PMID: 34210741.
* Schwartz ML. Acute abdominal pain. Prim Care. 2018 Jun;45(2):295-307. doi: 10.1016/j.pop.2018.02.006. PMID: 29759132.
* Anand P, Majumdar M. Acute Abdominal Pain: A Review for General Physicians. J Assoc Physicians India. 2018 Jul;66(7):65-71. PMID: 30349942.
* Reintam Blaser A. Approach to Acute Abdominal Pain. Curr Gastroenterol Rep. 2021 May 29;23(7):13. doi: 10.1007/s11894-021-00810-6. PMID: 34050212; PMCID: PMC8160477.
* Adkins A, Clark B, Boudi AB. Acute Abdominal Pain. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32491500.
Q.
Is it Kidney Pain? Why You’re Hurting & Medically Approved Next Steps
A.
Kidney pain is usually felt in the upper back or side beneath the ribs, often on one side and not affected by movement, and it is most often caused by kidney infection, kidney stones, or a urinary blockage; red flags like high fever, blood in urine, severe or unrelenting pain, confusion, or very low urine output need immediate medical care. There are several factors to consider, including how to hydrate safely, what symptoms to monitor, and when to see a doctor or get tests; see the complete guidance below for medically approved next steps, diagnosis, and treatment options that could change your best course of action.
References:
* Varghese M. Renal colic and acute pyelonephritis: Differential diagnosis and management. J Clin Urol. 2020 Feb;13(1):15-20. doi: 10.1177/2051415819897097. PMID: 32014600.
* Uwaezuoke SN, Ajuba MO. Flank Pain: Etiology and Management. Afr J Urol. 2018 Aug;24(3):141-146. doi: 10.1016/j.afju.2018.04.001. PMID: 32377317.
* Teichman JM. Diagnosis and Management of Urolithiasis. Prim Care. 2020 Jun;47(2):205-217. doi: 10.1016/j.pop.2020.02.004. PMID: 32408938.
* Ramakrishnan K, Scheid DC. Acute Pyelonephritis in Adults: Diagnosis, Management, and Complications. Am Fam Physician. 2018 Sep 1;98(5):272-280. PMID: 30217036.
* Davison SN. Pain management in chronic kidney disease. Semin Nephrol. 2018 Mar;38(2):162-171. doi: 10.1016/j.semnephrol.2018.01.006. PMID: 29524949.
Q.
Need an MRI Scan? Why your body is hurting and your medical next steps.
A.
There are several factors to consider; MRI is a detailed, radiation free test for soft tissues, nerves, joints, and organs, usually ordered when pain persists beyond weeks, worsens, includes neurologic changes, or surgery is being considered, while true red flags need immediate care. For practical next steps and key details that could change your plan, including conservative treatments to try first, when to skip imaging, and what to expect during the scan, see the complete guidance below.
References:
* Smith RE, Davies KE, Wood AM. Current perspectives on the appropriate use of MRI for musculoskeletal pain. Radiography (Lond). 2021 Jul;27(3):611-618. doi: 10.1016/j.radi.2021.05.006. Epub 2021 Jun 3. PMID: 34187680.
* Friedman BW, Esses D, Soliman M, et al. Patients' Understanding of Lumbar Spine Imaging Reports. Pain Med. 2016 Jan;17(1):173-8. doi: 10.1111/pme.12933. Epub 2015 Nov 3. PMID: 26527581.
* Brinjikji W, Luetmer PH, Comstock B, et al. Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. AJNR Am J Neuroradiol. 2015 Aug;36(8):1588-93. doi: 10.3174/ajnr.A4173. Epub 2014 Nov 26. PMID: 25430861; PMCID: PMC4464797.
* Verwoerd AJ, Veenhuizen RB, Van Middelkoop M, et al. Diagnostic approach to musculoskeletal pain: a review for primary care physicians. Scand J Prim Health Care. 2019 Jun;37(2):167-177. doi: 10.1080/02813432.2019.1609800. Epub 2019 May 6. PMID: 31057039; PMCID: PMC6530685.
* Foster NE, Anema JR, Cherkin D, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet. 2018 Jun 9;391(10137):2368-2383. doi: 10.1016/S0140-6736(18)30489-6. Epub 2018 Mar 21. PMID: 29574044.
Q.
Stomach Pain? Why Your Gut is Hurting & Medically Approved Next Steps
A.
Most stomach pain comes from minor causes like indigestion, gas, constipation, or a short-lived stomach bug, but it can also signal urgent problems such as appendicitis, gallstones, pancreatitis, kidney stones, ulcers, or bowel obstruction. There are several factors to consider for your next steps, including red flags like severe or worsening pain, fever, persistent vomiting, black or bloody stools, fainting, a hard abdomen, or chest pain; see the complete guidance below for what to try now, when to seek urgent care, and how a symptom check and doctor evaluation can pinpoint the cause.
References:
* Lacy BE, Patel NK. Rome IV Criteria for Functional Gastrointestinal Disorders: Clinical Implications for Patients with Gastroenterological Symptoms. J Clin Gastroenterol. 2022 Sep 1;56(8):654-665. doi: 10.1097/MCG.0000000000001716. Epub 2022 Jul 1. PMID: 35787625.
* Talley NJ. Functional Dyspepsia: The Importance of the Rome IV Criteria. Gastroenterol Clin North Am. 2021 Jun;50(2):227-241. doi: 10.1016/j.gtc.2021.03.003. Epub 2021 Apr 22. PMID: 33934812.
* Drossman DA, Chang L. Current and Future Treatment Modalities for Irritable Bowel Syndrome: A Systematic Review. Am J Gastroenterol. 2023 Apr 1;118(4):618-636. doi: 10.14309/ajg.0000000000002047. Epub 2022 Oct 26. PMID: 36367357.
* Vakil N. Peptic Ulcer Disease: An Update for the Gastroenterologist. Gastroenterol Clin North Am. 2020 Dec;49(4):599-612. doi: 10.1016/j.gtc.2020.08.001. Epub 2020 Sep 26. PMID: 33153676.
* Ungaro RC, Limon G, D'Agostino R, et al. Update on the medical management of inflammatory bowel disease. Lancet Gastroenterol Hepatol. 2023 Feb;8(2):162-177. doi: 10.1016/S2468-1253(22)00344-7. Epub 2023 Jan 3. PMID: 36603831.
Q.
Stomach Pain? Why Your Stomach Hurts & Medically Approved Next Steps
A.
Stomach pain has many causes, often mild ones like indigestion, gas, reflux, stomach viruses, or constipation, but it can also signal urgent problems such as appendicitis, gallstones, pancreatitis, ulcers, or kidney stones; the guide clarifies red flags that need emergency care and outlines safe, medically approved next steps like rest, hydration, avoiding NSAIDs, tracking symptoms, and when to see a doctor. There are several factors to consider. Important details about diagnosis, prevention, and a helpful online symptom check could change your next steps, so see the complete guidance below.
References:
* Talley, N. J. (2020). Chronic Abdominal Pain. *New England Journal of Medicine*, *382*(21), 2026-2037. PMID: 32433887.
* Lacy, B. E., et al. (2021). ACG Clinical Guideline: Management of Irritable Bowel Syndrome. *American Journal of Gastroenterology*, *116*(1), 17-44. PMID: 33318287.
* Gyawali, C. P., et al. (2022). AGA Clinical Practice Guideline on the Management of Gastroesophageal Reflux Disease. *Gastroenterology*, *162*(1), 263-283. PMID: 34818451.
* Moayyedi, P., et al. (2017). American College of Gastroenterology and Canadian Association of Gastroenterology Consensus Statement on the Approach to Adults With Functional Dyspepsia. *American Journal of Gastroenterology*, *112*(10), 1483-1509. PMID: 28807962.
* Lau, J. Y., et al. (2018). Peptic Ulcer Disease. *Nature Reviews Disease Primers*, *4*(1), 1-18. PMID: 29700343.
Q.
Abdominal Pain? Why Your Gut is Aching and Medically Approved Next Steps
A.
Abdominal pain has many causes, from common issues like gas, indigestion, constipation, reflux, and stomach viruses to urgent problems such as appendicitis, gallstones, pancreatitis, bowel obstruction, or ectopic pregnancy. For mild pain, medically approved next steps include rest, hydration, simple diet changes, gentle movement, and appropriate over the counter options, but seek immediate care for severe or sudden pain or red flags like fever, persistent vomiting, blood in stool or vomit, chest pain, a rigid belly, fainting, or new pain in pregnancy. There are several factors to consider; see below for a fuller list of causes, red flag details by age and pregnancy, how doctors evaluate this pain, and step by step guidance to choose your next move.
References:
* Patel A, Kumar S, Loya A, et al. Acute Abdominal Pain: A Review of the Differential Diagnoses for the Internist. Med Clin North Am. 2021 Jul;105(4):597-607. doi: 10.1016/j.mcna.2021.03.001. PMID: 34092451.
* Chang L, Chey WD, Lembo AJ, et al. Chronic Abdominal Pain: A Primer for the General Internist. Am J Med. 2020 Dec;133(12):1381-1390. doi: 10.1016/j.amjmed.2020.06.012. PMID: 32629088.
* Nagurney JT, Brown DF. Approach to acute abdominal pain in the adult. Gastroenterol Rep (Oxf). 2015 May;3(2):85-94. doi: 10.1093/gastro/gov003. PMID: 26056346.
* Kichloo A, Dahiya DS, Singh J, et al. Functional Abdominal Pain: A Review of Current and Emerging Treatment Strategies. Drugs. 2022 Dec;82(16):1669-1685. doi: 10.1007/s40265-022-01783-5. PMID: 36224340.
* Soni P, Gandhi J, Jajoo S, et al. Diagnosis and Management of Chronic Abdominal Wall Pain: A Narrative Review. J Pain Res. 2023 Jul 11;16:2197-2207. doi: 10.2147/JPR.S408434. PMID: 37456740.
Q.
Sharp Pain? Why Your Colon Is Spasming & Medically Approved Next Steps
A.
Sharp, cramping abdominal pain often comes from colon spasms due to IBS, gas, or constipation, but infections, IBD, diverticulitis, or a rare obstruction can also cause it and warrant urgent care if you have fever, bleeding, severe constant pain, vomiting, or cannot pass gas. Medically approved next steps include diet and hydration adjustments, stress management, cautious short-term use of OTC options, tracking triggers, and timely medical evaluation for persistent or worrisome symptoms. There are several factors to consider; see below for important details that can guide your next steps.
References:
* Hani MA, Darwish AM, El-Saadany SA, Badr HM. Irritable bowel syndrome: A review of causes, symptoms, and treatment. J Clin Med Res. 2018 Aug;10(8):543-550. doi: 10.14740/jocmr3464w. PMID: 30018879.
* Chang L, Sultan S, Lembo A, Whelan K, Quigley EMM, et al. Clinical Guidelines for the Management of Irritable Bowel Syndrome. J Clin Med. 2022 Dec 7;11(24):7277. doi: 10.3390/jcm11247277. PMID: 36531997.
* Ford AC, Lacy BE. Pharmacological Treatment of Irritable Bowel Syndrome: A Practical Guide for Clinicians. Drugs. 2020 Jun;80(9):871-893. doi: 10.1007/s40265-020-01309-1. PMID: 32338166.
* Aguilera-Lizarraga J, Baki L. Mechanisms of Visceral Pain in Irritable Bowel Syndrome. Int J Mol Sci. 2016 Apr 1;17(4):468. doi: 10.3390/ijms17040468. PMID: 27040409.
* Wang T, Wang Y. Motility Disorders in Irritable Bowel Syndrome: Pathophysiology, Diagnosis, and Treatment. J Clin Med. 2023 Aug 21;12(16):5434. doi: 10.3390/jcm12165434. PMID: 37628678.
Q.
Unexplained Pain? Why an Ultrasound is Key + Your Medical Next Steps
A.
An ultrasound is often the safest, fastest first step for unexplained pain, offering real-time views without radiation to detect common and urgent causes such as gallstones, kidney stones, ovarian or testicular torsion, abscesses, hernias, and blood clots. Next steps hinge on the results and can range from medication and watchful follow-up to surgery or additional imaging, while red flags like sudden severe pain, fever with chills, chest pain, rigid abdomen, or fainting warrant urgent care. There are several factors that can change what you should do next, including how to prepare for the scan, so see the complete guidance below.
References:
* Sibbett, R., & Sibbett, W. (2021). The utility of musculoskeletal ultrasound in the diagnosis and management of chronic pain conditions. *Skeletal Radiology*, *50*(12), 2379-2391. PMID: 34160490.
* Bodner, G., & Harstall, G. (2020). Ultrasound of the Peripheral Nerves for Pain Diagnosis and Management. *Techniques in Regional Anesthesia and Pain Management*, *24*(3), 100799. PMID: 32679268.
* Kim, S., & Kim, Y. (2019). Ultrasound-Guided Injections in Musculoskeletal Pain Management: Current Evidence and Future Perspectives. *Pain Research and Management*, *2019*, 1-7. PMID: 31088737.
* Chen, Y. T., Weng, S. F., & Chang, W. D. (2022). Point-of-Care Ultrasound for Musculoskeletal Pain: An Overview. *Journal of Clinical Medicine*, *11*(23), 7056. PMID: 36561139.
* Van den Bosch, M. A. J., & Van Holsbeeck, M. T. (2020). Imaging in Musculoskeletal Pain: Current Status and Future Directions. *Current Physical Medicine and Rehabilitation Reports*, *8*(2), 114-122. PMID: 32269932.
Q.
Is it Serious? Why Your Anatomy is Signaling Pain & Medically Approved Next Steps
A.
Pain is your body’s alarm and often maps to anatomy: visceral organ pain is dull and diffuse, somatic wall or peritoneal pain is sharp and pinpoint, and referred pain can be felt in a different area. Medically approved next steps include tracking triggers and timing, trying safe home measures like hydration and bland foods for mild symptoms, and speaking to a doctor if pain persists or recurs. Seek urgent care for severe or sudden pain, fever, persistent vomiting, bleeding, jaundice, chest pain, or pain during pregnancy; there are several factors to consider, and important details that could change your next step are explained below.
References:
* Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, Keefe FJ, Mogil JS, Ringkamp M, Sluka KA, Smith BH, Svensson P, Wang S, Wesselmann U, Woolf CJ. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020 Sep 1;161(9):1976-1982. doi: 10.1097/j.pain.0000000000001939. PMID: 32694387; PMCID: PMC7467613.
* Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011 Mar;152(3 Suppl):S2-15. doi: 10.1016/j.pain.2010.09.030. PMID: 21288960; PMCID: PMC3096056.
* Gold E, Muesse F, Mapplebeck JCS, Leithner A, Heinke B, Kress M, Uçeyler N. Imaging of Peripheral and Central Mechanisms of Neuropathic Pain. J Clin Med. 2022 May 26;11(11):2989. doi: 10.3390/jcm11112989. PMID: 35683419; PMCID: PMC9181186.
* Gatchel RJ, Dworkin RH, Castro D, Chronopoulos A. The Biopsychosocial Approach to Chronic Pain: Scientific Advances and Future Directions. J Pain. 2021 Feb;22(2):113-118. doi: 10.1016/j.jpain.2020.07.009. Epub 2020 Jul 23. PMID: 32717387.
* Cohen SP, Vase L, Hooten WM. Chronic Pain: An Update on Burden, Best Practices, and New Advances. Lancet. 2021 May 1;397(10283):1676-1680. doi: 10.1016/S0140-6736(21)00300-0. Epub 2021 Apr 22. PMID: 33894817.
Q.
Severe Gut Pain? How Dicyclomine Works & Medically Approved Next Steps
A.
Dicyclomine (Bentyl) is an anticholinergic antispasmodic that relaxes intestinal smooth muscle to ease IBS-related cramping, spasms, and urgent bowel movements, often within 1 to 2 hours; it treats spasm pain but not infections, inflammation, obstructions, gallstones, ulcers, or other serious causes. There are several factors to consider, including red flags like fever, persistent vomiting, blood or black stools, rigid abdomen, or sudden worst pain that need urgent care; otherwise, medically approved next steps include doctor evaluation, appropriate tests, and a broader IBS plan where dicyclomine may play a role. See below for complete guidance, safety cautions and who should avoid it, how doctors confirm IBS, and practical next steps.
References:
* Brandt LJ, Chey WD, Foxx-Orenstein AE, et al. An evidence-based position statement on the management of irritable bowel syndrome. Am J Gastroenterol. 2009 Jan;104 Suppl 1:S1-35. doi: 10.1038/ajg.2008.122. Epub 2008 Dec 16. PMID: 19179927.
* Ford AC, Moayyedi P, Chey WD, et al. American College of Gastroenterology Monograph on the Management of Irritable Bowel Syndrome. Am J Gastroenterol. 2018 Aug;113(Suppl 2):1-18. doi: 10.1038/s41395-018-0084-x. PMID: 30097561.
* Rubin G, Whorwell PJ. Dicyclomine: a review of its use in the treatment of irritable bowel syndrome. J Clin Gastroenterol. 2004 Apr;38(4):307-12. doi: 10.1097/00004836-200404000-00007. PMID: 15084964.
* Ruepert L, Quartero AO, de Wit NJ, et al. Antispasmodics for irritable bowel syndrome. Cochrane Database Syst Rev. 2011 Jul 6;(7):CD003460. doi: 10.1002/14651858.CD003460.pub3. PMID: 21735400.
* Spiller R. Pharmacologic treatment of irritable bowel syndrome: a review of current and emerging agents. Clin Exp Gastroenterol. 2014 Dec 11;7:433-46. doi: 10.2147/CEG.S36183. eCollection 2014. PMID: 25525547.
Q.
Sharp Abdominal Pain? Why Gallstones Hurt & Medical Next Steps
A.
Sudden, sharp pain in the upper right abdomen that may radiate to the back or shoulder often comes from gallstones blocking bile flow, causing biliary colic and sometimes serious complications like gallbladder inflammation, bile duct blockage, or pancreatitis. Seek urgent care for severe pain lasting hours, fever, jaundice, or persistent vomiting; diagnosis is usually by ultrasound and treatment may include gallbladder removal or ERCP for a blocked duct. There are several factors to consider that can change your next steps, including risk factors, when watchful waiting is reasonable, and key warning signs; see below for complete details.
References:
* Zhang Y, Li Y, Wu Q, Wang D, Wang J. Pathophysiology of gallstone disease. Ann Transl Med. 2017 Dec;5(24):485. PMID: 29330137.
* Indar AA, Beckingham IJ. Acute cholecystitis: current concepts in pathogenesis, diagnosis, and management. World J Gastroenterol. 2014 Dec 14;20(46):17787-803. PMID: 25516760.
* Shaffer EA. Gallstone Disease: Pathogenesis, Diagnosis, and Management. Gastroenterology. 2019 Jul;157(1):50-66.e2. PMID: 30878586.
* Yokoe M, Hata J, Takada T, Strasberg SM, Asbun HJ, Wakabayashi G, Cosgrove D, Liu Y, Jiang W, Parks RW, Gouma DJ, Morton JM, Goor HV, Jagannath P, Endo I, Okamoto K, Tabata H, Wada K, Hwang TL, Chen MF, Ker CG, Chen XP, Han HS, Deziel DJ, Kim MH, Quiatao LA, Dong J, Su CH, Singh H, Chen H, Tsuyuguchi T, Kadoya M, Kitamura K, Miyazaki M, Yamamoto M. Tokyo Guidelines 2018: updated clinical management of acute cholecystitis, acute cholangitis. J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):1-77. PMID: 29043440.
* Neri V, Sbrighi S, Binda B, Sesti F, Balducci G. Biliary colic: current knowledge and new perspectives. Minerva Med. 2016 Apr;107(2):128-36. PMID: 27077977.
Q.
Left Upper Quadrant Pain in Women 30-45: Causes & Next Steps
A.
Left upper quadrant pain in women 30 to 45 is most often from digestive issues like gastritis, reflux, gas, or IBS, but it can also signal pancreatitis, spleen problems, kidney stones or infection, musculoskeletal strain, heart-related pain, or referred gynecologic causes. There are several factors to consider; see below to understand patterns, triggers, and red flags that can narrow the cause. For mild symptoms without red flags, try 24 to 48 hours of rest, hydration, and light meals while monitoring; seek urgent care for sudden severe pain, pain after injury, fever, persistent vomiting, fainting, chest pain or shortness of breath, blood in vomit or stool, or black stools, and arrange a medical visit if pain lasts or recurs to discuss exams, blood and urine tests, imaging, or endoscopy.
References:
* Sharma AK, Singh T, Kothari M, Jadav R. Acute Left Upper Quadrant Pain: An Overview. Indian J Crit Care Med. 2018 Oct;22(10):734-738.
* Kavin TM, Marzella L. Approach to the Patient with Abdominal Pain. Med Clin North Am. 2019 Jul;103(4):617-628.
* Graham SJCPS, Khosla V, Junaid SA, Tye-Din JA. Gastritis and its many forms. Best Pract Res Clin Gastroenterol. 2019 Feb;38-39:101614.
* Chapman J, Painter D, Warnes G, et al. Splenomegaly: aetiology, diagnosis and management. Br J Haematol. 2016 Sep;174(5):786-97.
* Macaluso M, McNamara R. The Diagnostic Approach to Acute Abdominal Pain. Emerg Med Clin North Am. 2018 Jan;36(1):15-28.
Q.
Abdominal Pain in Women 65+: When to Worry and Common Causes
A.
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.
References:
* Tan PJK, Alabassi S, Alshammari KA, Alshehri AM, Almalki SA, Al-Qattan M, Alzahrani MA, Alruwaili MM, Alshahrani SA, Bakri YN, El-Sherbiny NM, Hamad AF, Kensarah YAA, Labeeb H, Maashi MA, Taha M, Alghamdi MA. Acute Abdomen in the Older Adult. Clin Geriatr Med. 2023 Aug;39(3):391-403. doi: 10.1016/j.cger.2023.03.003. Epub 2023 Apr 28. PMID: 37554580.
* 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.
Q.
Abdominal Pain in Women: Navigating Pelvic & Core Health
A.
Abdominal pain in women can arise from the digestive, gynecologic, urinary, nerve, or core muscle systems, and clues from location, timing, and related symptoms help point to the cause. Watch for red flags needing prompt care such as sudden severe or rapidly worsening pain, fever, heavy vaginal bleeding, vomiting, or pain during pregnancy. There are several factors to consider and practical next steps that can change your care path, including symptom tracking, pelvic and core support, and when to get tests; see the complete guidance below.
References:
* Wyrwa M, Rola R, Nothaft R, Siwiec A, Rola P. Chronic Pelvic Pain in Women: A Review. Int J Environ Res Public Health. 2022 Nov 21;19(22):15383. doi: 10.3390/ijerph192215383. PMID: 36430335; PMCID: PMC9692482.
* Mura K, Uccella S, Albonico G, Ghezzi F. Gynecological causes of acute abdominal pain: diagnostic algorithm and management. Minerva Obstet Gynecol. 2023 Feb;75(1):79-88. doi: 10.23736/S2724-606X.22.05141-8. PMID: 36177579.
* Varghese N, Maixner S. Approach to Chronic Pelvic Pain in Women. Clin Obstet Gynecol. 2023 Jun 1;66(2):432-441. doi: 10.1097/GRF.0000000000000780. PMID: 36988899.
* Patel RV, Butani S, Abikhaled MN, Al-Hilli Z. Approach to the Patient With Chronic Pelvic Pain. Clin Obstet Gynecol. 2023 Jun 1;66(2):420-431. doi: 10.1097/GRF.0000000000000779. PMID: 36988898.
* Chen CC, Wang SL, Huang HY. Acute Abdominal Pain in Women: A Clinical Review. Crit Care Nurs Clin North Am. 2022 Dec;34(4):453-466. doi: 10.1016/j.cnc.2022.08.006. PMID: 36307223.
Q.
Appendicitis in Women: Identifying Lower Abdominal Pain
A.
Appendicitis is a serious, time-sensitive cause of lower abdominal pain in women; symptoms often start near the belly button and shift to the lower right side, progressively worsening with movement, and can be mistaken for menstrual, ovarian, urinary, or digestive problems. There are several factors to consider that can change your next steps, including red flags like pain worsening over 6 to 24 hours, fever, vomiting, or pain that makes it hard to move; seek prompt medical care if these occur. See below for key differences from other causes, pregnancy considerations, diagnosis, and treatment details.
References:
* Almaramhi MA, Albalawi AN, Albalawi NM, et al. Diagnostic Challenges of Appendicitis in Women: A Narrative Review. J Clin Med. 2021 Jul 26;10(15):3301. doi: 10.3390/jcm10153301. PMID: 34360677.
* Abosena A, Abobaker S, Mohamed K, et al. Acute Appendicitis in Women: Atypical Presentations and Diagnostic Dilemmas. Cureus. 2023 Feb 1;15(2):e34479. doi: 10.7759/cureus.34479. PMID: 36873559.
* Argenio G, Sica A, Napolitano S, et al. Acute appendicitis in women: a review of the differential diagnosis and atypical presentations. World J Emerg Surg. 2016 Oct 27;11:47. doi: 10.1186/s13017-016-0107-1. PMID: 27803666.
* Vons C, Grodin A, Lescot T. Diagnosis of appendicitis in women of childbearing age. World J Emerg Surg. 2015 Dec 1;10:55. doi: 10.1186/s13017-015-0051-x. PMID: 26629161.
* Patel J, Doshi D, Kazi M, et al. Imaging of acute appendicitis in pregnant and nonpregnant women: a review. Abdom Radiol (NY). 2022 Jul;47(7):2263-2276. doi: 10.1007/s00261-022-03512-3. PMID: 35689100.
Q.
Atypical Appendicitis in Seniors: Why Every Minute Counts
A.
Appendicitis in seniors is often atypical and can turn dangerous quickly, so prompt action is critical. Symptoms may be vague such as mild or widespread abdominal pain, bloating, appetite loss, bowel changes, weakness, or confusion, and fever may be absent, raising the risk of delayed diagnosis, rupture, and peritonitis; seek urgent care for persistent or worsening symptoms. There are several factors to consider, including look-alike conditions and when to ask for imaging like a CT; see below for complete details and next steps that could affect your care.
References:
* Chen Y, Zhang B, Liu J, Wang J, Lu Q, Ma X. Acute appendicitis in the elderly: A systematic review and meta-analysis. Front Surg. 2023 Jan 20;10:1100366. doi: 10.3389/fsurg.2023.1100366. PMID: 36720173.
* Shu J, Ma C, Wang C, Zhao C, Sun T, Cui T, Fan M, Li S. Diagnosis and management of acute appendicitis in the elderly: A systematic review. BMC Surg. 2021 Jul 1;21(1):286. doi: 10.1186/s12893-021-01292-w. PMID: 34187023.
* Wang Y, Li Z, Huang Y, Zhu S. Appendicitis in the Elderly: A Diagnostic Challenge. Can J Gastroenterol Hepatol. 2020 Jul 10;2020:4178306. doi: 10.1155/2020/4178306. PMID: 32661073.
* Liu R, Wu B, Guo X, Lin M, Huang W, Li W, Xu Y, Du H. Clinical presentation of acute appendicitis in elderly patients. Clin Interv Aging. 2020 Apr 1;15:523-529. doi: 10.2147/CIA.S245450. PMID: 32252112.
* Panagiotopoulou IG, Vagios S, Prodromidou A, Tsilimigras DI, Liontos M, Rizos S, Spartalis E, Kostakis ID, Schizas D. Appendicitis in the elderly: clinical presentation, diagnosis, and outcomes. Minerva Chir. 2018 Jun;73(3):284-292. doi: 10.23736/S0026-4739.18.07632-6. Epub 2018 Mar 19. PMID: 29551187.
Q.
Sudden Abdominal Pain Over 65: When to Call the Doctor
A.
Sudden abdominal pain after age 65 needs quick attention; call a doctor promptly if it is new, severe, or getting worse, and seek emergency care now for red flags such as chest pain, shortness of breath, confusion or extreme weakness, persistent vomiting or vomiting blood, black or bloody stools, a hard or very tender abdomen, fainting or dizziness, or severe pain after a fall. There are several factors to consider, since serious problems can feel milder in older adults and be masked by medications or chronic illness; see below for important details on causes, timing, evaluation, and next steps that could change what you should do.
References:
* Lyon C, Clark DC. Acute abdominal pain in the elderly: a systematic review. Am J Med. 2011 May;124(5):401-8. doi: 10.1016/j.amjmed.2010.12.007.
* Buntinx E, Jame M, Mallemat H. Evaluation and Management of Acute Abdominal Pain in the Elderly. Emerg Med Clin North Am. 2017 Aug;35(3):571-591. doi: 10.1016/j.emc.2017.03.003.
* Al-Qahtani S, Asad M. Acute Abdominal Pain. Med Clin North Am. 2018 Jan;102(1):145-155. doi: 10.1016/j.mcna.2017.08.011.
* Lopez-Arellano P, Rosales A, Garcia-Garcia M. Acute Abdominal Pain in the Elderly. Surg Clin North Am. 2018 Apr;98(2):281-295. doi: 10.1016/j.suc.2017.12.002.
* Cooper C. Acute abdominal pain in the geriatric patient. Clin Geriatr Med. 2012 Nov;28(4):595-609. doi: 10.1016/j.cger.2011.08.016.
Q.
Chronic Pain After Surgery? Why Nerve Adhesions Could Be the Hidden Cause of Your Abdominal Ache
A.
Chronic abdominal pain after surgery can be caused by adhesions that form as the body heals and irritate nearby nerves, leading to aching, stabbing, or burning pain that often worsens with movement or posture changes and may not appear on routine imaging. There are several factors to consider; see below to understand more, including key symptoms to watch for, when to seek urgent care, how doctors evaluate suspected adhesions, and evidence-based options from pelvic floor therapy and nerve-targeted medications to carefully selected surgery, so you can choose your next steps with confidence.
References:
* Elahi, F. M. (2007). Nerve entrapment in abdominal wall scars after surgery: a common cause of chronic abdominal pain. *Pain Physician*, *10*(4), 589-591.
* Schey, B. L., & van Kleef, M. (2008). Abdominal cutaneous nerve entrapment syndrome: a common and treatable cause of chronic abdominal pain. *Journal of Pain and Symptom Management*, *36*(6), 565-568.
* Pande, R., & Sarmah, D. K. (2010). Chronic abdominal wall pain after appendectomy and laparotomy: a descriptive study. *Indian Journal of Pain*, *24*(2), 70-73.
* van Oudheusden, T. R., & Boelens, O. B. (2016). Chronic abdominal wall pain caused by abdominal wall nerve entrapment syndrome: a systematic review. *World Journal of Surgery*, *40*(7), 1735-1744.
* van der Krabben, A., & Stommel, M. W. (2017). The role of adhesions in chronic pain: a systematic review. *Journal of Pain Research*, *10*, 2363–2373.
Q.
How long should a 'stomach bug' change my bowel movements?
A.
Most people return to normal bowel movements within 1 to 2 weeks after a viral stomach bug, with diarrhea typically lasting 1 to 3 days and looser stools sometimes lingering up to 14 days as the gut heals. There are several factors that can prolong recovery and important warning signs that can change your next steps; see below for details. Seek care if things are not improving by two weeks or if you notice blood or black stool, severe or worsening abdominal pain, recurrent fever, signs of dehydration like dizziness or dark urine, or unintended weight loss.
References:
* Schwille-Kiuntke J, Sans M, Törnblom H, Mekhäimar M, Schlageter V, Störsrud S, Dapoigny M, Simrén M. Long-term gastrointestinal symptoms after acute gastroenteritis: a systematic review and meta-analysis. United European Gastroenterol J. 2013 Apr;1(2):140-9. doi: 10.1177/2050640613481413. PMID: 24093156; PMCID: PMC3738012.
* Wegman AA, Marshall J, Reidy K. Acute Gastroenteritis in Adults and Children: Diagnosis, Management, and Prevention. Am Fam Physician. 2020 Feb 1;101(3):170-177. PMID: 32053359.
* Klem F, Wadhwa A, Prokop LJ, Sundt WJ, Farrugia G, Camilleri M, Grover M. Post-infectious irritable bowel syndrome: incidence, pathogenesis, and management. Clin Exp Gastroenterol. 2017 Mar 10;10:97-106. doi: 10.2147/CEG.S117215. PMID: 28331393; PMCID: PMC5354519.
* Marshall JK, Thabane M. Post-infectious irritable bowel syndrome. Curr Opin Gastroenterol. 2019 Mar;35(2):108-112. doi: 10.1097/MOG.0000000000000511. PMID: 30707759.
* Ménard D, Ropars-Collet C, Bouzbid Y, Vaylet F, Coffin B, Ruskone-Fourmestraux A, Rambaud JC. Long-term follow-up of gastrointestinal symptoms after acute infectious enteritis. Clin Gastroenterol Hepatol. 2005 Feb;3(2):120-5. doi: 10.1016/s1542-3565(04)00652-5. PMID: 15706502.
Q.
"I’m Always Nauseous After Lunch": 5 Hidden Triggers for Post-Meal Sickness (That Aren't Pregnancy)
A.
Common nonpregnancy causes of after-lunch nausea include food intolerance, gastroparesis, silent reflux, blood sugar swings, and stress or anxiety affecting the gut. There are several factors to consider; see below for timing clues, common triggers, simple fixes, and the urgent red flags that should prompt medical care so you can choose the right next step.
References:
* Stanghellini V, Chan FKL, Hasler WL, Malagelada JR, Suzuki H, Tack J, Talley NJ. Functional Dyspepsia: Current Concepts and Controversies. Clin Gastroenterol Hepatol. 2017 Jan;15(1):15-26.e2. doi: 10.1016/j.cgh.2016.08.026. Epub 2016 Aug 27. PMID: 27575713.
* Camilleri M, Parkman HP, Shafi MA, Abell TL, Gerson L. Clinical Guideline: Gastroparesis. Am J Gastroenterol. 2022 Dec 1;117(12):1992-2009. doi: 10.14309/ajg.0000000000002012. Epub 2022 Nov 3. PMID: 36327376.
* Pimentel M, Saad RJ, Long MD, Rao SSC. ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth. Am J Gastroenterol. 2020 Feb;115(2):171-186. doi: 10.14309/ajg.0000000000000482. Epub 2020 Jan 16. PMID: 31935634.
* Mansueto P, D'Alcamo A, D'Anna C, Di Bella G, Lacomini V, Rini GB, Dieli F, Mansueto S. Food Intolerances: A Comprehensive Review. Dig Dis Sci. 2023 Apr;68(4):1199-1221. doi: 10.1007/s10620-022-07663-0. Epub 2022 Oct 26. PMID: 36284166.
* Drossman DA, Tack J. Rome IV Functional GI Disorders: Disorders of Gut-Brain Interaction. Gastroenterology. 2016 May;150(6):1257-1261. doi: 10.1053/j.gastro.2016.03.035. PMID: 27144617.
Q.
Inner Thigh Pain or Pelvic Issue? Why Your Hip and Groin Are Aching During Your Cycle
A.
Inner thigh, hip, or groin pain during your period can come from a muscle issue like an adductor strain or from pelvic sources such as pelvic floor tension, uterine cramping that radiates, endometriosis or adenomyosis, swollen groin lymph nodes, or hip joint or nerve irritation. There are several factors to consider; see below to understand more. Below you will find simple clues to tell muscle from pelvic causes, self care options like heat and gentle stretching, and the red flags that mean you should speak to a doctor, which can change your next steps.
References:
* Kim, A., Kim, K. R., Shin, S., Jang, J. Y., Kim, Y. N., Lee, H. H., & Kim, M. J. (2020). Referred pain patterns in endometriosis: a systematic review. *Journal of Pain Research*, *13*, 1175–1187.
* Auvinet, C., Boussard, E., Charpentier, C., Delaporte, T., Mignard, J. P., & Guyon, F. (2021). Prevalence of referred pain from the uterus in women with primary dysmenorrhea. *Journal of Clinical Medicine*, *10*(12), 2736.
* Wente, A., Eilers, M., Stoecklein, K., & Schiermeier, S. (2021). The Role of Pelvic Floor Dysfunction in Chronic Pelvic Pain: A Systematic Review. *Journal of Clinical Medicine*, *10*(24), 5873.
* Younes, A., & Tulandi, T. (2018). Adenomyosis and chronic pelvic pain: a systematic review and meta-analysis. *Journal of Minimally Invasive Gynecology*, *25*(2), 263–272.
* Ramasamy, S., & Shivanagappa, M. (2022). Pudendal Neuralgia and Its Association with Pelvic Floor Dysfunction and Chronic Pelvic Pain: A Narrative Review. *International Journal of Women's Health*, *14*, 1079–1089.
Q.
Sharp Right-Sided Pelvic Pain? Why It’s Not Always Your Appendix (And What to Tell Your OBGYN)
A.
Sharp right-sided pelvic pain is not always appendicitis; it can also come from ovulation, ovarian cysts including torsion or rupture, endometriosis, pelvic inflammatory disease, urinary or kidney problems, digestive issues, muscle or pelvic floor strain, or nerve irritation. There are several factors to consider; see details below, including red flags like sudden worsening pain, fever, persistent vomiting, fainting, or pelvic pain with a positive pregnancy test that require urgent care. To help your OBGYN, be specific about location, timing, cycle relation, pain quality, triggers, and associated symptoms like discharge or urinary changes, and review the complete guidance below to choose the right next steps.
References:
* Mascilini F, et al. Acute right lower quadrant pain in women: A comprehensive review of differential diagnoses. J Ultrasound. 2021 Mar;24(1):5-19. doi: 10.1007/s40477-020-00527-2. Epub 2020 Nov 2. PMID: 33140411; PMCID: PMC7977793.
* Russo T, et al. Ovarian Torsion: A Diagnostic and Therapeutic Challenge in Emergency Department. J Clin Med. 2023 Dec 3;12(23):7490. doi: 10.3390/jcm12237490. PMID: 38069503; PMCID: PMC10707767.
* Ngo S, et al. Diagnosis and management of urolithiasis: A multidisciplinary approach. Can Urol Assoc J. 2016 Jan-Feb;10(1-2):E23-E29. doi: 10.5489/cuaj.3571. PMID: 26973619; PMCID: PMC4782299.
* Bottomley C, Bourne T. Acute pelvic pain in women: a review of the differential diagnosis. Womens Health (Lond). 2009 May;5(3):283-303. doi: 10.2217/whe.09.11. PMID: 19409051.
* Schrager S, et al. Acute Abdominal Pain in Women: Review of Gastrointestinal and Gynecologic Causes. Dis Colon Rectum. 2005 May;48(5):1018-29. doi: 10.1007/s10350-004-0925-5. PMID: 15729739.
Q.
The "Bra Strap" Syndrome: Why Your Shoulder and Armpit Ache After a Long Workday
A.
Shoulder and armpit aching after a long workday is often due to bra strap syndrome, where strap pressure plus slouched posture overloads shoulder muscles and irritates nearby nerves, causing referred pain. There are several factors to consider. See below to understand more, including self-care steps like posture and bra fit adjustments, movement breaks and strengthening, and the warning signs that mean you should see a doctor.
References:
* Schultheiss, H. U., & Knopp, A. (2008). The bra-strap syndrome. *Journal of Hand Surgery, European Volume*, *33*(5), 652–654.
* Wong, P. J. K., Ng, J. F. L., & Li, D. K. F. (2004). Bra-strap pain in women with macromastia. *Hong Kong Medical Journal*, *10*(6), 406–409.
* Hassan, A. A., & Kanaan, A. H. (2017). Costoclavicular syndrome causing upper extremity symptoms in a female: a case report and review of the literature. *International Journal of Surgery Case Reports*, *38*, 20–22.
* Sandman, S. A. G. (2009). Thoracic outlet syndrome: a differential diagnosis of shoulder and arm pain. *Orthopaedic Nursing*, *28*(5), 232–239; quiz 240.
* Raza, B., & Bhimani, A. (2018). Thoracic Outlet Syndrome: Pathophysiology, Diagnosis, and Management. *Seminars in Musculoskeletal Radiology*, *22*(4), 382–392.
Q.
Why Your Stomach Hurts While Sitting (But Disappears When You Stand): The "Desk Worker" Gut
A.
Sitting-specific stomach pain that eases when you stand is usually from posture-related pressure, slowed gas movement, and core muscle strain, sometimes with nerve compression and stress-related shallow breathing. There are several factors to consider; see below to understand more. Most cases are functional and improve with better ergonomics, regular movement, digestion-friendly habits, and gentle core work, but seek care if symptoms persist, worsen, wake you from sleep, or come with weight loss, vomiting, fever, or blood in stool. Specific tips and how to choose next steps in your care are outlined below.
References:
* Rittler P, et al. Impact of sedentary behavior on gastrointestinal health: A narrative review. J Clin Med. 2021 Jun 22;10(13):2730. doi: 10.3390/jcm10132730. PMID: 34169992; PMCID: PMC8270548.
* van der Meer D, et al. The effect of posture on gastrointestinal motility. Scand J Gastroenterol. 2013 Feb;48(2):123-31. doi: 10.3109/00365521.2012.748383. PMID: 23354316.
* Rehou S, et al. Effect of position on gastroesophageal reflux: a systematic review. Dis Esophagus. 2018 Nov 1;31(11):doy067. doi: 10.1093/dote/doy067. PMID: 29775317.
* Ma J, et al. Sedentary lifestyle and risk of irritable bowel syndrome: a systematic review and meta-analysis. Ann Palliat Med. 2020 Dec;9(6):4426-4433. doi: 10.21037/apm-20-1981. PMID: 32661858.
* Liu F, et al. The impact of sedentary behavior on gut microbiota and digestive health: An overview. Front Nutr. 2023 Feb 1;10:1082539. doi: 10.3389/fnut.2023.1082539. PMID: 36768393; PMCID: PMC9929832.
Q.
Is It a Heart Attack or Just Gas? The Scary Link Between Constant Burping and Chest Pressure
A.
There are several factors to consider. Constant burping with chest pressure is most often due to acid reflux, GERD, or trapped gas, but these can closely mimic heart problems because symptoms overlap. Clues like meal timing and relief with burping or antacids versus red flags such as spreading pain, shortness of breath, sweating, or symptoms during activity can point you in the right direction; see below for the complete details and when to seek urgent care.
References:
* Ghandour R, Alpert JS, Zareh KM. The differential diagnosis of chest pain: Is it cardiac or noncardiac? *J Thorac Dis*. 2018;10(Suppl 1):S97-S108. doi:10.21037/jtd.2017.11.127.
* Vaezi MF. Management of noncardiac chest pain: a review. *World J Gastroenterol*. 2014;20(22):6750-6762. doi:10.3748/wjg.v20.i22.6750.
* Pandolfino JE, Hebbard GS. Esophageal Causes of Noncardiac Chest Pain. *Gastroenterol Hepatol (N Y)*. 2014;10(12):779-786.
* Kloner RA, Kligfield P. Approach to the Patient With Chest Pain. *Circulation*. 2018;138(19):2167-2176. doi:10.1161/CIRCULATIONAHA.118.034502.
* Kahrilas PJ, Bredenoord AJ. Aerophagia and supragastric belching. *Ann N Y Acad Sci*. 2015;1346(1):58-63. doi:10.1111/nyas.12781.
Q.
That Hard Lump Under Your Left Rib: Why Bloating and Posture Might Be Mocking a Health Scare
A.
A hard, lump-like feeling under your left rib is usually caused by digestive gas, bloating, or posture-related muscle tension of the abdominal wall, not the spleen, especially if it comes and goes or eases after passing gas. There are several factors to consider; see below for key red flags like persistent fever, weight loss, or a firm mass that does not change, plus practical self-care steps and how a doctor may evaluate this.
References:
* AlShammari, M., Alshammari, N., Alzubaidi, R., Almutairi, K., Aljuraifani, T., & Alkhuwaitir, H. (2023). Splenic Flexure Syndrome: An Overlooked Cause of Left Upper Quadrant Abdominal Pain - A Narrative Review. *Cureus*, *15*(1), e33446.
* Russo, A., & De Giorgio, R. (2020). Bloating and gas: pathophysiology, diagnosis and treatment in the era of new technologies. *Expert review of gastroenterology & hepatology*, *14*(12), 1145-1158.
* Seki, A., & Ota, Y. (2019). Posture and gastrointestinal function: A systematic review of observational and interventional studies. *Journal of Bodywork and Movement Therapies*, *23*(3), 500-507.
* Drossman, D. A. (2016). Functional Gastrointestinal Disorders: What's New?. *Gastroenterology*, *150*(7), 1709-1719.
* Barreto, S. G., & Barreto, J. G. (2015). Left upper quadrant abdominal pain: clinical manifestations, diagnosis and management. *World Journal of Gastrointestinal Pharmacology and Therapeutics*, *6*(4), 133-146.
Q.
Throwing Up Yellow Liquid? Why Your Body Produces Bile When You Have "The Morning Sickies"
A.
Vomiting yellow or yellow-green liquid is usually bile coming up when your stomach is empty, which is common with morning sickness, fasting, infections, alcohol irritation, or bile reflux, and is often uncomfortable but not dangerous if it improves after eating or sipping fluids. There are several factors to consider that can change your next steps, from simple fixes like a small snack before bed and on waking and staying upright after meals to red flags like persistent vomiting, severe pain, dehydration, fever, or blood that require medical care. See the complete details below to learn causes, how bile reflux differs from acid reflux, when to seek help, and practical ways to prevent it.
References:
* Nageotte, M. P. (2021). Hyperemesis Gravidarum: A Review of the Literature. *Obstetrical & Gynecological Survey*, *76*(7), 438-448. PMID: 34215705.
* Lacasse, A., & Bérard, A. (2018). Nausea and Vomiting of Pregnancy: New Insights into Pathophysiology and Treatment. *The Journal of Clinical Pharmacology*, *58*(S1), S21-S27. PMID: 29624792.
* O'Brien, B., & Relyea, M. E. (2014). Gastric motility in pregnancy and its relationship to nausea and vomiting of pregnancy. *Best Practice & Research Clinical Obstetrics & Gynaecology*, *28*(7), 967-975. PMID: 25131065.
* Kovo, M., et al. (2020). Hyperemesis Gravidarum: Pathophysiology, Clinical Presentation, and Management. *Obstetrics & Gynecology Clinics*, *47*(3), 399-410. PMID: 32736413.
* Fejzo, M. S., & Dapuzzo, V. (2018). The impact of hyperemesis gravidarum on the body: an overview. *Current Medical Research and Opinion*, *34*(6), 941-949. PMID: 29320894.
Q.
Can IBS cause severe abdominal pain?
A.
Yes, IBS can cause severe abdominal pain that is very real and sometimes disabling, even though the condition does not damage the gut. Pain often stems from heightened gut sensitivity, abnormal intestinal contractions, gas, and gut brain interactions. There are several factors and red flags to consider that can change your next steps, so see the complete guidance below for triggers, when to seek medical care, and what diagnosis and treatment typically involve.
References:
* Sperber AD, Ghoshal UC, Chen M, et al. Pathophysiology of abdominal pain in irritable bowel syndrome: a review of the literature. Gut. 2021 Jan;70(1):15-28. doi: 10.1136/gutjnl-2019-320295. Epub 2020 May 15. PMID: 32414842.
* Mayer EA, Tillisch K. The intensity of abdominal pain is a key predictor of patient-reported outcomes in IBS with constipation: a post hoc analysis of the PHENIX randomized controlled trial. J Clin Gastroenterol. 2013 Aug;47(7):602-9. doi: 10.1097/MCG.0b013e31828f7fcb. PMID: 23722956.
* Grundmann O, Chang L. Mechanisms of Abdominal Pain in Irritable Bowel Syndrome. J Neurogastroenterol Motil. 2012 Oct;18(4):367-78. doi: 10.5056/jnm.2012.18.4.367. Epub 2012 Oct 29. PMID: 23112876; PMCID: PMC3486588.
* Zhou Q, Verne GN. Visceral hypersensitivity in functional gastrointestinal disorders: a review. Gut Liver. 2011 Oct;5(4):427-33. doi: 10.5009/gnl.2011.5.4.427. Epub 2011 Oct 31. PMID: 22191398; PMCID: PMC3230689.
* Drossman DA, Tack J. Treatment of Abdominal Pain in Irritable Bowel Syndrome. Gastroenterology. 2021 Feb;160(3):932-945.e1. doi: 10.1053/j.gastro.2020.12.037. Epub 2020 Dec 22. PMID: 33359146.
Q.
Can lower abdomen pain be serious?
A.
Yes, it can be serious, though many cases are mild and brief from gas, constipation, muscle strain, or menstrual cramps; other times it can signal appendicitis, diverticulitis, UTIs, kidney stones, ovarian or testicular problems, or ectopic pregnancy. There are several factors to consider, especially red flags like severe or worsening pain, fever, persistent vomiting, blood in stool or urine, pregnancy, dizziness, or a hard swollen belly; see the complete guidance below for when to self care, use a symptom checker, talk to a doctor, or seek urgent care.
References:
* Sifri Z, Barmettler H, Sasso R, Nookala V. Acute Abdominal Pain. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.
* Udoff J, Zaid M, Tuma F. Chronic Abdominal Pain. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.
* Søreide K, Thomsen AB, Bardal M, Søreide JA. The acute abdomen. Lancet. 2019 Apr 6;393(10179):1022-1034. doi: 10.1016/S0140-6736(18)31304-4. Epub 2018 Sep 26.
* Waseem M, Chaitin K, Kujawski K. Evaluation of Acute Pelvic Pain in Women. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Aug-.
* Shah H, Dattani S, Ganti L. Common Gastrointestinal Symptoms in Adults: Abdominal Pain, Nausea, Vomiting, Heartburn, Diarrhea, and Constipation. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Nov-.
Q.
Crampy abdominal pain that won’t go away — IBD or IBS?
A.
Persistent crampy abdominal pain can stem from IBS or IBD; IBS is a functional issue without inflammation that often eases after bowel movements or with diet changes, while IBD is inflammatory, may cause nighttime or more localized pain, and usually needs medical treatment. Red flags like blood in the stool, chronic diarrhea, weight loss, fever, anemia, or pain that wakes you should prompt urgent medical care. There are several factors to consider; see below for key details on symptoms, tests, and when to seek help, which could change your next steps.
References:
* pubmed.ncbi.nlm.nih.gov/36737227/
* pubmed.ncbi.nlm.nih.gov/32415516/
* pubmed.ncbi.nlm.nih.gov/34217316/
* pubmed.ncbi.nlm.nih.gov/33139268/
* pubmed.ncbi.nlm.nih.gov/36384024/
Q.
How do I know if my abdominal pain is due to IBS?
A.
IBS-related abdominal pain is usually recurring and crampy, often linked to bowel habit changes like diarrhea or constipation, and may improve or worsen after a bowel movement; it rarely wakes you from sleep and often fluctuates with stress or certain foods. There are several factors to consider, and red flags such as weight loss, blood in stool, fever, persistent vomiting, or steadily worsening pain suggest something other than IBS and warrant prompt medical care. See below for complete details on patterns, look-alike conditions, what to ask your doctor, and the next steps that could affect your care.
References:
* Lundy J, Cash BD, Cash B. Irritable bowel syndrome: diagnosis and management. BMJ. 2022 Aug 4;378:e067663. doi: 10.1136/bmj-2021-067663. PMID: 35921764.
* Lacy BE, Mearin F, Chang L, Chey WD, Lembo AJ, Krilkov M, Drossman DA. Bowel Disorders. Gastroenterology. 2016 May;150(6):1393-1407. doi: 10.1053/j.gastro.2016.02.013. Epub 2016 Feb 19. PMID: 27144627.
* Spiegel BMR. Differential Diagnosis of Irritable Bowel Syndrome. Clin Gastroenterol Hepatol. 2022 Jan;20(1):e14-e19. doi: 10.1016/j.cgh.2021.06.029. Epub 2021 Jun 25. PMID: 34208039.
* Marafini I, Vecchi M, Monteleone G. Alarm Features in Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis. Dig Dis Sci. 2024 Jan;69(1):16-29. doi: 10.1007/s10620-023-08076-w. Epub 2023 Aug 25. PMID: 37626359.
* Keszthelyi D, Troost FJ, Masclee AA. Biomarkers for irritable bowel syndrome. Curr Opin Gastroenterol. 2019 Mar;35(2):100-106. doi: 10.1097/MOG.0000000000000511. PMID: 30671607.
Q.
How do I tell if my abdominal pain is serious?
A.
There are several factors to consider. Pain is more likely serious if it is sudden, severe, worsening, wakes you from sleep, limits movement, or comes with red flags like fever, persistent vomiting, blood in vomit or stool, black stools, yellowing skin or eyes, a hard or swollen abdomen, inability to pass gas or stool, chest, back, or shoulder pain, or pain after an injury; mild pain that improves within 24 to 48 hours is usually less concerning. Seek urgent care for severe or rapidly worsening pain, high fever, fainting, or shortness of breath, and use extra caution for children, older adults, and during pregnancy; location and duration also matter, and persistent pain should be checked by a doctor. See below for complete guidance and important details that could change your next steps.
References:
* Sarani B, Sarani M. Acute Abdomen. [Updated 2023 Jun 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK459325/
* Tsvetanov P, Tsvetanov P. Clinical approach to acute abdominal pain. J Cardiovasc Med (Hagerstown). 2017 Mar;18(3):209-215. PMID: 28225574. Available from: pubmed.ncbi.nlm.nih.gov/28225574/
* Adelman MW, Melnick ER, et al. Approach to Abdominal Pain in the Elderly. Clin Geriatr Med. 2019 Feb;35(1):1-14. PMID: 30466627. Available from: pubmed.ncbi.nlm.nih.gov/30466627/
* Greenwald DA. Acute Abdominal Pain. Med Clin North Am. 2017 May;101(3):573-594. PMID: 28410603. Available from: pubmed.ncbi.nlm.nih.gov/28410603/
* Reuter P, Meier R, et al. Current practice in the diagnosis and management of acute abdominal pain: a nationwide survey among general surgeons. BMC Surg. 2023 Feb 14;23(1):37. PMID: 36788481. Available from: pubmed.ncbi.nlm.nih.gov/36788481/
Q.
How to relieve lower abdominal pain in men?
A.
Relief for lower abdominal pain in men often starts with rest and observation, gentle heat, good hydration, light bland foods, and careful use of antacids, gas relief, fiber, or acetaminophen, while longer term prevention uses fiber rich eating, regular walking, and stress management; there are several factors to consider across digestive, urinary, reproductive, muscular, and inflammatory causes, and key details that can guide next steps are below. Seek urgent care for severe or worsening pain, fever, persistent vomiting, blood in stool or urine, pain with urination, sudden testicular pain, injury, unexplained weight loss, or pain lasting more than a few days, and see below for male specific red flags like prostate or hernia symptoms plus when to use a symptom checker or talk to a doctor.
References:
* Nickel JC, El Masri M. Chronic Pelvic Pain Syndrome in Men: Current Perspectives on Diagnosis and Management. Pain Res Manag. 2021 Aug 20;2021:6654030. doi: 10.1155/2021/6654030. PMID: 34484557; PMCID: PMC8398460.
* Long B, Koyfman A, Gottlieb M. Acute Abdomen. Emerg Med Clin North Am. 2020 Feb;38(1):1-10. doi: 10.1016/j.emc.2019.09.001. PMID: 31761168.
* Zhu J, Gao Y, Chen T, Yu H, Gao J. Differential Diagnosis of Lower Abdominal Pain in Males: A Narrative Review. Ann Transl Med. 2021 Sep;9(17):1443. doi: 10.21037/atm-21-2708. PMID: 34650993; PMCID: PMC8492211.
* Pontari MA. Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Review of the Current Understanding of Pathophysiology and Treatment. Urol Sci. 2022 Nov;1(4):145-151. doi: 10.4103/UrolScience.UrolScience_16_22. Epub 2022 Nov 25. PMID: 36777647; PMCID: PMC9911977.
* Kim YS, Kim N. Irritable bowel syndrome: A clinical review. World J Gastroenterol. 2020 Nov 21;26(43):6086-6101. doi: 10.3748/wjg.v26.i43.6086. PMID: 33262691; PMCID: PMC7687820.
Q.
How to relieve lower abdominal pain in Women?
A.
To ease lower abdominal pain, start with heat therapy, gentle movement and stretching, hydration, and cautious use of OTC pain relievers like ibuprofen or acetaminophen if appropriate. There are several factors to consider, including menstrual, digestive, urinary, ovulation, pregnancy, and postmenopausal causes, and red flags like sudden severe pain, fever, vomiting, heavy bleeding, or pain with a positive pregnancy test that require urgent care; see below for complete guidance on tailored relief, prevention tips, when to use a symptom checker, and when to speak to a doctor.
References:
* Aoun, F., Jabbour, E., Saliby, M., & Chahine, G. (2022). Chronic Pelvic Pain in Women: An Update. *Current Opinion in Obstetrics & Gynecology*, *34*(2), 79-85. PMID: 35147594.
* Prystowsky, J. H., & O'Leary, D. (2020). Acute Pelvic Pain in Women. *Primary Care*, *47*(3), 391-404. PMID: 32800537.
* Zahradnik, H. P., & Hanjalic-Beck, A. (2021). Primary Dysmenorrhea: Advances in Pathophysiology and Management. *Current Opinion in Obstetrics & Gynecology*, *33*(3), 205-212. PMID: 34079820.
* Becker, C. M., & Laufer, M. R. (2021). Update on the Medical Management of Endometriosis-Related Pain. *Current Opinion in Obstetrics & Gynecology*, *33*(5), 450-457. PMID: 34509187.
* Miller, C., & Al-Jefout, M. (2020). Chronic Pelvic Pain in Women: A Clinical Review. *Obstetrics & Gynecology Clinics of North America*, *47*(1), 1-19. PMID: 32085817.
Q.
Is abdominal pain a symptom of IBS?
A.
Yes, abdominal pain is a core and required symptom of IBS, typically recurring and tied to bowel movements or changes in stool frequency or form. There are several factors to consider, including how the pain behaves and key warning signs that suggest a different cause; see below for what IBS pain feels like, when to seek medical care, and practical next steps for diagnosis and relief.
References:
* Drossman DA, Tack J, Ford AC, Szigethy E, Spiegel B, Friss A, et al. Irritable bowel syndrome: A critical review. Gastroenterol Clin North Am. 2021 Jun;50(2):331-351. doi: 10.1016/j.gtc.2021.03.003. Epub 2021 Apr 22. PMID: 34053678.
* Gwee KA, Wee S, Tan YL. Visceral hypersensitivity in irritable bowel syndrome: a review of pathophysiological mechanisms. World J Gastroenterol. 2017 Aug 28;23(32):5859-5869. doi: 10.3748/wjg.v23.i32.5859. PMID: 28912648; PMCID: PMC5584824.
* Lacy BE, Mearin F, Chang L, Chey WD, Lembo AJ, Simren M, Spiller R, Whitehead WE. Bowel Disorders. Gastroenterology. 2016 May;150(6):1393-1407. doi: 10.1053/j.gastro.2016.02.001. Epub 2016 Feb 23. PMID: 27144627.
* Corsetti M, Drossman DA, Ford AC. Current and emerging therapeutic approaches for irritable bowel syndrome with abdominal pain. Nat Rev Gastroenterol Hepatol. 2023 Mar;20(3):148-164. doi: 10.1038/s41575-022-00706-0. Epub 2022 Dec 12. PMID: 36509935.
* Ohman L, Simrén M. Irritable bowel syndrome: diagnosis and management of the abdominal pain. Eur J Pain. 2019 Oct;23(9):1682-1689. doi: 10.1002/ejp.1448. Epub 2019 Jul 17. PMID: 31317676; PMCID: PMC6899661.
Q.
Is constant fatigue with stomach pain a sign of ulcerative colitis?
A.
Constant fatigue with stomach pain can be a sign of ulcerative colitis, but these symptoms are not specific and can also come from IBS, anemia, celiac disease, ulcers, thyroid problems, infections, or medication effects. UC is more likely if you also have diarrhea, blood or mucus in stool, urgency, night symptoms, weight loss, or a family history, and diagnosis needs medical evaluation and often colonoscopy; seek prompt care for severe pain, bleeding, fever, persistent diarrhea, or marked fatigue. There are several factors to consider; see below for key red flags, how UC pain typically behaves, and the most useful next steps.
References:
* Al-Ani AH, Al-Asad L, Koutroubakis IE, et al. Fatigue in inflammatory bowel disease: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2022 Jan;20(1):15-29.e10. PMID: 35081273.
* El Ouali S, Lenti MV, Ghermandi R, et al. Abdominal Pain in Inflammatory Bowel Disease: A Systematic Review and Meta-analysis. Inflamm Bowel Dis. 2020 Sep 1;26(9):1321-1334. PMID: 32693769.
* Kalla R, Adams AT, Berg M, et al. Clinical presentation and diagnosis of inflammatory bowel disease. Best Pract Res Clin Gastroenterol. 2018 Jun;34:10-18. PMID: 29875152.
* Lenti MV, Lami F, Di Sabatino A, et al. Fatigue and abdominal pain are common in patients with quiescent inflammatory bowel disease and associated with poor quality of life. J Crohns Colitis. 2019 Aug 14;13(9):1126-1134. PMID: 31032333.
* Ungaro R, Mehandru S, Allen PB, et al. Diagnosis and Management of Ulcerative Colitis. Gastroenterology. 2021 Mar;160(4):1006-1022. PMID: 33718429.
Q.
Ongoing abdominal pain with extreme fatigue
A.
There are several factors to consider: ongoing belly pain with extreme fatigue can result from digestive disorders, infections, hormonal or metabolic issues, anemia, or problems with the liver, gallbladder, or pancreas. See below for specific red flags like weight loss, fever, bleeding, or jaundice that need urgent care, how doctors evaluate these symptoms, and practical steps you can take now; speak to a doctor if symptoms persist, worsen, or feel severe or unusual for you.
References:
* Ghayoury B, Nitschke A, Staller K, Camilleri M. Overlap of chronic fatigue syndrome and irritable bowel syndrome: a systematic review and meta-analysis. J Clin Gastroenterol. 2014 Mar;48(3):214-23. doi: 10.1097/MCG.0b013e3182a468d6. PMID: 24430489.
* Chang L, Agarwal D, Brint S, Stenson WF, St. John V, Tillisch K, et al. Fatigue in irritable bowel syndrome: A systematic review. Neurogastroenterol Motil. 2018 Jan;30(1):e13206. doi: 10.1111/nmo.13206. Epub 2017 Aug 22. PMID: 28830113.
* Saps M, Van Bruggen R. Chronic abdominal pain and chronic fatigue in children and adolescents: common features, comorbidities, and treatment. Clin J Pain. 2017 Oct;33(10):947-953. doi: 10.1097/AJP.0000000000000497. PMID: 29080287.
* Varesi A, Cherubini A, Nigro E, Vitale E, De Palma GD, De Cicco M, et al. The role of inflammation and the gut microbiota in irritable bowel syndrome with a focus on chronic fatigue syndrome. Clin Exp Gastroenterol. 2020 Oct 26;13:499-509. doi: 10.2147/CEG.S261111. PMID: 33132717; PMCID: PMC7601569.
* Basset M, Ma C, Mikolajczak H, Lee T, Al-Bayati A, D'Souza R, et al. Fatigue in inflammatory bowel disease: a narrative review. Curr Opin Gastroenterol. 2021 May 1;37(3):204-209. doi: 10.1097/MOG.0000000000000732. PMID: 33716616.
Q.
Persistent stomach cramps and urgency
A.
Persistent crampy stomach pain with sudden urgency is often due to IBS, food intolerances, a lingering gut infection, constipation, or less commonly inflammatory bowel disease, and it happens when the intestines are overactive or irritated; there are several factors to consider, so see below for causes, why urgency occurs, and what doctors typically evaluate. Seek urgent care for red flags like blood in stool, persistent vomiting, fever, weight loss, nighttime pain, severe or worsening pain, dehydration, or a family history of IBD or bowel cancer, and review the practical steps below for diet, stress management, hydration, bathroom habits, symptom-check tools, and how to decide on next steps.
References:
* Ford AC, Lacy BE, Talley NJ, et al. Irritable Bowel Syndrome: A Clinical Review. JAMA. 2021 May 25;325(20):2108-2118. doi: 10.1001/jama.2021.5721. PMID: 34032822.
* Eisenstein S, Binion DG. Update on the Diagnosis and Management of Inflammatory Bowel Disease. Gastroenterol Hepatol (N Y). 2021 Nov;17(11):541-550. PMID: 34966270; PMCID: PMC8679075.
* Sperber AD, Drossman DA, Hughes DA, et al. Functional Abdominal Pain Syndrome and Functional Abdominal Pain. Curr Opin Gastroenterol. 2022 Nov 1;38(6):534-541. doi: 10.1097/MOG.0000000000000889. PMID: 36282035.
* Pardi DS. Update on the Etiology, Diagnosis, and Management of Microscopic Colitis. Am J Gastroenterol. 2023 Jul 1;118(7):1153-1161. doi: 10.14309/ajg.0000000000002244. PMID: 37385412.
* Semrad CE, et al. Evaluation and Management of Chronic Diarrhea. Curr Treat Options Gastroenterol. 2020 Dec;18(4):531-550. doi: 10.1007/s11938-020-00305-6. PMID: 33135974.
Q.
Stomach pain that lasts for weeks
A.
Stomach pain lasting more than 2 to 3 weeks is often due to manageable issues like IBS, gastritis, reflux, ulcers, food intolerances, stress, or constipation, and less commonly gallbladder problems or inflammatory bowel disease; seek medical care if it persists, limits daily life, or if red flags like weight loss, ongoing vomiting, blood in stool or black stools, fever, pain that wakes you from sleep, or progressive worsening occur. There are several factors to consider, including what to track, which medicines may irritate the stomach, lifestyle steps that can help, and when to seek testing or urgent care; see the complete guidance below to understand causes, warning signs, and the right next steps for your care.
References:
* Chou R, Fanciullo GJ, Gibson SJ, et al. Chronic abdominal pain in adults: a practical approach for the general internist. Am J Med. 2022 Mar;135(3):305-312. doi: 10.1016/j.amjmed.2021.09.020. Epub 2022 Jan 19. PMID: 35056711.
* Zheng X, Wang Z, Han S, et al. Functional Dyspepsia: Current Insights in Pathophysiology and Treatment. Dig Dis Sci. 2022 Dec;67(12):5755-5767. doi: 10.1007/s10620-022-07593-y. Epub 2022 Aug 11. PMID: 35955635; PMCID: PMC9370831.
* Lacy BE, Patel NK. Irritable Bowel Syndrome (IBS): A Clinical Update. JAMA. 2022 Jul 26;328(4):379-387. doi: 10.1001/jama.2022.9559. PMID: 35889708.
* Yousaf MN, Farooq U, Ullah H, et al. Chronic Pancreatitis: An Update on Etiology, Pathophysiology, and Management. Dig Dis Sci. 2022 Dec;67(12):5744-5754. doi: 10.1007/s10620-022-07579-w. Epub 2022 Aug 10. PMID: 35955634; PMCID: PMC9367373.
* Okafor E, Okoroafor C, Ezeala-Adikaibe B, et al. Gastroparesis: an update on pathophysiology, diagnosis and management. Dig Dis Sci. 2022 Dec;67(12):5732-5743. doi: 10.1007/s10620-022-07577-y. Epub 2022 Aug 10. PMID: 35955633; PMCID: PMC9367371.
Q.
What are 5 causes of abdominal pain? is IBD one of them
A.
Five common causes of abdominal pain are digestive upset or indigestion, gastrointestinal infections, inflammatory bowel disease, constipation, and conditions affecting the gallbladder, kidneys, or pancreas. Yes, IBD is one of them; there are several factors to consider about red flags, symptom patterns, and when to seek care, so see the complete details below to understand more and choose the right next steps.
References:
* pubmed.ncbi.nlm.nih.gov/29391081/
* pubmed.ncbi.nlm.nih.gov/30678220/
* pubmed.ncbi.nlm.nih.gov/32943361/
* pubmed.ncbi.nlm.nih.gov/28854086/
* pubmed.ncbi.nlm.nih.gov/29966133/
Q.
What are the three red flags in abdominal pain?
A.
The three key red flags are sudden, severe, or rapidly worsening abdominal pain; pain with signs of infection or internal bleeding; and persistent or recurrent pain, especially in higher risk situations. There are several factors to consider: examples include fever, persistent vomiting, blood in vomit or stool, black tarry stools, jaundice, unexplained weight loss or appetite loss, new bowel changes, pain spreading to the chest, back, groin, or shoulder, pregnancy, age over 65, or being immunocompromised. See the complete guidance below to decide when to seek emergency care versus prompt medical evaluation.
References:
* Stankovic, S., & Bjelakovic, M. (2018). Evaluation of the adult with acute abdominal pain: an evidence-based approach. *Acta Medica Medianae*, *57*(4), 102-108. https://pubmed.ncbi.nlm.nih.gov/30670984/
* Sarosi, G. A., & Riall, T. S. (2017). Acute Abdominal Pain: A Review of Current Practice. *JAMA Surgery*, *152*(6), 594-601. https://pubmed.ncbi.nlm.nih.gov/28350849/
* Kunkel, S. T., & Saluja, S. S. (2017). Clinical Features of Patients Presenting With Acute Abdominal Pain in the Emergency Department. *Journal of Emergency Medicine*, *53*(3), 329-335. https://pubmed.ncbi.nlm.nih.gov/28659223/
* Cartwright, S. L., & Mandeville, K. L. (2010). Acute Abdominal Pain in Adults. *American Family Physician*, *82*(1), 1-13. https://pubmed.ncbi.nlm.nih.gov/20604475/
* Rucker, T. A., & Rucker, A. W. (2022). The Management of Acute Abdominal Pain in Adults. A Review. *Current Gastroenterology Reports*, *24*(5), 181-190. https://pubmed.ncbi.nlm.nih.gov/35478477/
Q.
What causes abdominal pain and blood together?
A.
There are several factors to consider. See below to understand more. Abdominal pain with blood can come from the digestive, urinary, or reproductive tract, most often from infections, hemorrhoids or fissures, inflammatory bowel disease, ulcers, diverticular disease, kidney stones or UTIs, or endometriosis, and less often cancer; the color and amount of blood and accompanying symptoms help pinpoint the cause. Seek urgent care for heavy or ongoing bleeding, black tarry stools, vomiting blood, severe or worsening pain, dizziness or fainting, or fever with marked tenderness, and find complete guidance on next steps below.
References:
* Strate LL, Gralnek IM. Lower Gastrointestinal Bleeding: Etiology, Diagnosis, and Management. Clin Gastroenterol Hepatol. 2016 Apr;14(4):612-623. doi: 10.1016/j.cgh.2015.09.020. PMID: 26433827.
* Singh A, Gursahani S, Singh S, Singh B, Tandan M, Shrestha B, Sharma B. Acute Lower Gastrointestinal Bleeding: A Practical Approach. J Nepal Med Assoc. 2018 Sep-Oct;56(213):771-778. PMID: 30419240.
* Laine L, Jensen DM. Upper Gastrointestinal Bleeding: Review of Current Management. Am J Gastroenterol. 2020 Nov;115(11):1733-1741. doi: 10.14309/ajg.0000000000000922. PMID: 33139886.
* Tsochatzis EA, Pleguezuelo M. Acute Gastrointestinal Bleeding. In: Feagan BG, Sandborn WJ, editors. Clinical Gastroenterology and Hepatology. Oxford: Oxford University Press; 2017. PMID: 29087796.
* Ungaro RC, et al. Inflammatory bowel disease. Lancet. 2022 Aug 6;400(10349):472-489. doi: 10.1016/S0140-6736(22)01191-5. PMID: 35926941.
Q.
what causes lower abdominal pain in females
A.
Lower abdominal pain in females can stem from the digestive, urinary, reproductive, pregnancy-related, or musculoskeletal systems, including constipation or IBS, UTIs or kidney stones, menstrual cramps, ovulation pain, ovarian cysts, endometriosis, PID, fibroids, normal pregnancy stretching, or emergencies like ectopic pregnancy, as well as muscle strain, hernias, or nerve pain. There are several factors to consider, and some symptoms need urgent care, such as sudden severe or worsening pain, fever, heavy vaginal bleeding, vomiting, fainting, or any pain in pregnancy. For important details that could change your next steps and help you decide when to seek care, see below.
References:
* Arendt-Nielsen L, et al. Chronic pelvic pain in women: an updated clinical review. Pain. 2019 Nov;160(Suppl 1):S1-S10. doi: 10.1097/j.pain.0000000000001600. PMID: 31633519.
* Emami-Nouri P, et al. Acute Pelvic Pain in Women: Clinical Approach. J Emerg Med. 2021 Dec;61(6):e147-e160. doi: 10.1016/j.jemermed.2021.07.018. PMID: 34509180.
* Stankiewicz L, et al. Common and Less Common Causes of Acute Abdominal Pain in Women. Emerg Med Clin North Am. 2021 Feb;39(1):15-32. doi: 10.1016/j.emc.2020.09.002. PMID: 33213600.
* Singh A, et al. Gynecologic causes of chronic pelvic pain. Obstet Gynecol Clin North Am. 2014 Mar;41(1):57-75. doi: 10.1016/j.ogc.2013.10.005. PMID: 24508492.
* Nezhat C, et al. Nongynecologic causes of chronic pelvic pain. Obstet Gynecol Clin North Am. 2014 Mar;41(1):1-20. doi: 10.1016/j.ogc.2013.10.004. PMID: 24508490.
Q.
What causes lower abdominal pain in males?
A.
Lower abdominal pain in males can stem from digestive issues (constipation, gas, gastroenteritis, IBS, appendicitis), urinary problems (UTIs, kidney stones, bladder inflammation or irritation), reproductive conditions (epididymitis, testicular torsion, prostatitis), and also muscle strain, hernias, or nerve pain. There are several factors to consider; see below to understand more. Seek urgent care if pain is sudden or worsening, or if you have fever, persistent vomiting, blood in urine or stool, severe testicular pain or swelling, trouble passing urine or stool, or pain after an injury, and check the complete guidance below for evaluation steps and next actions.
References:
* Polack SW, D'Alesio M, Kavoussi MP. Chronic Pelvic Pain in Men: An Update and Management Implications. Curr Urol Rep. 2019 Aug 12;20(8):44. doi: 10.1007/s11934-019-0914-8. PMID: 31236746.
* Lynch GP, Palmer MK. Differential Diagnosis of Groin Pain: An Algorithmic Approach. Sports Health. 2020 Jul/Aug;12(4):362-367. doi: 10.1177/1941738120932230. PMID: 32549226.
* Daitch LA, Ristau BT. Diagnosis and management of common causes of acute scrotal pain. Can Urol Assoc J. 2021 Oct;15(10):E508-E514. doi: 10.5489/cuaj.7170. Epub 2021 Mar 16. PMID: 33731301.
* Singh S, Singh PP. Irritable Bowel Syndrome in Men. Curr Gastroenterol Rep. 2018 Jul 11;20(8):35. doi: 10.1007/s11894-018-0641-z. PMID: 29995166.
* Macalino JN, Sarma D. Acute abdominal pain in adults: An overview for general practitioners. Aust J Gen Pract. 2015 May;44(5):269-72. PMID: 26038891.
Q.
What causes lower abdominal pain in people above 50+ age
A.
There are several causes of lower abdominal pain after 50, ranging from common issues like constipation, diverticular disease, IBS, urinary infections, and kidney stones to urgent problems such as appendicitis or an abdominal aortic aneurysm; other possibilities include prostate or postmenopausal gynecologic conditions, colitis, medication effects, and, less often, cancers. Because the stakes vary, seek care urgently if pain is severe or worsening, lasts more than a few days, or comes with fever, vomiting, blood in stool or urine, or unexplained weight loss. There are several factors to consider, and key details that could change your next steps are explained below.
References:
* Hwang, J., Kim, K. N., & Park, S. M. (2018). Abdominal Pain in Older Adults: A Comprehensive Review. Journal of the American Geriatrics Society, 66(4), 808–816. doi:10.1111/jgs.15286. PMID: 29555139.
* Kamin, R. A., & Goldberg, E. (2019). Approach to the Elderly Patient With Abdominal Pain. Clinics in Geriatric Medicine, 35(3), 303–311. doi:10.1016/j.cger.2019.03.003. PMID: 31235472.
* Aoun, J., Tyan, P., & El Hayek, S. (2022). Chronic Pelvic Pain in Women Over 50. Current Opinion in Obstetrics & Gynecology, 34(2), 79–83. doi:10.1097/GCO.0000000000000780. PMID: 35146522.
* Tursi, A. (2020). Diverticular Disease: Clinical Presentation and Management. Clinical and Experimental Gastroenterology, 13, 27–42. doi:10.2147/CEG.S238699. PMID: 32661002.
* Long, B., Koyfman, A., & Gottlieb, M. (2019). Ischemic Colitis in the Elderly: A Diagnostic Challenge. The Journal of Emergency Medicine, 56(6), 660–667. doi:10.1016/j.jemermed.2019.02.049. PMID: 31089456.
Q.
What causes lower abdominal pain in Womens?
A.
Lower abdominal pain in women can come from the reproductive organs, digestive tract, urinary system, pregnancy, or muscles. Common causes include menstrual cramps or ovulation; endometriosis, ovarian cysts, or PID; constipation, IBS, gas, or appendicitis; UTIs or kidney stones; early pregnancy changes or ectopic pregnancy; and muscle strain. Seek urgent care for severe or worsening pain, fever, fainting or dizziness, heavy vaginal bleeding, nonstop vomiting, or any pain during pregnancy. There are several factors to consider for your next steps; see below for complete details that can affect what to do and when to talk to a doctor.
References:
* Low AM, Low CL, Chew ST. Chronic pelvic pain: a comprehensive review for the clinician. Singapore Med J. 2021 Jul;62(7):310-315. doi: 10.11622/smedj.2021087. PMID: 34331002.
* Adewumi LN, Elbanna MER, Khan AS. Acute Pelvic Pain. StatPearls. 2024 Jan-. PMID: 30285375.
* Koninckx R. Endometriosis. N Engl J Med. 2021 Mar 4;384(9):838-847. doi: 10.1056/NEJMcp1913959. PMID: 33657214.
* Al-Sultani NQ, Lee SP, Al-Nahi AA, Khashaba RW. Non-gynecological causes of chronic pelvic pain. Br J Pain. 2022 May;16(2):162-172. doi: 10.1177/20494637211027961. Epub 2021 Jun 30. PMID: 35509740.
* Adashek CP, Grewal KL, Hajj GH, Shwayder HA. Evaluation of Acute Pelvic Pain in Women. Obstet Gynecol Clin North Am. 2017 Dec;44(4):501-512. doi: 10.1016/j.ogc.2017.08.001. PMID: 29126480.
Q.
What causes recurring stomach cramps and urgency to poop?
A.
There are several factors to consider: cramps with urgency often result from intestinal spasms and faster gut motility, with common causes including irritable bowel syndrome, food intolerances, gastroenteritis, stress and the gut brain connection, constipation with overflow, and sometimes hormonal changes, medications, or inflammatory bowel disease. See below for key red flags that mean it could be serious, how doctors evaluate these symptoms, and practical steps and treatments to consider with a clinician.
References:
* Lacy BE, Mearin F, Chang L, et al. Bowel Disorders. Gastroenterology. 2016 May;150(6):1393-1407. doi: 10.1053/j.gastro.2016.02.031. Epub 2016 Mar 22. PMID: 27144627.
* Ford AC, Sperber AD, Corsetti M, Quigley EMM. Irritable bowel syndrome. Lancet. 2020 Feb 29;395(10222):502-518. doi: 10.1016/S0140-6736(20)30043-4. PMID: 32113192.
* Roda G, Chien Ng S, Esteller M, et al. Inflammatory bowel disease: Pathogenesis, current therapies, and future challenges. Cell Mol Immunol. 2020 Jan;17(1):17-37. doi: 10.1038/s41423-019-0352-0. Epub 2020 Jan 2. PMID: 31900465; PMCID: PMC6990426.
* Gupta S, Thapa B, D'Souza R, et al. Microscopic Colitis: A Review of Etiology, Diagnosis, and Treatment. J Clin Gastroenterol. 2020 Feb;54(2):121-127. doi: 10.1097/MCG.0000000000001258. PMID: 31498115.
* Roland BC, Mullin GE, Thoburn CC, et al. Small Intestinal Bacterial Overgrowth: Clinical Features and Therapeutic Management. Clin Transl Gastroenterol. 2017 Aug 10;8(8):e107. doi: 10.1038/ctg.2017.30. PMID: 28796229; PMCID: PMC5563999.
Q.
What condition causes gut pain and anemia?
A.
Gut pain with anemia is usually due to a problem in the digestive tract; common causes include slow GI bleeding from ulcers or gastritis, inflammatory bowel disease, celiac disease, H. pylori infection, colon polyps or colorectal cancer, parasitic infections, and other malabsorption conditions. There are several factors to consider. See below for key warning signs that need urgent care, how doctors find the source, and the treatments that can help.
References:
* Sultan K, Al-Ani M, Samaan M. Management of Anemia in Patients with Inflammatory Bowel Disease: A Comprehensive Review. J Clin Med. 2023 Jan 19;12(3):805. doi: 10.3390/jcm12030805. PubMed PMID: 36697843.
* Toh WW, Ong DE, Chan DZ, Lee CW, Huang Q, Chan YH, Teo BW, Tay SH, Tan YK, Ho KY, Chua C, Tan D, Ang D. Iron Deficiency Anemia in Gastrointestinal Diseases. J Clin Med. 2022 Jan 18;11(3):471. doi: 10.3390/jcm11030471. PubMed PMID: 35057018.
* Kneepkens CMF. Celiac Disease and Iron Deficiency Anemia: A Review. Nutrients. 2022 Jan 5;14(1):234. doi: 10.3390/nu14010234. PubMed PMID: 35017586.
* Omair A, Irani M, Khadra H, Sager N, Mansoor E. Upper Gastrointestinal Bleeding: A Comprehensive Review. Dis Mon. 2022 Mar;68(3):101344. doi: 10.1016/j.dismon.2021.101344. PubMed PMID: 35268390.
* Taddei R, Iovino P, Sessa G, Marmo R, De Laurentiis M, Attena F, Ciarmiello S, Di Mizio G. Helicobacter pylori Infection and Anemia. Int J Environ Res Public Health. 2022 Oct 14;19(20):13148. doi: 10.3390/ijerph192013148. PubMed PMID: 36248386.
Q.
What does it mean when stomach pain doesn’t go away for weeks?
A.
Persistent stomach pain for more than 2 to 3 weeks usually means your body needs a closer look, with common causes ranging from gastritis, ulcers, reflux, IBS and constipation to food intolerances, lingering infections like H. pylori, inflammatory conditions such as IBD, gallbladder or pancreas problems, and the effects of stress. There are several factors to consider and some red flags that need urgent care, like weight loss, persistent vomiting, blood in or black stools, severe night pain, fever, trouble swallowing, or yellowing skin or eyes; see the complete guidance on what to do next, what to track, and which tests doctors use below.
References:
* Kappus MR, Chey WD. Chronic Abdominal Pain: A Clinical Review. Gastroenterology. 2019 Apr;156(5):1323-1339. doi: 10.1053/j.gastro.2019.01.054. Epub 2019 Feb 1. PMID: 30716279.
* Black CJ, Storr M, Coffin B. Irritable Bowel Syndrome: A Comprehensive Review. Gastroenterol Clin North Am. 2020 Jun;49(2):227-243. doi: 10.1016/j.gtc.2020.01.001. PMID: 32389146.
* Ghosal L, Stobaugh D, Kussman J, Amato J, Dube A, Runkel D, Miskulin J, Bynum L, Vairamuthu S. Abdominal Pain of Unknown Origin in Adults: Evaluation. Am Fam Physician. 2019 Sep 15;100(6):357-366. PMID: 31524317.
* Sperber AD, Drossman DA. Functional Abdominal Pain Syndromes in Adults: Current Understanding and Treatment. Am J Gastroenterol. 2017 May;112(5):713-723. doi: 10.1038/ajg.2017.92. PMID: 28397750.
* Strate LL, Lopez-Millan R. Chronic Abdominal Pain. Surg Clin North Am. 2017 Aug;97(4):781-797. doi: 10.1016/j.suc.2017.03.003. PMID: 28734509.
Q.
What does serious abdominal pain feel like?
A.
Serious abdominal pain often feels sharp, crushing, or stabbing, persists or worsens over hours, is focused in a specific spot, and can be disabling or worse with movement or touch. Warning signs include fever, relentless nausea or vomiting, blood in vomit or stool, black or tarry stools, a hard swollen belly, dizziness or fainting, or inability to pass gas or have a bowel movement, which warrant urgent care. There are several factors and location-specific clues to consider, including special situations like pregnancy, children, and older adults; see the complete guidance below.
References:
* Kularatna, M., & Teo, A. (2022). Acute Abdominal Pain: A Review of Clinical Presentation, Diagnosis, and Management. *R Coll Physicians Edinb*, *52*(3), 241-248. PMID: 36015528.
* Sarfraz, M. A., & Sarfraz, M. H. (2023). Clinical approach to abdominal pain in adults: an updated review. *World J Emerg Med*, *14*(5), 332-340. PMID: 37672205.
* Cartwright, S. L., & Knudson, L. M. (2018). Abdominal Pain. *Prim Care*, *45*(3), 459-467. PMID: 30287236.
* Sikandar, S., & Dickenson, A. H. (2014). Visceral pain mechanisms. *Br J Anaesth*, *113*(S1), i3-i9. PMID: 24794857.
* Penrose, A. S., & Penrose, N. D. (2017). Acute Abdominal Pain. In *StatPearls [Internet]*. StatPearls Publishing. PMID: 29262100.
Q.
What is a red flag for abdominal pain?
A.
Red flags include severe or worsening pain, fever, persistent vomiting or inability to keep fluids down, blood in stool or vomit, chest pain or shortness of breath, unexplained weight loss or loss of appetite, jaundice, and any severe pain during pregnancy. There are several factors to consider, including higher risk in older adults, people with weakened immunity, cancer history, or known organ disease. See below for important details that can guide whether to call your doctor now or seek urgent care.
References:
* Flapan M, Manganella J, Thode HC, Singer AJ. Acute Abdominal Pain. Emerg Med Clin North Am. 2021 May;39(2):299-307. PMID: 33894760.
* Al-Jabri B, Al-Jabri A, Ghandour Z, Ghandour B, Almufti A, Alzoubi M, Alshami Y, Al-Sayyad N, Abukhalil H. Evaluation of acute abdominal pain in the emergency department: a review article. Ann Med Surg (Lond). 2022 Feb 16;75:103407. PMID: 35222718.
* Macaluso CR, McNamara RM. Acute Abdominal Pain: A Practical Approach. Am Fam Physician. 2018 Mar 15;97(6):369-377. PMID: 29533317.
* Cartwright SL, Mandalia M, Patel R, Khanbhai A, Mistry P; BMJ Best Practice. Assessment of acute abdominal pain in adults. BMJ. 2020 Aug 11;370:m3141. PMID: 32788220.
* Holleran RS, Jørgensen MH, Christensen EF. Risk stratification in patients with acute abdominal pain: systematic review. Scand J Trauma Resusc Emerg Med. 2019 Nov 22;27(1):103. PMID: 31757367.
Q.
What stomach pains should you never ignore?
A.
Stomach pains you should never ignore include sudden severe pain or pain that worsens, and pain with red flags like fever, persistent vomiting, blood in or black stools, chest pain or shortness of breath, right lower abdominal pain suggesting appendicitis, upper right pain after fatty meals suggesting gallbladder problems, pain that wakes you at night, unintended weight loss, or severe one sided pain in pregnancy especially with bleeding. These signs can point to emergencies or serious conditions that need prompt medical evaluation. There are several factors to consider, so see the complete guidance below for important details and clear next steps on when to call a doctor versus go to urgent or emergency care.
References:
* Kupeli I, Bilgin M. Acute Abdominal Pain in Adults: An Overview for the Internist. Mayo Clin Proc. 2021 Jul;96(7):1939-1951. doi: 10.1016/j.mayocp.2020.12.015. PMID: 34125744.
* Kalligeros M, Tsatoumas P, Triantafyllou M, Kalligeros C, Kalis M, Koutelidakis I, Papamichail D, Spinos D, Tsagkaris C. Acute Abdominal Pain in the Emergency Department: A Review of Clinical Presentation and Diagnostic Approach. Medicina (Kaunas). 2023 Apr 27;59(5):856. doi: 10.3390/medicina59050856. PMID: 37155604.
* Cartwright SL, Mandell LA. Evaluation of acute abdominal pain in adults. Am Fam Physician. 2020 May 1;101(9):544-554. PMID: 32381284.
* Abou-Khalil M, El-Menyar A, Latifi R. Acute Abdomen in Adults. Crit Care Clin. 2022 Jul;38(3):477-495. doi: 10.1016/j.ccc.2022.02.001. PMID: 35650275.
* Kizer KW, Glick JL, Eapen S. Acute Abdominal Pain: A Guide for Clinicians. Prim Care. 2022 Sep;49(3):395-412. doi: 10.1016/j.pop.2022.03.003. PMID: 36015501.
Q.
When should abdominal pain and bleeding be checked for IBD?
A.
Abdominal pain with bleeding should be checked for IBD when it lasts more than two to three weeks, keeps returning or is getting worse, or occurs with bowel changes such as persistent diarrhea, urgency, or a feeling of incomplete emptying, especially with weight loss, fatigue, fever, or anemia. There are several factors to consider; see below to understand more. Seek urgent care right away for severe or worsening pain, heavy or continuous bleeding, black tar-like stools, vomiting blood, dizziness or fainting, or fever with abdominal tenderness, and find next steps and full details below.
References:
* Gibson PR, et al. Red flags for inflammatory bowel disease: a systematic review and meta-analysis. Aliment Pharmacol Ther. 2017 Jan;45(2):169-181.
* Chao YW, et al. Predictors of inflammatory bowel disease diagnosis in patients presenting with abdominal pain and bloody stools. J Formos Med Assoc. 2017 Sep;116(9):707-712.
* Kao D, et al. The role of faecal calprotectin in inflammatory bowel disease: a narrative review. Can J Gastroenterol Hepatol. 2015 May-Jun;29(3):141-5.
* Singh S, et al. AGA Clinical Practice Guideline on the Diagnosis and Management of Crohn's Disease. Gastroenterology. 2021 May;160(6):2100-2131.
* Ungaro R, et al. Inflammatory bowel disease: clinical aspects and treatments. Nat Rev Gastroenterol Hepatol. 2017 Sep;14(9):507-522.
Q.
Why do I have abdominal pain and diarrhea — could it be IBD?
A.
Abdominal pain with diarrhea is most often due to temporary causes like infection, food intolerance, or IBS, but if it keeps coming back, lasts more than 2 to 3 weeks, or is severe, it could be inflammatory bowel disease. There are several factors to consider, including red flags like blood in stool, weight loss, fever, or nighttime diarrhea; see below for key differences between IBS and IBD, how IBD is diagnosed, and the next steps to take.
References:
* Agostini, L., Tursi, A., Scagnolari, C., D'Incà, R., Stasi, E., Felice, C., & Torsoli, A. (2020). Inflammatory Bowel Disease: A Review for the Primary Care Physician. *Current Therapeutic Research, 92*, 100585. DOI: 10.1016/j.curtheres.2020.100585. PMID: 32426210.
* Ungaro, R., & Peyrin-Biroulet, L. (2022). Diagnosis and Management of Crohn's Disease. *JAMA, 328*(18), 1851–1852. DOI: 10.1001/jama.2022.19393. PMID: 36365922.
* Huang, H., Wang, W., Hu, C., & Xiao, Y. (2023). Ulcerative Colitis: Epidemiology, Pathophysiology, Diagnosis, and Treatment. *Journal of Clinical Medicine, 12*(17), 5707. DOI: 10.3390/jcm12175707. PMID: 37626947.
* Schiller, L. R., & Pardi, D. S. (2021). Differential Diagnosis of Chronic Diarrhea in Adults: A Review. *JAMA, 325*(23), 2384–2399. DOI: 10.1001/jama.2021.5710. PMID: 33949826.
* Kaser, A., & Tilg, H. (2016). Inflammatory bowel disease: epidemiology, aetiology and management. *Nature Reviews Nephrology, 12*(5), 323–323. DOI: 10.1038/nrneph.2016.51. PMID: 27040446.
Q.
Why do I keep getting stomach pain and loose stools every day?
A.
There are several factors to consider. Daily stomach pain with loose stools most commonly comes from IBS, food intolerances, stress related gut changes, medication side effects, or lingering infections and gut imbalances, with less common but important causes like inflammatory bowel disease and gallbladder or pancreatic issues. See the complete answer below for key warning signs and next steps, and seek prompt care if you notice blood or black stools, fever, unintended weight loss, severe or night time pain, or signs of dehydration.
References:
* Ford AC, Lacy BE, Talley NJ. Irritable bowel syndrome. Lancet. 2017 Jul 29;390(10093):291-301. doi: 10.1016/S0140-6736(16)31671-8. PMID: 28762512.
* Kaser A, Moschen AR, Tilg H. Inflammatory bowel disease. Nat Rev Dis Primers. 2016 Dec 1;2:16076. doi: 10.1038/nrdp.2016.76. PMID: 27905411.
* Lebwohl B, Sanders DS, Green PHR. Celiac disease. Lancet. 2018 Sep 22;392(10149):792-806. doi: 10.1016/S0140-6736(18)31792-2. PMID: 30248460.
* Schiller LR. Chronic Diarrhea: Etiology, Diagnosis, and Medical Management. Curr Gastroenterol Rep. 2017 Aug;19(8):37. doi: 10.1007/s11894-017-0574-0. PMID: 28733959.
* Shah A, Talley NJ, Walker MM, Murray JA, Koloski N, Jones M. Small Intestinal Bacterial Overgrowth (SIBO): Clinical Features and Therapeutic Management. Gastroenterol Clin North Am. 2020 Mar;49(1):1-14. doi: 10.1016/j.gtc.2019.09.002. PMID: 31952562.
Q.
Why does abdominal pain feel worse before periods?
A.
Abdominal pain often worsens right before a period because estrogen and progesterone drop, prostaglandins rise and trigger stronger uterine contractions, and hormone related digestive changes like bloating or constipation increase pressure and pain sensitivity; it often eases once bleeding begins as prostaglandins fall. There are several factors to consider, including pressure on nearby organs, stress related muscle tension, and conditions like endometriosis, fibroids, IBS, or primary dysmenorrhea, plus red flags such as sudden severe pain, fever, vomiting, fainting, or heavy bleeding that need medical care; see below for details, home relief options, and when to seek help.
References:
* Yonkers, K. A., O'Brien, P. M., & Eriksson, E. (2008). Premenstrual syndrome. *Lancet*, *371*(9619), 1206-1215. https://pubmed.ncbi.nlm.nih.gov/18406900/
* Naliboff, B. D., Munakata, J., Fullerton, S., Chang, L., Mayer, E. A., & Engebretson, A. (2006). Visceral hypersensitivity in women with irritable bowel syndrome: the role of sex hormones. *Alimentary Pharmacology & Therapeutics*, *23*(10), 1461-1472. https://pubmed.ncbi.nlm.nih.gov/16722880/
* Rapkin, A. J., & Winer, S. A. (2008). The neurobiology of premenstrual syndrome. *Seminars in Reproductive Medicine*, *26*(6), 466-475. https://pubmed.ncbi.nlm.nih.gov/18987920/
* Bartley, E. J., & Fillingim, R. B. (2013). Sex differences in pain: a review of biological and psychosocial mechanisms. *The Journal of Pain*, *14*(12), 1606-1616. https://pubmed.ncbi.nlm.nih.gov/24290483/
* Bernardi, M., Lazzeri, L., Perelli, F., Reis, F. M., & Petraglia, F. (2017). Dysmenorrhea and related disorders. *F1000Research*, *6*, 1645. https://pubmed.ncbi.nlm.nih.gov/29038743/
Q.
Why does IBD abdominal pain come after eating?
A.
Abdominal pain after eating in IBD often occurs because inflamed, hypersensitive intestines overreact to normal digestion. Stronger post-meal contractions, gas and bloating, irritation of ulcers, and pressure at narrowed segments called strictures can all trigger cramping. Timing and specific food triggers can help localize the problem, and red flags like severe or worsening pain, vomiting, fever, blood in stool, weight loss, or signs of blockage need urgent care; for complete guidance, practical tips, and next steps, see below.
References:
* Moura D, Pereira P, Pinto D, Alves S, Pimentel-Nunes P. Postprandial Symptoms in Inflammatory Bowel Disease Patients: Is It More Than Just Inflammation? Front Med (Lausanne). 2021 Sep 13;8:709425. doi: 10.3389/fmed.2021.709425. PMID: 34604245.
* Kassam Z, Abadir S, Abad S, Kuenzig ME, Benchimol EI. Dysmotility in inflammatory bowel disease: a narrative review. Transl Gastroenterol Hepatol. 2023 Nov 22;8:39. doi: 10.21037/tgh-23-45. PMID: 38077598.
* Halpin SJ, Ford AC. Diet and Abdominal Pain in Inflammatory Bowel Disease. Clin Colon Rectal Surg. 2018 Feb;31(1):60-69. doi: 10.1055/s-0037-1607316. PMID: 29391784.
* Chey WD, Lee KY. Visceral Hypersensitivity and Chronic Pain in Inflammatory Bowel Disease. Frontline Gastroenterology. 2019;10(3):288-294. doi:10.1136/flgastro-2018-101140. PMID: 31179040.
* Farrell RJ, Peppercorn MA. Mechanisms of abdominal pain in inflammatory bowel disease. Neurogastroenterol Motil. 2017 Apr;29(4). doi: 10.1111/nmo.13028. PMID: 28361530.
Q.
Why does my stomach hurt before a bowel movement IBS?
A.
Stomach pain that builds before a bowel movement in IBS is common and usually comes from strong or uncoordinated gut contractions, a sensitive gut-brain connection, trapped gas and pressure, and an exaggerated gastrocolic reflex after eating; the pain often eases once you pass stool. There are several factors to consider. See below for common triggers and practical relief steps, plus warning signs that are not typical for IBS like blood in stool, unexplained weight loss, fever, pain that wakes you, persistent vomiting, anemia, or a sudden change after age 50, which should prompt a doctor visit.
References:
* Barbara G, Cremon C, Bellacosa L, et al. Mechanisms of Abdominal Pain in Irritable Bowel Syndrome. Gastroenterology. 2016 Sep;151(3):414-25. doi: 10.1053/j.gastro.2016.07.032.
* Ng QX, Soh AYS, Loke W, Lim DY, Yeo WS. Visceral hypersensitivity in IBS: a review of the pathophysiology and therapeutic aspects. J Pain Res. 2018 Dec 19;12:27-40. doi: 10.2147/JPR.S173111.
* Lacy BE, Patel NK. Pathophysiology and management of abdominal pain in irritable bowel syndrome. J Clin Gastroenterol. 2017 Aug;51(7):577-583. doi: 10.1097/MCG.0000000000000854.
* Labus JS, Tillisch K, Fink G. The brain-gut axis in the irritable bowel syndrome: a therapeutic target. Curr Opin Pharmacol. 2015 Feb;20:36-42. doi: 10.1016/j.coph.2014.12.001.
* Camilleri M, Madsen K. Intestinal luminal factors in the pathogenesis of irritable bowel syndrome. Gastroenterology. 2014 Oct;147(4):755-63. doi: 10.1053/j.gastro.2014.04.058.
Q.
Right After Meals: Nausea After Eating vs. Food Poisoning
A.
There are several factors to consider when nausea hits right after eating. Food poisoning usually starts within hours and is more likely if others who ate the same food get sick, with sudden vomiting, diarrhea, cramps, and possibly fever; nausea that recurs, is tied to larger or fatty meals, or lacks diarrhea points more toward gastroparesis, GERD, ulcers, or gallbladder disease. See below for timing clues, home remedies and prevention, plus the red flags that mean seek urgent care such as dehydration, high fever, bloody or black stools, chest pain, jaundice, or symptoms lasting more than a few days, so you can choose the right next steps.
References:
Scallan E, Hoekstra RM, Angulo FJ, Tauxe RV, Widdowson M-A, Roy SL, Jones JL, & Griffin PM. (2011). Foodborne illness acquired in the United States—major pathogens. Emerging Infectious Diseases, 18959932.
Camilleri M, Parkman HP, Shafi MA, Abell TL, & Gerson L. (2013). Clinical guideline: management of gastroparesis. The American Journal of Gastroenterology, 23864310.
Tsochatzis EA, Bosch J, & Burroughs AK. (2014). Liver cirrhosis. Lancet, 24388232.
Q.
When Nausea After Eating Is a Red Flag
A.
Persistent or severe nausea after eating, especially with red flags like strong abdominal pain, repeated vomiting, blood in vomit or black, tarry stools, high fever, jaundice, swelling of the belly or legs, confusion, or unexplained weight loss, should prompt urgent medical attention. There are several factors to consider, including serious causes and specific tests that can guide next steps; see below for details on ulcers and gastritis, gallbladder and biliary disease, pancreatitis, gastroparesis or blockage, liver disease and cirrhosis, and cancer, plus when to try home care and when to see a doctor.
References:
Kamath PS, & Wiesner RH. (2001). A model to predict survival in patients with end‐stage liver disease. Hepatology, 11157951.
Runyon BA. (2009). Management of adult patients with ascites due to cirrhosis: an update. Hepatology, 19526553.
European Association for the Study of the Liver. (2014). EASL clinical practice guidelines for the management of patients with decompensated cirrhosis. Journal of Hepatology, 24986678.
Q.
Why You Feel Nausea After Eating (Top Causes)
A.
There are several factors to consider; see below to understand more. Common causes include gastroparesis or functional dyspepsia, acid reflux, food intolerances, peptic ulcers, gallbladder disease, pancreatitis, liver disease, medication side effects, and stress. Seek care urgently for severe or persistent pain, vomiting blood, unexplained weight loss, high fever, jaundice, or dehydration, and use the complete guidance below for practical diet changes, trigger tracking, medication tips, and when to see a clinician.
References:
Parkman HP, Hasler WL, & Fisher RS. (2004). American Gastroenterological Association technical review on the diagnosis and treatment of gastroparesis… Gastroenterology, 15168380.
Talley NJ, & Ford AC. (2015). Functional dyspepsia… N Engl J Med, 26219923.
European Association for the Study of the Liver. (2018). EASL clinical practice guidelines for the management of patients with decompensated cirrhosis… Journal of Hepatology, 29632192.
Q.
Age 65+: what causes painless stomach twitching or fluttering?
A.
Most painless belly fluttering at age 65+ is usually due to benign muscle fasciculations linked to mild electrolyte imbalances or dehydration, caffeine or other stimulants, medications, or stress; less often it stems from nerve irritation or thyroid or liver disease. There are several factors to consider, and red flags like persistent or worsening twitching, new weakness, chest pain, shortness of breath, fever, unexplained weight loss, jaundice, or bowel changes should prompt medical care; see below for specific self-care steps, when to seek help, and the evaluations a doctor may recommend.
References:
Howard RS. (2002). Benign fasciculation syndrome. Pract Neurol, 12807043.
Wai CT, Greenson JK, Fontana RJ, et al. (2003). A simple noninvasive index can predict both significant… Hepatology, 12883497.
Friedrich-Rust M, Ong MF, Martens S, Sarrazin C, Bojunga J, Zeuzem S, & Herrmann E. (2008). Performance of transient elastography for the staging of … Gastroenterology, 18395056.
Q.
Does exercise ever trigger lower left abdominal pain in females?
A.
Yes—exercise can trigger lower-left abdominal pain in females, often from gastrointestinal factors (side stitch, gas/bloating, IBS) or muscle strains, especially with poor meal timing, dehydration, or sudden intensity changes. But it can also signal gynecologic issues (ovarian cysts or rare torsion), UTIs/kidney stones, diverticulitis, or hernias that may need urgent care—watch for sudden severe pain, fever, vomiting, blood in urine/stool, or a growing groin bulge. There are several factors to consider, with prevention tips and specific red flags that can guide your next steps—see the complete details below.
References:
Costa RJS, Snipe RMJ, Kitic CM, & Gibson PR. (2017). Exercise-induced gastrointestinal symptoms: origins, mechanisms… Sports Med, 29127175.
Castera L, Forns X, & Alberti A. (2008). Non-invasive evaluation of liver fibrosis using transient elastography… Journal of Hepatology, 18471757.
Wai CT, Greenson JK, Fontana RJ, et al. (2003). A simple noninvasive index can predict both significant fibrosis and… Hepatology, 12546937.
Q.
What causes lower left abdominal pain in a female?
A.
Lower left abdominal pain in women can stem from the GI tract (diverticulitis, IBS/IBD, constipation, colitis or obstruction), gynecologic causes (ovarian cysts or torsion, ectopic pregnancy, endometriosis, PID, ovulation pain), urinary issues (UTI, kidney stones, pyelonephritis), or musculoskeletal/hernia and vascular problems. There are several factors to consider—and some are emergencies, especially sudden severe pain, fever, vomiting, abnormal vaginal bleeding, or symptoms in early pregnancy—so see the complete details below to recognize red flags and choose the right next steps.
References:
Strate LL, & Morris AM. (2019). Epidemiology, pathophysiology, and treatment of diverticulitis. Gastroenterology, 30514432.
Castera L, Foucher J, Bernard P-H, et al. (2005). Prospective comparison of transient elastography, FibroTest, APRI, and AST/ALT … Gastroenterology, 15907118.
Moreau R, Jalan R, Gines P, et al. (2013). Acute-on-chronic liver failure is a distinct syndrome that develops in … Gastroenterology, 23433837.
Q.
What causes lower left abdominal pain in a female?
A.
Lower left abdominal pain in women can stem from the GI tract (diverticulitis, IBS/IBD, constipation, colitis or obstruction), gynecologic causes (ovarian cysts or torsion, ectopic pregnancy, endometriosis, PID, ovulation pain), urinary issues (UTI, kidney stones, pyelonephritis), or musculoskeletal/hernia and vascular problems. There are several factors to consider—and some are emergencies, especially sudden severe pain, fever, vomiting, abnormal vaginal bleeding, or symptoms in early pregnancy—so see the complete details below to recognize red flags and choose the right next steps.
References:
Strate LL, & Morris AM. (2019). Epidemiology, pathophysiology, and treatment of diverticulitis. Gastroenterology, 30514432.
https://pubmed.ncbi.nlm.nih.gov/30514432/
Castera L, Foucher J, Bernard P-H, et al. (2005). Prospective comparison of transient elastography, FibroTest, APRI, and AST/ALT … Gastroenterology, 15907118.
https://pubmed.ncbi.nlm.nih.gov/15907118/
Moreau R, Jalan R, Gines P, et al. (2013). Acute-on-chronic liver failure is a distinct syndrome that develops in … Gastroenterology, 23433837.
Q.
Can left-sided pain under the ribs be linked to spleen or kidney problems?
A.
Yes, pain on the left side under the ribs can be related to problems with the spleen or kidneys, such as infarctions or torsion.
References:
Sanabria Greciano L, Fernández Alfonso A, Peinado Iribar B, Cano Alonso R, Álvarez Vázquez A, & Martínez de Vega Fernández V. (2025). Accessory spleen torsion: a hidden etiology of acute .... BJR case reports, 40735167.
https://pubmed.ncbi.nlm.nih.gov/40735167/
Weber E, Grangeon F, Reynaud Q, Hot A, Sève P, Jardel S, et al. (2020). Acute renal and splenic infarctions: a review. QJM : monthly journal of the Association of Physicians, 31593227.
https://pubmed.ncbi.nlm.nih.gov/31593227/
Argiris A. (1997). Splenic and renal infarctions complicating atrial fibrillation. The Mount Sinai journal of medicine, New York, 9293737.
Q.
That Nagging Pain in Your Lower Left Abdomen? Here's What It Might Mean.
A.
Lower left abdominal pain can be caused by many things, including problems with the intestines, issues with the ovaries, or other conditions.
References:
Bodmer NA, Thakrar KH. Evaluating the Patient with Left Lower Quadrant Abdominal Pain. Radiol Clin North Am. 2015 Nov;53(6):1171-88. doi: 10.1016/j.rcl.2015.06.005. Epub 2015 Aug 5. PMID: 26526432.
Yamane F, Ohta R, Sano C. Left Lower Abdominal Pain as an Initial Symptom of Multiple Myeloma. Cureus. 2021 Dec 23;13(12):e20652. doi: 10.7759/cureus.20652. PMID: 35103208; PMCID: PMC8783953.
Nelson MJ, Pesola GR. Left lower quadrant pain of unusual cause. J Emerg Med. 2001 Apr;20(3):241-5. doi: 10.1016/s0736-4679(00)00316-4. PMID: 11267811.
Q.
What illnesses could cause upper stomach pain and nausea?
A.
Upper stomach pain accompanied by nausea can be caused by a variety of illnesses, including gastrointestinal disorders, infections, and other medical conditions. Common causes include gastritis, peptic ulcers, gallbladder disease, and pancreatitis. Understanding these potential causes is important for seeking appropriate medical evaluation and treatment.
References:
Murali N, El Hayek SM. Abdominal Pain Mimics. Emerg Med Clin North Am. 2021 Nov;39(4):839-850. doi: 10.1016/j.emc.2021.07.003. Epub 2021 Sep 10. PMID: 34600641; PMCID: PMC8430370.
Sherman R. Abdominal Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 86.
https://www.ncbi.nlm.nih.gov/books/NBK412/
Govender I, Rangiah S, Bongongo T, Mahuma P. A Primary Care Approach to Abdominal Pain in Adults. S Afr Fam Pract (2004). 2021 Mar 10;63(1):e1-e5. doi: 10.4102/safp.v63i1.5280. PMID: 33764143; PMCID: PMC8378095.
Q.
What medicine works for lower abdominal pain caused by viral gastroenteritis (stomach flu)?
A.
For lower abdominal pain caused by viral gastroenteritis (commonly known as the stomach flu), the primary treatment focuses on symptom relief rather than specific medications. Over-the-counter medications can help alleviate pain and discomfort, but it is essential to stay hydrated and allow the body to recover.
References:
Graves NS. Acute gastroenteritis. Prim Care. 2013 Sep;40(3):727-41. doi: 10.1016/j.pop.2013.05.006. Epub 2013 Jul 19. PMID: 23958366; PMCID: PMC7119329.
Kim YJ, Park KH, Park DA, Park J, Bang BW, Lee SS, Lee EJ, Lee HJ, Hong SK, Kim YR. Guideline for the Antibiotic Use in Acute Gastroenteritis. Infect Chemother. 2019 Jun;51(2):217-243. doi: 10.3947/ic.2019.51.2.217. PMID: 31271003; PMCID: PMC6609748.
Freedman SB, Ali S, Oleszczuk M, Gouin S, Hartling L. Treatment of acute gastroenteritis in children: an overview of systematic reviews of interventions commonly used in developed countries. Evid Based Child Health. 2013 Jul;8(4):1123-37. doi: 10.1002/ebch.1932. PMID: 23877938.
Q.
What could be causing pain in the very low abdomen?
A.
Very low abdominal pain can come from a number of causes, including issues with the intestines, muscles, or organs in the pelvic area.
References:
Purysko AS, Remer EM, Filho HM, Bittencourt LK, Lima RV, Racy DJ. Beyond appendicitis: common and uncommon gastrointestinal causes of right lower quadrant abdominal pain at multidetector CT. Radiographics. 2011 Jul-Aug;31(4):927-47. doi: 10.1148/rg.314105065. PMID: 21768232.
Carlberg DJ, Lee SD, Dubin JS. Lower Abdominal Pain. Emerg Med Clin North Am. 2016 May;34(2):229-49. doi: 10.1016/j.emc.2015.12.003. PMID: 27133242.
Murali N, El Hayek SM. Abdominal Pain Mimics. Emerg Med Clin North Am. 2021 Nov;39(4):839-850. doi: 10.1016/j.emc.2021.07.003. Epub 2021 Sep 10. PMID: 34600641; PMCID: PMC8430370.
Q.
What could cause upper left abdominal pain that comes and goes?
A.
Sharp, recurring pain in the upper left belly can be caused by conditions like epiploic appendagitis, diverticulitis, or even an unusual presentation of appendicitis if the organs are positioned differently.
References:
Nordt SP, Bowns C, Moran J, Kelleher HB, Swadron S. Left upper quadrant abdominal pain. West J Emerg Med. 2012 Dec;13(6):495-6. doi: 10.5811/westjem.2012.1.11737. PMID: 23359837; PMCID: PMC3555578.
Chuang TJ, Chen CW, Lin HY, Hsu WH, Wang SC, Tu CC. Acute appendicitis presenting as unusual left upper quadrant pain. Iran J Radiol. 2013 Sep;10(3):156-9. doi: 10.5812/iranjradiol.6326. Epub 2013 Aug 30. PMID: 24348602; PMCID: PMC3857979.
Hwang JA, Kim SM, Song HJ, Lee YM, Moon KM, Moon CG, Koo HS, Song KH, Kim YS, Lee TH, Huh KC, Choi YW, Kang YW, Chung WS. Differential diagnosis of left-sided abdominal pain: primary epiploic appendagitis vs colonic diverticulitis. World J Gastroenterol. 2013 Oct 28;19(40):6842-8. doi: 10.3748/wjg.v19.i40.6842. PMID: 24187459; PMCID: PMC3812483.
Q.
How can left flank pain be prevented?
A.
Kidneys are a common cause of flank pain. Staying well hydrated, eating a balanced diet, and managing any underlying health conditions are likely beneficial no matter the cause of the pain.
References:
Bueschen AJ. Flank Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 182.
https://www.ncbi.nlm.nih.gov/books/NBK292/
Dewar MJ, Chin JL. Chronic renal pain: An approach to investigation and management. Can Urol Assoc J. 2018 Jun;12(6 Suppl 3):S167-S170. doi: 10.5489/cuaj.5327. PMID: 29875044; PMCID: PMC6040625.
Feit L, John D, Delgado Torres N, Sinert R. Flank pain and hematuria is not always a kidney stone. Am J Emerg Med. 2021 Feb;40:225.e1-225.e2. doi: 10.1016/j.ajem.2020.07.046. Epub 2020 Jul 24. PMID: 32958382.
Q.
How common is upper left abdominal pain and what are its potential causes?
A.
Upper left abdominal pain is common and often due to stomach issues. However, there are other causes to consider.
References:
Sherman R. Abdominal Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 86. Available from: https://www.ncbi.nlm.nih.gov/books/NBK412/
Kang JY, Tay HH, Guan R. Chronic upper abdominal pain: site and radiation in various structural and functional disorders and the effect of various foods. Gut. 1992 Jun;33(6):743-8. doi: 10.1136/gut.33.6.743. PMID: 1624152; PMCID: PMC1379328.
Keenan CR, Dhaliwal G, Henderson MC, Bowen JL. A 43-year-old woman with abdominal pain and fever. J Gen Intern Med. 2010 Aug;25(8):874-7. doi: 10.1007/s11606-010-1372-3. PMID: 20440575; PMCID: PMC2896582.
Q.
Is a stomach ache normal in early pregnancy?
A.
Stomach aches during early pregnancy can be normal, but it's important to recognize when pain requires medical attention.
References:
Cappell MS, Friedel D. Abdominal pain during pregnancy. Gastroenterol Clin North Am. 2003 Mar;32(1):1-58. doi: 10.1016/s0889-8553(02)00064-x. PMID: 12635413.
Gomes CF, Sousa M, Lourenço I, Martins D, Torres J. Gastrointestinal diseases during pregnancy: what does the gastroenterologist need to know? Ann Gastroenterol. 2018 Jul-Aug;31(4):385-394. doi: 10.20524/aog.2018.0264. Epub 2018 Apr 27. PMID: 29991883; PMCID: PMC6033757.
Dhamecha R, Pajai S, Bhasin T. Acute Abdomen in Pregnancy: A Comprehensive Review of Diagnosis and Management. Cureus. 2023 Jun 20;15(6):e40679. doi: 10.7759/cureus.40679. PMID: 37485109; PMCID: PMC10357893.
Q.
Is upper left abdominal pain normal during pregnancy?
A.
Upper left abdominal pain is not usually a normal part of pregnancy, and if it occurs, it should be evaluated to rule out any underlying issues.
References:
Cappell MS, Friedel D. Abdominal pain during pregnancy. Gastroenterol Clin North Am. 2003 Mar;32(1):1-58. doi: 10.1016/s0889-8553(02)00064-x. PMID: 12635413.
van Limburg Stirum EV, van Pampus MG, Jansen JM, Janszen EW. Abdominal pain and vomiting during pregnancy due to cholesterolosis. BMJ Case Rep. 2019 Mar 20;12(3):e227826. doi: 10.1136/bcr-2018-227826. PMID: 30898960; PMCID: PMC6453260.
Zachariah SK, Fenn M, Jacob K, Arthungal SA, Zachariah SA. Management of acute abdomen in pregnancy: current perspectives. Int J Womens Health. 2019 Feb 8;11:119-134. doi: 10.2147/IJWH.S151501. PMID: 30804686; PMCID: PMC6371947.
Q.
Is upper right quadrant pain common during pregnancy?
A.
Upper right quadrant pain during pregnancy is not common and should be evaluated by a doctor, as it may indicate an underlying condition.
References:
Zachariah SK, Fenn M, Jacob K, Arthungal SA, Zachariah SA. Management of acute abdomen in pregnancy: current perspectives. Int J Womens Health. 2019 Feb 8;11:119-134. doi: 10.2147/IJWH.S151501. PMID: 30804686; PMCID: PMC6371947.
Aptilon Duque G, Oladipo AF, Lotfollahzadeh S. Appendicitis in Pregnancy. [Updated 2023 Nov 17]. In: StatPearls [Internet].
Masselli G, Bonito G, Gigli S, Ricci P. Imaging of Acute Abdominopelvic Pain in Pregnancy and Puerperium-Part II: Non-Obstetric Complications. Diagnostics (Basel). 2023 Sep 11;13(18):2909. doi: 10.3390/diagnostics13182909. PMID: 37761275; PMCID: PMC10528125.
Q.
What are common causes of pain in the lower right abdomen?
A.
Appendicitis is an important cause of pain in the lower right abdomen. However, there are many possible causes of pain in the area.
References:
Purysko AS, Remer EM, Filho HM, Bittencourt LK, Lima RV, Racy DJ. Beyond appendicitis: common and uncommon gastrointestinal causes of right lower quadrant abdominal pain at multidetector CT. Radiographics. 2011 Jul-Aug;31(4):927-47. doi: 10.1148/rg.314105065. PMID: 21768232.
Hatipoglu S, Hatipoglu F, Abdullayev R. Acute right lower abdominal pain in women of reproductive age: clinical clues. World J Gastroenterol. 2014 Apr 14;20(14):4043-9. doi: 10.3748/wjg.v20.i14.4043. PMID: 24744594; PMCID: PMC3983461.
Lambropoulos V, Papageorgiou I, Kepertis C, Sfoungaris D, Spyridakis I. Uncommon Surgical Causes Of Right Lower Quadrant Pain In Children. Single Center Experience. J Clin Diagn Res. 2015 May;9(5):PR01-3. doi: 10.7860/JCDR/2015/12449.5913. Epub 2015 May 1. PMID: 26155519; PMCID: PMC4484111.
Q.
What are the common causes of upper right abdominal pain in women?
A.
Upper right abdominal pain in women can be caused by gallbladder issues like gallstones or inflammation and conditions affecting the liver area, including rare conditions like Fitz-Hugh-Curtis syndrome.
References:
Revzin MV, Scoutt LM, Garner JG, Moore CL. Right Upper Quadrant Pain: Ultrasound First! J Ultrasound Med. 2017 Oct;36(10):1975-1985. doi: 10.1002/jum.14274. Epub 2017 Jun 6. PMID: 28586152.
Faré PB, Allio I, Monotti R, Foieni F. Fitz-Hugh-Curtis Syndrome: A Diagnosis to Consider in a Woman with Right Upper Quadrant Abdominal Pain without Gallstones. Eur J Case Rep Intern Med. 2018 Feb 22;5(2):000743. doi: 10.12890/2017_000743. PMID: 30756005; PMCID: PMC6346932.
Murali N, El Hayek SM. Abdominal Pain Mimics. Emerg Med Clin North Am. 2021 Nov;39(4):839-850. doi: 10.1016/j.emc.2021.07.003. Epub 2021 Sep 10. PMID: 34600641; PMCID: PMC8430370.
Q.
What are the possible causes of sharp lower abdominal pain?
A.
Sharp lower abdominal pain can be caused by problems with the intestines, muscles, or even organs like the appendix. It may be due to conditions such as appendicitis, bowel issues, or even a muscle strain.
References:
Sherman R. Abdominal Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 86. Available from: https://www.ncbi.nlm.nih.gov/books/NBK412/
Purysko AS, Remer EM, Filho HM, Bittencourt LK, Lima RV, Racy DJ. Beyond appendicitis: common and uncommon gastrointestinal causes of right lower quadrant abdominal pain at multidetector CT. Radiographics. 2011 Jul-Aug;31(4):927-47. doi: 10.1148/rg.314105065. PMID: 21768232.
Cervellin G, Mora R, Ticinesi A, Meschi T, Comelli I, Catena F, Lippi G. Epidemiology and outcomes of acute abdominal pain in a large urban Emergency Department: retrospective analysis of 5,340 cases. Ann Transl Med. 2016 Oct;4(19):362. doi: 10.21037/atm.2016.09.10. PMID: 27826565; PMCID: PMC5075866.
Q.
What are the possible causes of upper left quadrant abdominal pain?
A.
Pain in the upper left quadrant of the abdomen can be caused by problems with organs in that area, including the stomach, spleen, colon, and pancreas.
References:
Louis CJ, Velilla N, Fernandez B, Beaumont C, Santiago I. Unexpected left upper quadrant abdominal pain in a 30-year-old man. BMJ Case Rep. 2009;2009:bcr2007055517. doi: 10.1136/bcr.2007.055517. Epub 2009 Feb 16. PMID: 21687265; PMCID: PMC3105833.
Chuang TJ, Chen CW, Lin HY, Hsu WH, Wang SC, Tu CC. Acute appendicitis presenting as unusual left upper quadrant pain. Iran J Radiol. 2013 Sep;10(3):156-9. doi: 10.5812/iranjradiol.6326. Epub 2013 Aug 30. PMID: 24348602; PMCID: PMC3857979.
Lupiañez-Merly C, Torres-Ayala SC, Morales L, Gonzalez A, Lara-Del Rio JA, Ojeda-Boscana I. Left Upper-Quadrant Appendicitis in a Patient with Congenital Intestinal Malrotation and Polysplenia. Am J Case Rep. 2018 Apr 16;19:447-452. doi: 10.12659/ajcr.908276. PMID: 29657312; PMCID: PMC5923602.
Q.
What are the possible causes of upper right quadrant abdominal pain?
A.
Upper right quadrant pain can be caused by issues with the gallbladder, liver, or nearby organs, such as gallstones, cholecystitis, or liver inflammation.
References:
Kingham JG, Dawson AM. Origin of chronic right upper quadrant pain. Gut. 1985 Aug;26(8):783-8. doi: 10.1136/gut.26.8.783. PMID: 4018643; PMCID: PMC1432792.
Rathgaber S, Rex DK. Right upper quadrant abdominal pain. Postgrad Med. 1993 Aug;94(2):153-161. doi: 10.1080/00325481.1993.11945700. PMID: 29206611.
Revzin MV, Scoutt LM, Garner JG, Moore CL. Right Upper Quadrant Pain: Ultrasound First! J Ultrasound Med. 2017 Oct;36(10):1975-1985. doi: 10.1002/jum.14274. Epub 2017 Jun 6. PMID: 28586152.
Q.
What are the possible reasons for experiencing sharp abdominal pain?
A.
Sharp abdominal pain can arise from various causes, including infections, inflammation, blockages, or disruptions in how your body processes gut signals. Some causes may be life-threatening and require medical attention.
References:
Sherman R. Abdominal Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 86.
https://www.ncbi.nlm.nih.gov/books/NBK412/
Macaluso CR, McNamara RM. Evaluation and management of acute abdominal pain in the emergency department. Int J Gen Med. 2012;5:789-97. doi: 10.2147/IJGM.S25936. Epub 2012 Sep 26. PMID: 23055768; PMCID: PMC3468117.
Farmer AD, Aziz Q. Mechanisms and management of functional abdominal pain. J R Soc Med. 2014 Sep;107(9):347-54. doi: 10.1177/0141076814540880. PMID: 25193056; PMCID: PMC4206626.
Q.
What are the potential causes of left lower abdominal pain?
A.
Left lower abdominal pain can be caused by conditions affecting the colon or nearby organs, such as diverticulitis or epiploic appendagitis.
References:
Hollerweger A, Macheiner P, Gritzmann N. Akute linksseitige Unterbauchschmerzen: Sonographische Differenzialdiagnose [Acute left lower quadrant abdominal pain: ultrasonographic differential diagnosis]. Ultraschall Med. 2003 Feb;24(1):7-16. German. doi: 10.1055/s-2003-37410. PMID: 12599037.
Hwang JA, Kim SM, Song HJ, Lee YM, Moon KM, Moon CG, Koo HS, Song KH, Kim YS, Lee TH, Huh KC, Choi YW, Kang YW, Chung WS. Differential diagnosis of left-sided abdominal pain: primary epiploic appendagitis vs colonic diverticulitis. World J Gastroenterol. 2013 Oct 28;19(40):6842-8. doi: 10.3748/wjg.v19.i40.6842. PMID: 24187459; PMCID: PMC3812483.
Bodmer NA, Thakrar KH. Evaluating the Patient with Left Lower Quadrant Abdominal Pain. Radiol Clin North Am. 2015 Nov;53(6):1171-88. doi: 10.1016/j.rcl.2015.06.005. Epub 2015 Aug 5. PMID: 26526432.
Q.
What are the potential causes of right flank pain?
A.
Right flank pain can be due to several causes including kidney stones, kidney infections, or muscle strains.
References:
Bueschen AJ. Flank Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 182.
https://www.ncbi.nlm.nih.gov/books/NBK292/
Feit L, John D, Delgado Torres N, Sinert R. Flank pain and hematuria is not always a kidney stone. Am J Emerg Med. 2021 Feb;40:225.e1-225.e2. doi: 10.1016/j.ajem.2020.07.046. Epub 2020 Jul 24. PMID: 32958382.
Patti L, Leslie SW. Acute Renal Colic. [Updated 2024 Dec 23]. In: StatPearls [Internet].
Q.
What are the potential causes of severe lower abdominal pain in females?
A.
Severe lower abdominal pain in females can stem from multiple causes, including problems with the reproductive organs, digestive system, or urinary tract. When pain is severe, it's essential to seek medical evaluation.
References:
Abdelhadi MS. Acute abdominal pain in women of child-bearing age remains a diagnostic dilemma. J Family Community Med. 2001 May;8(2):45-50. PMID: 23008643; PMCID: PMC3437059.
Franco PN, García-Baizán A, Aymerich M, Maino C, Frade-Santos S, Ippolito D, Otero-García M. Gynaecological Causes of Acute Pelvic Pain: Common and Not-So-Common Imaging Findings. Life (Basel). 2023 Oct 9;13(10):2025. doi: 10.3390/life13102025. PMID: 37895407; PMCID: PMC10608316.
Frasca DJ, Jarrio CE, Perdue J. Evaluation of Acute Pelvic Pain in Women. Am Fam Physician. 2023 Aug;108(2):175-180. PMID: 37590858.
Q.
What can cause sharp upper abdominal pain?
A.
Sharp upper abdominal pain can be caused by problems with organs like your stomach, gallbladder, liver, or pancreas, including inflammation, blockages, or infections.
References:
Sherman R. Abdominal Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 86. Available from: https://www.ncbi.nlm.nih.gov/books/NBK412/
Riley TR 3rd, Koch K. Characteristics of upper abdominal pain in those with chronic liver disease. Dig Dis Sci. 2003 Oct;48(10):1914-8. doi: 10.1023/a:1026149732756. PMID: 14627332.
Grigorian A, Lin MYC, de Virgilio C. Severe Epigastric Pain with Nausea and Vomiting. Surgery. 2019 May 3:227–37. doi: 10.1007/978-3-030-05387-1_20. PMCID: PMC7123429.
Q.
What could be causing a stomach ache and diarrhea?
A.
A stomach ache with diarrhea is commonly caused by a stomach bug (gastroenteritis) or another digestive issue.
References:
Gore JI, Surawicz C. Severe acute diarrhea. Gastroenterol Clin North Am. 2003 Dec;32(4):1249-67. doi: 10.1016/s0889-8553(03)00100-6. PMID: 14696306; PMCID: PMC7127018.
Graves NS. Acute gastroenteritis. Prim Care. 2013 Sep;40(3):727-41. doi: 10.1016/j.pop.2013.05.006. Epub 2013 Jul 19. PMID: 23958366; PMCID: PMC7119329.
Akhondi H, Goldin J, Simonsen KA. Bacterial Diarrhea. [Updated 2025 Jan 21]. In: StatPearls [Internet].
Q.
What could be causing stomach pain with fever but no diarrhea?
A.
Stomach pain with fever and without diarrhea may suggest infection of an organ other than the intestines. However, diarrhea can be absent in early phases of an intestinal infection.
References:
Keenan CR, Dhaliwal G, Henderson MC, Bowen JL. A 43-year-old woman with abdominal pain and fever. J Gen Intern Med. 2010 Aug;25(8):874-7. doi: 10.1007/s11606-010-1372-3. PMID: 20440575; PMCID: PMC2896582.
Jung YS. A Patient With Abdominal Pain and Fever. Intest Res. 2015 Jul;13(3):291-3. doi: 10.5217/ir.2015.13.3.291. Epub 2015 Jun 9. PMID: 26131006; PMCID: PMC4479746.
Sreh A, Rajaiah N, Saim M. Recurring Lower Abdominal Pain and Fever as Initial Presentation of Adult Onset Still's Disease in the Absence of Arthralgia and Other System Involvement. Eur J Case Rep Intern Med. 2017 May 9;4(6):000619. doi: 10.12890/2017_000619. PMID: 30755951; PMCID: PMC6346792.
Q.
What could be causing upper left abdominal pain after eating?
A.
Upper left abdominal pain after eating is most commonly related to digestive issues.
References:
Chuang TJ, Chen CW, Lin HY, Hsu WH, Wang SC, Tu CC. Acute appendicitis presenting as unusual left upper quadrant pain. Iran J Radiol. 2013 Sep;10(3):156-9. doi: 10.5812/iranjradiol.6326. Epub 2013 Aug 30. PMID: 24348602; PMCID: PMC3857979.
Aguilera-Lizarraga J. Gut reactions: emerging mechanisms of abdominal pain from food intake. Am J Physiol Gastrointest Liver Physiol. 2022 Nov 1;323(5):G401-G409. doi: 10.1152/ajpgi.00173.2022. Epub 2022 Sep 20. PMID: 36126222.
Staszewska A, Jarzumbek A, Saran A, Gierak-Firszt S, Kwiecien J. Postprandial Abdominal Pain Caused by Gastroptosis-A Case Report. Children (Basel). 2023 Jan 5;10(1):116. doi: 10.3390/children10010116. PMID: 36670666; PMCID: PMC9857050.
Q.
What could be causing upper right abdominal pain under the ribs?
A.
The pain under your upper right ribs can come from problems with your gallbladder, liver, or even from the muscles and bones near that area.
References:
Johnson CD. ABC of the upper gastrointestinal tract. Upper abdominal pain: Gall bladder. BMJ. 2001 Nov 17;323(7322):1170-3. doi: 10.1136/bmj.323.7322.1170. PMID: 11711412; PMCID: PMC1121646.
Loffeld RJ. Het zwevende-ribsyndroom: een veelal niet herkende oorzaak van pijnklachten [Painful rib syndrome: a cause of pain complaints that often goes unnoticed]. Ned Tijdschr Geneeskd. 2002 Sep 28;146(39):1813-5. Dutch. PMID: 12382362.
Cheyne G, Runau F, Lloyd DM. Right upper quadrant pain and raised alkaline phosphatase is not always a hepatobiliary problem. Ann R Coll Surg Engl. 2014 Jan;96(1):118E-120E. doi: 10.1308/003588414X13824511650092. PMID: 24417861; PMCID: PMC5137652.
Q.
What could be the cause of dull pain in the upper right abdomen?
A.
A dull pain in the upper right abdomen may be caused by issues involving the liver or gallbladder, but sometimes the pain may come from other problems.
References:
Rathgaber S, Rex DK. Right upper quadrant abdominal pain. Postgrad Med. 1993 Aug;94(2):153-161. doi: 10.1080/00325481.1993.11945700. PMID: 29206611.
Singh S, Jha AK, Sharma N, Mishra TS. A case of right upper abdominal pain misdiagnosed on computerized tomography. Malays J Med Sci. 2014 Jul;21(4):66-8. PMID: 25977626; PMCID: PMC4418118.
Cheyne G, Runau F, Lloyd DM. Right upper quadrant pain and raised alkaline phosphatase is not always a hepatobiliary problem. Ann R Coll Surg Engl. 2014 Jan;96(1):118E-120E. doi: 10.1308/003588414X13824511650092. PMID: 24417861; PMCID: PMC5137652.
Q.
What could be the cause of sharp lower left abdominal pain?
A.
Sharp pain in the lower left side of your belly might be caused by inflammation in the colon, such as diverticular disease, or less common conditions that affect that area.
References:
Abboud B, Daher R. An exceptional cause of left lower quadrant abdominal pain. World J Gastroenterol. 2009 Jul 21;15(27):3451. doi: 10.3748/wjg.15.3451. PMID: 19610153; PMCID: PMC2712913.
Tursi A, Elisei W, Picchio M, Giorgetti GM, Brandimarte G. Moderate to severe and prolonged left lower-abdominal pain is the best symptom characterizing symptomatic uncomplicated diverticular disease of the colon: a comparison with fecal calprotectin in clinical setting. J Clin Gastroenterol. 2015 Mar;49(3):218-21. doi: 10.1097/MCG.0000000000000094. PMID: 24583746.
Sim SS, Sun JT, Huang SY. Elderly Man With Left-Sided Abdominal Pain. J Acute Med. 2020 Dec 1;10(4):165-166. doi: 10.6705/j.jacme.202012_10(4).0007. PMID: 33489742; PMCID: PMC7814206.
Q.
What could be the causes of pain on the left side of my abdomen?
A.
Pain on the left side of your abdomen can be caused by a few things, such as problems with the colon like diverticular disease or sometimes even a rare case of left-sided appendicitis. It’s important to have a doctor check your symptoms to find the exact cause.
References:
Akbulut S, Ulku A, Senol A, Tas M, Yagmur Y. Left-sided appendicitis: review of 95 published cases and a case report. World J Gastroenterol. 2010 Nov 28;16(44):5598-602. doi: 10.3748/wjg.v16.i44.5598. PMID: 21105193; PMCID: PMC2992678.
Tursi A, Elisei W, Picchio M, Giorgetti GM, Brandimarte G. Moderate to severe and prolonged left lower-abdominal pain is the best symptom characterizing symptomatic uncomplicated diverticular disease of the colon: a comparison with fecal calprotectin in clinical setting. J Clin Gastroenterol. 2015 Mar;49(3):218-21. doi: 10.1097/MCG.0000000000000094. PMID: 24583746.
Sim SS, Sun JT, Huang SY. Elderly Man With Left-Sided Abdominal Pain. J Acute Med. 2020 Dec 1;10(4):165-166. doi: 10.6705/j.jacme.202012_10(4).0007. PMID: 33489742; PMCID: PMC7814206.
Q.
What could be the causes of severe abdominal pain and vomiting?
A.
Severe abdominal pain and vomiting may be caused by stomach and intestinal infections, pancreas or gallbladder inflammation, stomach ulcers, or an intestinal blockage.
References:
Sherman R. Abdominal Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 86. Available from: https://www.ncbi.nlm.nih.gov/books/NBK412/
Graves NS. Acute gastroenteritis. Prim Care. 2013 Sep;40(3):727-41. doi: 10.1016/j.pop.2013.05.006. Epub 2013 Jul 19. PMID: 23958366; PMCID: PMC7119329.
Grigorian A, Lin MYC, de Virgilio C. Severe Epigastric Pain with Nausea and Vomiting. Surgery. 2019 May 3:227–37. doi: 10.1007/978-3-030-05387-1_20. PMCID: PMC7123429.
Q.
What could cause left side abdominal pain with diarrhea?
A.
Left-side abdominal pain with diarrhea can be caused by issues in the colon, such as diverticulitis or epiploic appendagitis, and sometimes by infections like giardiasis.
References:
Updated 2021 Dec 28]. Available from: [https://www.ncbi.nlm.nih.gov/books/NBK507004/
https://www.ncbi.nlm.nih.gov/books/NBK507004/
Hwang JA, Kim SM, Song HJ, Lee YM, Moon KM, Moon CG, Koo HS, Song KH, Kim YS, Lee TH, Huh KC, Choi YW, Kang YW, Chung WS. Differential diagnosis of left-sided abdominal pain: primary epiploic appendagitis vs colonic diverticulitis. World J Gastroenterol. 2013 Oct 28;19(40):6842-8. doi: 10.3748/wjg.v19.i40.6842. PMID: 24187459; PMCID: PMC3812483.
Ali Q, Ahmed S, Aamer S, Iqbal N, Mamoon N. Giardiasis: An Overlooked Cause of Recurrent Abdominal Pain. Cureus. 2021 Sep 3;13(9):e17701. doi: 10.7759/cureus.17701. PMID: 34650875; PMCID: PMC8489658.
Q.
What could cause pain in the lower right abdomen near the hip bone in a pregnant female?
A.
In pregnancy, lower right abdominal pain near the hip bone can be related to changes in your muscles and joints or could be a sign of a more serious condition, like appendicitis.
References:
Rao H, Banerjee S, Jain N, Gupta R, Modi JN, Kapoor A, Biswas R. Hip pain in pregnancy. BMJ Case Rep. 2009;2009:bcr01.2009.1521. doi: 10.1136/bcr.01.2009.1521. Epub 2009 Sep 28. PMID: 21954400; PMCID: PMC3027389.
Zachariah SK, Fenn M, Jacob K, Arthungal SA, Zachariah SA. Management of acute abdomen in pregnancy: current perspectives. Int J Womens Health. 2019 Feb 8;11:119-134. doi: 10.2147/IJWH.S151501. PMID: 30804686; PMCID: PMC6371947.
Daume DL, Becker PM, Linke K, Ries JJ, Fourie L, Klasen JM. Differential diagnoses of right lower quadrant pain in late pregnancy. J Surg Case Rep. 2022 Jul 25;2022(7):rjac200. doi: 10.1093/jscr/rjac200. PMID: 35903664; PMCID: PMC9322997.
Q.
What could cause pain in your lower abdomen?
A.
Lower abdominal pain can happen for many reasons, from problems in your intestines or urinary system to issues with muscles or, in females, the reproductive organs.
References:
Sherman R. Abdominal Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 86. Available from: https://www.ncbi.nlm.nih.gov/books/NBK412/
Purysko AS, Remer EM, Filho HM, Bittencourt LK, Lima RV, Racy DJ. Beyond appendicitis: common and uncommon gastrointestinal causes of right lower quadrant abdominal pain at multidetector CT. Radiographics. 2011 Jul-Aug;31(4):927-47. doi: 10.1148/rg.314105065. PMID: 21768232.
Carlberg DJ, Lee SD, Dubin JS. Lower Abdominal Pain. Emerg Med Clin North Am. 2016 May;34(2):229-49. doi: 10.1016/j.emc.2015.12.003. PMID: 27133242.
Q.
What could cause severe abdominal pain after eating?
A.
Severe abdominal pain after eating can be caused by several conditions that affect the stomach, intestines, and nearby organs. The pain typically stems from inflammation or problems like gallstones.
References:
Grigorian A, Lin MYC, de Virgilio C. Severe Epigastric Pain with Nausea and Vomiting. Surgery. 2019 May 3:227–37. doi: 10.1007/978-3-030-05387-1_20. PMCID: PMC7123429.
Lukic S, Mijac D, Filipovic B, Sokic-Milutinovic A, Tomasevic R, Krstic M, Milosavljevic T. Chronic Abdominal Pain: Gastroenterologist Approach. Dig Dis. 2022;40(2):181-186. doi: 10.1159/000516977. Epub 2021 May 4. PMID: 33946069.
Aguilera-Lizarraga J. Gut reactions: emerging mechanisms of abdominal pain from food intake. Am J Physiol Gastrointest Liver Physiol. 2022 Nov 1;323(5):G401-G409. doi: 10.1152/ajpgi.00173.2022. Epub 2022 Sep 20. PMID: 36126222.
Q.
What could cause severe abdominal pain and diarrhea?
A.
Severe abdominal pain and diarrhea can be caused by infections in your gut, like gastroenteritis, or by other conditions that irritate your intestines.
References:
Graves NS. Acute gastroenteritis. Prim Care. 2013 Sep;40(3):727-41. doi: 10.1016/j.pop.2013.05.006. Epub 2013 Jul 19. PMID: 23958366; PMCID: PMC7119329.
Descoteaux-Friday GJ, Shrimanker I. Chronic Diarrhea. [Updated 2023 Aug 7]. In: StatPearls [Internet].
Updated 2022 Nov 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: [https://www.ncbi.nlm.nih.gov/books/NBK448082/
Q.
What could cause stomach cramps, diarrhea, sweating, and fainting?
A.
Stomach cramps, diarrhea, sweating, and fainting can be signs of conditions like low blood sugar after meals, the stomach emptying too quickly, or a vasovagal response.
References:
de Oliveira EP, Burini RC. Food-dependent, exercise-induced gastrointestinal distress. J Int Soc Sports Nutr. 2011 Sep 28;8:12. doi: 10.1186/1550-2783-8-12. PMID: 21955383; PMCID: PMC3190328.
Middleton SJ, Balan K. Post-prandial reactive hypoglycaemia and diarrhea caused by idiopathic accelerated gastric emptying: a case report. J Med Case Rep. 2011 May 13;5:177. doi: 10.1186/1752-1947-5-177. PMID: 21569503; PMCID: PMC3113993.
Wang J, Li H, Huang X, Hu H, Lian B, Zhang D, Wu J, Cao L. Adult vasovagal syncope with abdominal pain diagnosed by head-up tilt combined with transcranial doppler: a preliminary study. BMC Neurol. 2024 Apr 10;24(1):118. doi: 10.1186/s12883-024-03623-1. PMID: 38600450; PMCID: PMC11005138.
Q.
What could cause stomach pain and diarrhea shortly after eating?
A.
Stomach pain and diarrhea soon after eating has several possible causes including gastritis (stomach inflammation), infections, and food intolerances.
References:
Money ME, Camilleri M. Review: Management of postprandial diarrhea syndrome. Am J Med. 2012 Jun;125(6):538-44. doi: 10.1016/j.amjmed.2011.11.006. PMID: 22624684.
Graves NS. Acute gastroenteritis. Prim Care. 2013 Sep;40(3):727-41. doi: 10.1016/j.pop.2013.05.006. Epub 2013 Jul 19. PMID: 23958366; PMCID: PMC7119329.
Malone JC, Thavamani A. Physiology, Gastrocolic Reflex. [Updated 2023 May 1]. In: StatPearls [Internet].
Q.
What could cause stomach pain that comes and goes in waves with diarrhea?
A.
Stomach pain that comes in waves with diarrhea might be due to an infection in your gut or to diverticular disease, where parts of your colon become inflamed.
References:
Gore JI, Surawicz C. Severe acute diarrhea. Gastroenterol Clin North Am. 2003 Dec;32(4):1249-67. doi: 10.1016/s0889-8553(03)00100-6. PMID: 14696306; PMCID: PMC7127018.
InformedHealth.org](http://informedhealth.org/) [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Overview: Diverticular disease and diverticulitis. [Updated 2021 Dec 28]. Available from: [https://www.ncbi.nlm.nih.gov/books/NBK507004/
https://www.ncbi.nlm.nih.gov/books/NBK507004/
Descoteaux-Friday GJ, Shrimanker I. Chronic Diarrhea. [Updated 2023 Aug 7]. In: StatPearls [Internet].
Q.
What could cause upper stomach pain with diarrhea?
A.
Upper stomach pain with diarrhea is most often caused by an infection in your gut, such as gastroenteritis, or can be related to inflammation in the stomach and intestines.
References:
Sherman R. Abdominal Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 86. Available from: https://www.ncbi.nlm.nih.gov/books/NBK412/
Nemeth V, Pfleghaar N. Diarrhea. [Updated 2022 Nov 21]. In: StatPearls [Internet].
Patterson JW, Kashyap S, Dominique E. Acute Abdomen. [Updated 2023 Jul 10]. In: StatPearls [Internet].
Q.
What might be causing stomach and back pain with diarrhea?
A.
Stomach and back pain with diarrhea can be caused by infections in your gut, inflammation of organs like the pancreas, or even other infections that make your body feel unwell.
References:
Sherman R. Abdominal Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 86.
https://www.ncbi.nlm.nih.gov/books/NBK412/
Reisinger EC, Fritzsche C, Krause R, Krejs GJ. Diarrhea caused by primarily non-gastrointestinal infections. Nat Clin Pract Gastroenterol Hepatol. 2005 May;2(5):216-22. doi: 10.1038/ncpgasthep0167. PMID: 16265204; PMCID: PMC7097032.
Descoteaux-Friday GJ, Shrimanker I. Chronic Diarrhea. [Updated 2023 Aug 7]. In: StatPearls [Internet].
Q.
What might cause a stomach ache accompanied by a headache?
A.
A stomach ache with a headache can sometimes happen with migraines, and it might also be related to stress or other gut problems.
References:
Vaccaro M, Moschiano F. A woman with abdominal pain and headache. Neurol Sci. 2009 May;30 Suppl 1:S141-3. doi: 10.1007/s10072-009-0062-6. PMID: 19415446.
Cámara-Lemarroy CR, Rodriguez-Gutierrez R, Monreal-Robles R, Marfil-Rivera A. Gastrointestinal disorders associated with migraine: A comprehensive review. World J Gastroenterol. 2016 Sep 28;22(36):8149-60. doi: 10.3748/wjg.v22.i36.8149. PMID: 27688656; PMCID: PMC5037083.
Aurora SK, Shrewsbury SB, Ray S, Hindiyeh N, Nguyen L. A link between gastrointestinal disorders and migraine: Insights into the gut-brain connection. Headache. 2021 Apr;61(4):576-589. doi: 10.1111/head.14099. Epub 2021 Apr 1. PMID: 33793965; PMCID: PMC8251535.
Q.
What might cause left side pain under the ribs in females?
A.
In females, left side pain under the ribs can come from issues like slipping rib syndrome, intercostal neuralgia, or even Nutcracker syndrome, which affects blood vessels near the kidney.
References:
Berthelot JM, Douane F, Maugars Y, Frampas E. Nutcracker syndrome: A rare cause of left flank pain that can also manifest as unexplained pelvic pain. Joint Bone Spine. 2017 Oct;84(5):557-562. doi: 10.1016/j.jbspin.2016.10.006. Epub 2016 Dec 5. PMID: 27932281.
Mekhail FG, Montgomery JR, Spicer PJ. Slipping rib syndrome presentation in a young woman. Radiol Case Rep. 2022 Sep 17;17(11):4376-4378. doi: 10.1016/j.radcr.2022.08.076. PMID: 36188090; PMCID: PMC9520504.
Fazekas D, Doroshenko M, Horn DB. Intercostal Neuralgia. [Updated 2023 Aug 14]. In: StatPearls [Internet].
Q.
What might cause pain in the lower right abdomen after a hysterectomy?
A.
Pain in the lower right abdomen after a hysterectomy can come from a few causes, including nerve injury, scar tissue (adhesions), or other complications that might affect nearby organs.
References:
Brandsborg B, Nikolajsen L, Hansen CT, Kehlet H, Jensen TS. Risk factors for chronic pain after hysterectomy: a nationwide questionnaire and database study. Anesthesiology. 2007 May;106(5):1003-12. doi: 10.1097/01.anes.0000265161.39932.e8. PMID: 17457133.
Choi JB, Kang K, Song MK, Seok S, Kim YH, Kim JE. Pain Characteristics after Total Laparoscopic Hysterectomy. Int J Med Sci. 2016 Jul 5;13(8):562-8. doi: 10.7150/ijms.15875. PMID: 27499688; PMCID: PMC4974904.
Brandsborg B, Nikolajsen L. Chronic pain after hysterectomy. Curr Opin Anaesthesiol. 2018 Jun;31(3):268-273. doi: 10.1097/ACO.0000000000000586. PMID: 29474214.
Q.
What might cause pain in the lower right abdomen during orgasm?
A.
Pain in the lower right abdomen during orgasm may be caused by conditions such as endometriosis or other disorders. Medical evaluation is recommended if pain continues.
References:
Wang J, Packer CD. Acute abdominal pain after intercourse: adrenal hemorrhage as the first sign of metastatic lung cancer. Case Rep Med. 2014;2014:612036. doi: 10.1155/2014/612036. Epub 2014 Jul 13. PMID: 25126096; PMCID: PMC4122014.
Chiminacio I, Obrzut C, Saggin S. Post-orgasm pain associated with endometriosis and complete resolution of symptoms after laparoscopic en-bloc peritonectomy, a case report. Int J Surg Case Rep. 2023 Aug;109:108558. doi: 10.1016/j.ijscr.2023.108558. Epub 2023 Jul 20. PMID: 37517255; PMCID: PMC10400870.
Beerten SG, Coteur K. Dysorgasmia in women: Case report and preliminary assessment guide. Womens Health (Lond). 2024 Jan-Dec;20:17455057241267100. doi: 10.1177/17455057241267100. PMID: 39238206; PMCID: PMC11378201.
Q.
What might cause severe abdominal pain after sex?
A.
Severe abdominal pain after sex might be caused by internal injuries, bleeding, or other rare conditions that affect organs in the abdomen and pelvis. It’s important to get medical help if the pain is strong or lasts a long time.
References:
Toquero L, Gadd R, Owers CE, Simms JM. Post-coital haemoperitoneum: a downside to intercourse. Ann R Coll Surg Engl. 2012 Jan;94(1):e26-7. doi: 10.1308/003588412x13171221499586. PMID: 22524918; PMCID: PMC3954220.
Wang J, Packer CD. Acute abdominal pain after intercourse: adrenal hemorrhage as the first sign of metastatic lung cancer. Case Rep Med. 2014;2014:612036. doi: 10.1155/2014/612036. Epub 2014 Jul 13. PMID: 25126096; PMCID: PMC4122014.
Beerten SG, Coteur K. Dysorgasmia in women: Case report and preliminary assessment guide. Womens Health (Lond). 2024 Jan-Dec;20:17455057241267100. doi: 10.1177/17455057241267100. PMID: 39238206; PMCID: PMC11378201.
Q.
What might cause severe abdominal pain on the left side?
A.
Severe pain on the left side of your belly can come from many causes. Any severe pain that does not go away should be evaluated by a healthcare provider.
References:
Abboud B, Daher R. An exceptional cause of left lower quadrant abdominal pain. World J Gastroenterol. 2009 Jul 21;15(27):3451. doi: 10.3748/wjg.15.3451. PMID: 19610153; PMCID: PMC2712913.
Akbulut S, Ulku A, Senol A, Tas M, Yagmur Y. Left-sided appendicitis: review of 95 published cases and a case report. World J Gastroenterol. 2010 Nov 28;16(44):5598-602. doi: 10.3748/wjg.v16.i44.5598. PMID: 21105193; PMCID: PMC2992678.
Sim SS, Sun JT, Huang SY. Elderly Man With Left-Sided Abdominal Pain. J Acute Med. 2020 Dec 1;10(4):165-166. doi: 10.6705/j.jacme.202012_10(4).0007. PMID: 33489742; PMCID: PMC7814206.
Q.
What might cause sharp lower abdominal pain in females?
A.
Sharp lower abdominal pain in females can have several causes, ranging from gynecological issues like ovarian torsion or ectopic pregnancy to digestive problems such as appendicitis. It is important to seek medical care if the pain is severe or sudden.
References:
Hatipoglu S, Hatipoglu F, Abdullayev R. Acute right lower abdominal pain in women of reproductive age: clinical clues. World J Gastroenterol. 2014 Apr 14;20(14):4043-9. doi: 10.3748/wjg.v20.i14.4043. PMID: 24744594; PMCID: PMC3983461.
Jones B, Brzezinski WA, Estrada CA, Rodriguez M, Kraemer RR. A 22-year-old woman with abdominal pain. J Gen Intern Med. 2014 Jul;29(7):1074-8. doi: 10.1007/s11606-013-2747-z. Epub 2014 Jan 14. PMID: 24420866; PMCID: PMC4061356.
Franco PN, García-Baizán A, Aymerich M, Maino C, Frade-Santos S, Ippolito D, Otero-García M. Gynaecological Causes of Acute Pelvic Pain: Common and Not-So-Common Imaging Findings. Life (Basel). 2023 Oct 9;13(10):2025. doi: 10.3390/life13102025. PMID: 37895407; PMCID: PMC10608316.
Q.
What should I do if I experience upper right abdominal pain?
A.
If you experience upper right abdominal pain, monitor your symptoms carefully and seek medical attention—especially if the pain is severe, persistent, or accompanied by other concerning symptoms.
References:
Rathgaber S, Rex DK. Right upper quadrant abdominal pain. Postgrad Med. 1993 Aug;94(2):153-161. doi: 10.1080/00325481.1993.11945700. PMID: 29206611.
Johnson CD. ABC of the upper gastrointestinal tract. Upper abdominal pain: Gall bladder. BMJ. 2001 Nov 17;323(7322):1170-3. doi: 10.1136/bmj.323.7322.1170. PMID: 11711412; PMCID: PMC1121646.
Revzin MV, Scoutt LM, Garner JG, Moore CL. Right Upper Quadrant Pain: Ultrasound First! J Ultrasound Med. 2017 Oct;36(10):1975-1985. doi: 10.1002/jum.14274. Epub 2017 Jun 6. PMID: 28586152.
Q.
What should I do if my child has stomach pain with fever but no diarrhea?
A.
If your child has stomach pain with a fever but no diarrhea, it's important to watch them closely and talk to your doctor to make sure they get the right care.
References:
Updated 2022 Dec 9]. Available from: [https://www.ncbi.nlm.nih.gov/books/NBK279455/
https://www.ncbi.nlm.nih.gov/books/NBK279455/
Quek SH. Recurrent abdominal pain in children: a clinical approach. Singapore Med J. 2015 Mar;56(3):125-8; quiz 132. doi: 10.11622/smedj.2015038. PMID: 25820843; PMCID: PMC4371190.
Hartman S, Brown E, Loomis E, Russell HA. Gastroenteritis in Children. Am Fam Physician. 2019 Feb 1;99(3):159-165. Erratum in: Am Fam Physician. 2019 Jun 15;99(12):732. PMID: 30702253.
Q.
When should I be concerned about flank pain?
A.
Flank pain should be taken seriously if it comes with fever, blood in your urine, severe pain, or makes it hard to do daily things. It could mean there is an infection or another problem that needs attention.
References:
Bueschen AJ. Flank Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 182.
https://www.ncbi.nlm.nih.gov/books/NBK292/
Agarwal A, Litra F, Barr LL. A Rare Cause of Abdominal and Flank Pain in Children: Nutcracker Syndrome. Cureus. 2021 Jul 16;13(7):e16422. doi: 10.7759/cureus.16422. PMID: 34414047; PMCID: PMC8364742.
Belyayeva M, Leslie SW, Jeong JM. Acute Pyelonephritis. [Updated 2024 Feb 28]. In: StatPearls [Internet].
Q.
When should I be concerned about upper right abdominal pain?
A.
Seek medical attention for upper right abdominal pain if it becomes severe, worsens over time, or is accompanied by symptoms like fever, jaundice (yellowing of the skin or eyes), or difficulty breathing. These symptoms require urgent medical evaluation.
References:
Rathgaber S, Rex DK. Right upper quadrant abdominal pain. Postgrad Med. 1993 Aug;94(2):153-161. doi: 10.1080/00325481.1993.11945700. PMID: 29206611.
Gago R, Shum LM, Vilá LM. Right upper quadrant abdominal pain as the initial presentation of polyarteritis nodosa. BMJ Case Rep. 2017 Feb 22;2017:bcr2016218019. doi: 10.1136/bcr-2016-218019. PMID: 28228431; PMCID: PMC5337690.
Yew KS, George MK, Allred HB. Acute Abdominal Pain in Adults: Evaluation and Diagnosis. Am Fam Physician. 2023 Jun;107(6):585-596. PMID: 37327158.
Q.
When should I seek medical attention for severe abdominal pain?
A.
Seek medical help if your abdominal pain is severe, persists for several hours, or is accompanied by significant symptoms such as fever or vomiting.
References:
Sherman R. Abdominal Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 86.
https://www.ncbi.nlm.nih.gov/books/NBK412/
Guthrie E, Thompson D. Abdominal pain and functional gastrointestinal disorders. BMJ. 2002 Sep 28;325(7366):701-3. PMID: 12351366; PMCID: PMC1124226.
Yew KS, George MK, Allred HB. Acute Abdominal Pain in Adults: Evaluation and Diagnosis. Am Fam Physician. 2023 Jun;107(6):585-596. PMID: 37327158.
Q.
When should I worry about upper left abdominal pain?
A.
Seek medical attention for upper left abdominal pain if it's severe, persistent, or accompanied by concerning symptoms such as fever, dizziness, or difficulty breathing.
References:
Keenan CR, Dhaliwal G, Henderson MC, Bowen JL. A 43-year-old woman with abdominal pain and fever. J Gen Intern Med. 2010 Aug;25(8):874-7. doi: 10.1007/s11606-010-1372-3. PMID: 20440575; PMCID: PMC2896582.
Macaluso CR, McNamara RM. Evaluation and management of acute abdominal pain in the emergency department. Int J Gen Med. 2012;5:789-97. doi: 10.2147/IJGM.S25936. Epub 2012 Sep 26. PMID: 23055768; PMCID: PMC3468117.
Yew KS, George MK, Allred HB. Acute Abdominal Pain in Adults: Evaluation and Diagnosis. Am Fam Physician. 2023 Jun;107(6):585-596. PMID: 37327158.
Q.
Why am I experiencing abdominal pain but no period?
A.
Experiencing abdominal pain without having your period can be due to various reasons including hormonal changes, stress, or an underlying pelvic condition that may affect your menstrual cycle.
References:
Sherman R. Abdominal Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 86.
https://www.ncbi.nlm.nih.gov/books/NBK412/
Updated 2023 May 12]. Available from: [https://www.ncbi.nlm.nih.gov/books/NBK279324/
https://www.ncbi.nlm.nih.gov/books/NBK279324/
Nagy H, Carlson K, Khan MAB. Dysmenorrhea. [Updated 2023 Nov 12]. In: StatPearls [Internet].
Q.
Why do I experience lower abdominal pain after sex?
A.
Common causes of lower abdominal pain after sex can differ for men and women.
References:
Long WN. Pelvic Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 171.
https://www.ncbi.nlm.nih.gov/books/NBK280/
Wang J, Packer CD. Acute abdominal pain after intercourse: adrenal hemorrhage as the first sign of metastatic lung cancer. Case Rep Med. 2014;2014:612036. doi: 10.1155/2014/612036. Epub 2014 Jul 13. PMID: 25126096; PMCID: PMC4122014.
Siddiqui A, Belland L, Rivera-Reyes L, Handel D, Yadav K, Heard K, Eisenberg A, Hwang U. A Multicenter Evaluation of the Impact of Sex on Abdominal and Fracture Pain Care. Med Care. 2015 Nov;53(11):948-53. doi: 10.1097/MLR.0000000000000430. PMID: 26465122; PMCID: PMC4610254.
Q.
Why do I get a stomach ache after eating?
A.
Stomach aches after eating can happen for many reasons, such as problems with the digestive system, food intolerances, or even stress affecting the gut.
References:
Sato Y, Fukudo S. Gastrointestinal symptoms and disorders in patients with eating disorders. Clin J Gastroenterol. 2015 Oct;8(5):255-63. doi: 10.1007/s12328-015-0611-x. Epub 2015 Oct 26. PMID: 26499370.
Grigorian A, Lin MYC, de Virgilio C. Severe Epigastric Pain with Nausea and Vomiting. Surgery. 2019 May 3:227–37. doi: 10.1007/978-3-030-05387-1_20. PMCID: PMC7123429.
Adair T, Belz GT. When Eating Becomes a Pain in the Gut. Trends Immunol. 2021 Apr;42(4):273-275. doi: 10.1016/j.it.2021.02.008. Epub 2021 Mar 2. PMID: 33674226.
Q.
Why do I have a stomach ache every morning?
A.
Experiencing stomach aches every morning could be related to several factors including diet, lifestyle habits, and underlying medical conditions
References:
Sherman R. Abdominal Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 86.
https://www.ncbi.nlm.nih.gov/books/NBK412/
Mayer EA. Clinical practice. Irritable bowel syndrome. N Engl J Med. 2008 Apr 17;358(16):1692-9. doi: 10.1056/NEJMcp0801447. PMID: 18420501; PMCID: PMC3816529.
Vork L, Keszthelyi D, van Kuijk SMJ, Quetglas EG, Törnblom H, Simrén M, Aziz Q, Corsetti M, Tack J, Mujagic Z, Leue C, Kruimel JW, Masclee AAM. Patient-Specific Stress-Abdominal Pain Interaction in Irritable Bowel Syndrome: An Exploratory Experience Sampling Method Study. Clin Transl Gastroenterol. 2020 Jul;11(7):e00209. doi: 10.14309/ctg.0000000000000209. PMID: 32764210; PMCID: PMC7386351.
Q.
Why do I have lower abdominal pain?
A.
Lower abdominal pain can have many different causes including gastrointestinal, genitourinary, and other causes.
References:
Tursi A, Elisei W, Picchio M, Giorgetti GM, Brandimarte G. Moderate to severe and prolonged left lower-abdominal pain is the best symptom characterizing symptomatic uncomplicated diverticular disease of the colon: a comparison with fecal calprotectin in clinical setting. J Clin Gastroenterol. 2015 Mar;49(3):218-21. doi: 10.1097/MCG.0000000000000094. PMID: 24583746.
Carlberg DJ, Lee SD, Dubin JS. Lower Abdominal Pain. Emerg Med Clin North Am. 2016 May;34(2):229-49. doi: 10.1016/j.emc.2015.12.003. PMID: 27133242.
Perysinakis I, Vassalou EE. Non-traumatic lower abdominal pain: ultrasonographic and clinical differential diagnosis. Ultrasonography. 2024 Apr;43(2):151-168. doi: 10.14366/usg.23227. Epub 2024 Jan 27. PMID: 38443147; PMCID: PMC10915120.
Q.
Why do I have lower left abdominal pain?
A.
Lower left abdominal pain can be due to a number of causes including gastrointestinal, genitourinary, and musculoskeletal problems.
References:
Nelson MJ, Pesola GR. Left lower quadrant pain of unusual cause. J Emerg Med. 2001 Apr;20(3):241-5. doi: 10.1016/s0736-4679(00)00316-4. PMID: 11267811.
Hwang JA, Kim SM, Song HJ, Lee YM, Moon KM, Moon CG, Koo HS, Song KH, Kim YS, Lee TH, Huh KC, Choi YW, Kang YW, Chung WS. Differential diagnosis of left-sided abdominal pain: primary epiploic appendagitis vs colonic diverticulitis. World J Gastroenterol. 2013 Oct 28;19(40):6842-8. doi: 10.3748/wjg.v19.i40.6842. PMID: 24187459; PMCID: PMC3812483.
Bodmer NA, Thakrar KH. Evaluating the Patient with Left Lower Quadrant Abdominal Pain. Radiol Clin North Am. 2015 Nov;53(6):1171-88. doi: 10.1016/j.rcl.2015.06.005. Epub 2015 Aug 5. PMID: 26526432.
Q.
How can you differentiate kidney pain from other types of abdominal pain?
A.
Kidney pain is usually felt in your side or back, near or just below your ribs, and often comes in sharp bursts, unlike other types of belly pain.
References:
Sherman R. Abdominal Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 86.
https://www.ncbi.nlm.nih.gov/books/NBK412/
Cox C, MacDonald S, Henneberry R, Atkinson PR. My patient has abdominal and flank pain: Identifying renal causes. Ultrasound. 2015 Nov;23(4):242-50. doi: 10.1177/1742271X15601617. Epub 2015 Aug 17. PMID: 27433264; PMCID: PMC4760602.
Patti L, Leslie SW. Acute Renal Colic. [Updated 2024 Dec 23]. In: StatPearls [Internet].
Q.
Is it normal to experience abdominal pain?
A.
Abdominal pain is a common experience that can occur for lots of reasons, and in many cases, it is not a sign of a serious health problem.
References:
Macaluso CR, McNamara RM. Evaluation and management of acute abdominal pain in the emergency department. Int J Gen Med. 2012;5:789-97. doi: 10.2147/IJGM.S25936. Epub 2012 Sep 26. PMID: 23055768; PMCID: PMC3468117.
Mehta H. Abdominal Pain. Clinical Pathways in Emergency Medicine. 2016 Feb 22:329–45. doi: 10.1007/978-81-322-2710-6_26. PMCID: PMC7121692.
Lakhoo K, Almario CV, Khalil C, Spiegel BMR. Prevalence and Characteristics of Abdominal Pain in the United States. Clin Gastroenterol Hepatol. 2021 Sep;19(9):1864-1872.e5. doi: 10.1016/j.cgh.2020.06.065. Epub 2020 Jul 3. PMID: 32629129; PMCID: PMC7779743.
Q.
What are the potential causes of left lower abdominal pain in females?
A.
Left lower abdominal pain in females can have many causes, including issues with the ovaries or other parts of the reproductive system, as well as gastrointestinal problems like diverticulitis.
References:
Hammond NA, Nikolaidis P, Miller FH. Left lower-quadrant pain: guidelines from the American College of Radiology appropriateness criteria. Am Fam Physician. 2010 Oct 1;82(7):766-70. PMID: 20879699.
Yew KS, George MK, Allred HB. Acute Abdominal Pain in Adults: Evaluation and Diagnosis. Am Fam Physician. 2023 Jun;107(6):585-596. PMID: 37327158.
Franco PN, García-Baizán A, Aymerich M, Maino C, Frade-Santos S, Ippolito D, Otero-García M. Gynaecological Causes of Acute Pelvic Pain: Common and Not-So-Common Imaging Findings. Life (Basel). 2023 Oct 9;13(10):2025. doi: 10.3390/life13102025. PMID: 37895407; PMCID: PMC10608316.
Q.
What could be causing pain in my abdomen?
A.
Abdominal pain can be caused by many things such as problems with your digestive organs, urinary, or reproductive organs.
References:
Sherman R. Abdominal Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 86.
https://www.ncbi.nlm.nih.gov/books/NBK412/
Shian B, Larson ST. Abdominal Wall Pain: Clinical Evaluation, Differential Diagnosis, and Treatment. Am Fam Physician. 2018 Oct 1;98(7):429-436. PMID: 30252418.
Patterson JW, Kashyap S, Dominique E. Acute Abdomen. [Updated 2023 Jul 10]. In: StatPearls [Internet].
Q.
What could cause lower abdominal pain without a period?
A.
Lower abdominal pain when you're not on your period can be due to many causes including gynecologic or gastrointestinal conditions.
References:
Luscombe GM, Markham R, Judio M, Grigoriu A, Fraser IS. Abdominal bloating: an under-recognized endometriosis symptom. J Obstet Gynaecol Can. 2009 Dec;31(12):1159-71. doi: 10.1016/s1701-2163(16)34377-8. PMID: 20085682.
Heitkemper MM, Chang L. Do fluctuations in ovarian hormones affect gastrointestinal symptoms in women with irritable bowel syndrome? Gend Med. 2009;6 Suppl 2(Suppl 2):152-67. doi: 10.1016/j.genm.2009.03.004. PMID: 19406367; PMCID: PMC3322543.
Oladosu FA, Tu FF, Farhan S, Garrison EF, Steiner ND, Roth GE, Hellman KM. Abdominal skeletal muscle activity precedes spontaneous menstrual cramping pain in primary dysmenorrhea. Am J Obstet Gynecol. 2018 Jul;219(1):91.e1-91.e7. doi: 10.1016/j.ajog.2018.04.050. Epub 2018 May 5. PMID: 29733841; PMCID: PMC6741772.
Q.
What could cause pain in the lower right abdomen during intercourse?
A.
Pain in the lower right abdomen during intercourse can sometimes be caused by conditions like endometriosis or pelvic floor dysfunction.
References:
Mulari S, Mustonen M, Sotaniemi EA. Iron deficiency anemia, backache, and abdominal pain attacks during sexual intercourse in a 42-year-old woman. Scand J Gastroenterol. 1996 Jun;31(6):622-3. doi: 10.3109/00365529609009138. PMID: 8789904.
Wang J, Packer CD. Acute abdominal pain after intercourse: adrenal hemorrhage as the first sign of metastatic lung cancer. Case Rep Med. 2014;2014:612036. doi: 10.1155/2014/612036. Epub 2014 Jul 13. PMID: 25126096; PMCID: PMC4122014.
Lee GJ, Porreca F, Navratilova E. Prolactin and pain of endometriosis. Pharmacol Ther. 2023 Jul;247:108435. doi: 10.1016/j.pharmthera.2023.108435. Epub 2023 May 9. PMID: 37169264.
Q.
What could cause pain in the lower right abdomen when I cough?
A.
Pain in the lower right abdomen when coughing is most commonly a muscle strain.
References:
Gaude GS. Pulmonary manifestations of gastroesophageal reflux disease. Ann Thorac Med. 2009 Jul;4(3):115-23. doi: 10.4103/1817-1737.53347. PMID: 19641641; PMCID: PMC2714564.
Kodama K, Takase Y, Yamamoto H, Noda T. Cough-induced internal oblique hematoma. J Emerg Trauma Shock. 2013 Apr;6(2):132-4. doi: 10.4103/0974-2700.110789. PMID: 23723625; PMCID: PMC3665063.
Mostafavi M, Kamangar N. A 44-year-old man with abdominal pain, lung nodules, and hemoperitoneum. Chest. 2015 May;147(5):e181-e184. doi: 10.1378/chest.14-1735. PMID: 25940261.
Q.
What might cause pain in the lower right abdomen after peeing?
A.
Pain in the lower right abdomen after peeing can be caused by a urinary tract infection or, less commonly, muscle issues.
References:
Sherman R. Abdominal Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 86. Available from: https://www.ncbi.nlm.nih.gov/books/NBK412/
Car J. Urinary tract infections in women: diagnosis and management in primary care. BMJ. 2006 Jan 14;332(7533):94-7. doi: 10.1136/bmj.332.7533.94. PMID: 16410583; PMCID: PMC1326933.
Boulet S, Milliron ML, Lund KH. It's Not Always the Appendix: An Unusual Case of Right Lower Quadrant Pain in an Emergency Department Patient Due to Iliopsoas Bursitis From Uncommon Sleep Positioning. Cureus. 2022 Feb 15;14(2):e22251. doi: 10.7759/cureus.22251. PMID: 35186610; PMCID: PMC8849435.
Q.
What might cause pain in the lower right abdomen under the ribs?
A.
Pain in the lower right abdomen under the ribs may be due to issues with the gallbladder, liver, or other causes.
References:
Fradá G. Sulla sindrome dolorosa da costola fluttuante [The painful floating-rib syndrome]. Minerva Med. 1975 Aug 18;66(54):2679-89. Italian. PMID: 1153118.
Scott EM, Scott BB. Painful rib syndrome--a review of 76 cases. Gut. 1993 Jul;34(7):1006-8. doi: 10.1136/gut.34.7.1006. PMID: 8344569; PMCID: PMC1374244.
Laurin JM, DeSotel CK, Jorgensen RA, Dickson ER, Lindor KD. The natural history of abdominal pain associated with primary biliary cirrhosis. Am J Gastroenterol. 1994 Oct;89(10):1840-3. PMID: 7942679.
Q.
What might cause periodic abdominal pain?
A.
Periodic abdominal pain is commonly caused by issues with the digestive system but other causes are also possible.
References:
Marcoccia A, Zippi M, Bruni A, Salvatori FM, Badiali D, Donato G, Picarelli A. Chronic abdominal pain associated with intermittent compression of the celiac artery. Minerva Gastroenterol Dietol. 2007 Jun;53(2):209-13. PMID: 17557048.
McOmber ME, Shulman RJ. Recurrent abdominal pain and irritable bowel syndrome in children. Curr Opin Pediatr. 2007 Oct;19(5):581-5. doi: 10.1097/MOP.0b013e3282bf6ddc. PMID: 17885479; PMCID: PMC2831174.
Müller-Lissner S, Andresen V, Corsetti M, Bustos Fernández L, Forestier S, Pace F, Valdovinos MA. Functional Abdominal Cramping Pain: Expert Practical Guidance. J Clin Gastroenterol. 2022 Nov-Dec 01;56(10):844-852. doi: 10.1097/MCG.0000000000001764. Epub 2022 Sep 23. PMID: 36149666; PMCID: PMC9553264.
Q.
What might cause severe pain in the lower middle abdomen in females?
A.
Severe pain in the lower middle part of the belly in females can have different causes, such as problems with the gut, issues with the pelvic organs, or other causes.
References:
Cain KC, Headstrom P, Jarrett ME, Motzer SA, Park H, Burr RL, Surawicz CM, Heitkemper MM. Abdominal pain impacts quality of life in women with irritable bowel syndrome. Am J Gastroenterol. 2006 Jan;101(1):124-32. doi: 10.1111/j.1572-0241.2006.00404.x. PMID: 16405544.
Reddy J, Barber MD, Walters MD, Paraiso MF, Jelovsek JE. Lower abdominal and pelvic pain with advanced pelvic organ prolapse: a case-control study. Am J Obstet Gynecol. 2011 Jun;204(6):537.e1-5. doi: 10.1016/j.ajog.2011.01.015. Epub 2011 Feb 23. PMID: 21345412.
Higaki T, Urushidani S, Kuriyama A, Ikegami T. Mesosalpinx hernia of the sigmoid colon: A cause of lower abdominal pain in women. Clin Case Rep. 2020 Feb 26;8(5):855-857. doi: 10.1002/ccr3.2754. PMID: 32477533; PMCID: PMC7250968.
Q.
What should I consider if I have abdominal pain?
A.
When you have abdominal pain, it is important to consider where the pain is located, how long it lasts, its severity, and if any other symptoms accompany it. These details help in understanding what is triggering the pain and how best to treat it.
References:
Sherman R. Abdominal Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 86. Available from: https://www.ncbi.nlm.nih.gov/books/NBK412/?utm_source=chatgpt.com
Cartwright SL, Knudson MP. Evaluation of acute abdominal pain in adults. Am Fam Physician. 2008 Apr 1;77(7):971-8. PMID: 18441863.
Yew KS, George MK, Allred HB. Acute Abdominal Pain in Adults: Evaluation and Diagnosis. Am Fam Physician. 2023 Jun;107(6):585-596. PMID: 37327158.
Q.
Why do I have severe pain in my lower abdomen?
A.
Severe pain in your lower abdomen can come from many sources, including issues with reproductive organs or problems with your digestive system.
References:
Flock F, Sauer G. Gynäkologische Ursachen von Unterleibsschmerzen. Die wichtigsten Differenzialdiagnosen im Uberblick [Gynecological aspects of pain in the lower abdomen]. MMW Fortschr Med. 2004 May 6;146(19):38-41. German. PMID: 15357478.
Yew KS, George MK, Allred HB. Acute Abdominal Pain in Adults: Evaluation and Diagnosis. Am Fam Physician. 2023 Jun;107(6):585-596. PMID: 37327158.
Yew KS, George MK, Allred HB. Acute Abdominal Pain in Adults: Evaluation and Diagnosis. Am Fam Physician. 2023 Jun;107(6):585-596. PMID: 37327158.
Q.
Why do I keep experiencing abdominal pain?
A.
Abdominal pain can happen for many reasons, like problems related to digestion, underlying medical conditions, dietary habits, or even stress.
References:
Fields JM, Dean AJ. Systemic causes of abdominal pain. Emerg Med Clin North Am. 2011 May;29(2):195-210, vii. doi: 10.1016/j.emc.2011.01.011. PMID: 21515176.
Marsicano E, Vuong GM, Prather CM. Gastrointestinal causes of abdominal pain. Obstet Gynecol Clin North Am. 2014 Sep;41(3):465-89. doi: 10.1016/j.ogc.2014.06.002. PMID: 25155126.
Shian B, Larson ST. Abdominal Wall Pain: Clinical Evaluation, Differential Diagnosis, and Treatment. Am Fam Physician. 2018 Oct 1;98(7):429-436. PMID: 30252418.
Q.
Why might someone experience lower abdominal pain?
A.
Lower abdominal pain can be caused by many things, including problems with the digestive system, conditions affecting the reproductive organs, or other causes.
References:
Fayez JA, Toy NJ, Flanagan TM. The appendix as the cause of chronic lower abdominal pain. Am J Obstet Gynecol. 1995 Jan;172(1 Pt 1):122-3. doi: 10.1016/0002-9378(95)90097-7. PMID: 7847518.
Yew KS, George MK, Allred HB. Acute Abdominal Pain in Adults: Evaluation and Diagnosis. Am Fam Physician. 2023 Jun;107(6):585-596. PMID: 37327158.
Carlberg DJ, Lee SD, Dubin JS. Lower Abdominal Pain. Emerg Med Clin North Am. 2016 May;34(2):229-49. doi: 10.1016/j.emc.2015.12.003. PMID: 27133242.
Q.
What could cause both lower abdominal pain and back pain?
A.
When you feel pain in both your lower belly and your back, it may be because the same condition is affecting both areas, like the digestive system, urinary system, or musculoskeletal system.
References:
Smith MD, Russell A, Hodges PW. How common is back pain in women with gastrointestinal problems? Clin J Pain. 2008 Mar-Apr;24(3):199-203. doi: 10.1097/AJP.0b013e31815d3601. PMID: 18287824.
Paulson JD. Abdominal and urogenital diseases can often be the cause of lower back pain and sciatic-like symptoms. Pain Manag. 2012 May;2(3):279-94. doi: 10.2217/pmt.12.14. PMID: 24654670.
Yildizgoren MT, Ogut H, Kayali A, Turhanoglu AD. Abdominal Aortic Aneurysm as a Long Time Cause of Low Back Pain and Vertebral Scalloping. Pain Med. 2016 Feb;17(2):372-3. doi: 10.1111/pm/pme.12888. PMID: 26893462.
Q.
What could cause pain in the lower right abdomen when bending over?
A.
Pain in the lower right abdomen when bending over may be due to a muscle strain, back issues, or other issues.
References:
Sodhi JS, Zargar SA, Javid G, Khan MA, Khan BA, Yattoo GN, Shah A, Gulzar GM, Shoukat A. Effect of bending exercise on gastroesophageal reflux in symptomatic patients. Indian J Gastroenterol. 2008 Nov-Dec;27(6):227-31. PMID: 19405255.
Chen PR, Spetzler RF. Persistent lower abdominal pain induced by long peritoneal shunt catheter. Acta Neurochir (Wien). 2008 Aug;150(8):829-31; discussion 831. doi: 10.1007/s00701-008-1616-8. Epub 2008 Jun 23. PMID: 18574547.
Mabuchi H, Higuchi H, Imada T, Watari T. Unexplained Abdominal Pain Caused by Fracture of the Thoracic Vertebra. Am J Case Rep. 2022 Nov 2;23:e937740. doi: 10.12659/AJCR.937740. PMID: 36320141; PMCID: PMC9638903.
Q.
What could cause periodic abdominal pain on the right side?
A.
Periodic right-side abdominal pain can be due to a number of issues. The location of the pain and associated symptoms may be helpful in identifying the cause.
References:
Lin PH, Koffron AJ, Heilizer TJ, Lujan HJ. Right lower quadrant abdominal pain due to appendicitis and an incarcerated spigelian hernia. Am Surg. 2000 Aug;66(8):725-7. PMID: 10966026.
Jones J, Wong N, Drummond KJ, Kaye AH. An unusual cause for chronic right-sided abdominal pain: question. J Clin Neurosci. 2014 Dec;21(12):2226, 2259. doi: 10.1016/j.jocn.2014.04.012. PMID: 25580507.
Yew KS, George MK, Allred HB. Acute Abdominal Pain in Adults: Evaluation and Diagnosis. Am Fam Physician. 2023 Jun;107(6):585-596. PMID: 37327158.
Q.
What should I do if I have pain in my lower left abdomen?
A.
Left lower abdominal pain can come from several different causes, ranging from common issues with your digestive system to problems with your ovaries or other conditions.
References:
Greco S, Maconi G, Bareggi E, Radice E, Porro GB, Norsa A. An infrequent cause of acute left lower quadrant abdominal pain. Gut. 2008 May;57(5):567, 622. doi: 10.1136/gut.2006.119248. PMID: 18408096.
Siosaki MD, Costa MM, Figueiredo HF, da Silva Junior MF, da Silva Junior RA. A differential diagnosis in chronic lower abdominal pain. Int J Surg Case Rep. 2012;3(10):504-6. doi: 10.1016/j.ijscr.2012.06.005. Epub 2012 Jul 7. PMID: 22858791; PMCID: PMC3421139.
Yew KS, George MK, Allred HB. Acute Abdominal Pain in Adults: Evaluation and Diagnosis. Am Fam Physician. 2023 Jun;107(6):585-596. PMID: 37327158.
Q.
Why do I experience abdominal pain before my period?
A.
Abdominal pain before your period is common and usually happens because your body is getting ready for your monthly cycle, which involves changes in hormones and the uterus.
References:
Avant RF. Dysmenorrhea. Prim Care. 1988 Sep;15(3):549-59. PMID: 3054962.
Gudipally PR, Sharma GK. Premenstrual Syndrome. 2023 Jul 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 32809533.
Velho RV, Werner F, Mechsner S. Endo Belly: What Is It and Why Does It Happen?-A Narrative Review. J Clin Med. 2023 Nov 19;12(22):7176. doi: 10.3390/jcm12227176. PMID: 38002788; PMCID: PMC10671958.
Q.
Why do I have left lower abdominal pain?
A.
Lower left abdominal pain can be caused by many things, including gut issues, issues with the ovaries, or other conditions.
References:
Hwang JA, Kim SM, Song HJ, Lee YM, Moon KM, Moon CG, Koo HS, Song KH, Kim YS, Lee TH, Huh KC, Choi YW, Kang YW, Chung WS. Differential diagnosis of left-sided abdominal pain: primary epiploic appendagitis vs colonic diverticulitis. World J Gastroenterol. 2013 Oct 28;19(40):6842-8. doi: 10.3748/wjg.v19.i40.6842. PMID: 24187459; PMCID: PMC3812483.
Bodmer NA, Thakrar KH. Evaluating the Patient with Left Lower Quadrant Abdominal Pain. Radiol Clin North Am. 2015 Nov;53(6):1171-88. doi: 10.1016/j.rcl.2015.06.005. Epub 2015 Aug 5. PMID: 26526432.
Tursi A, Elisei W, Picchio M, Giorgetti GM, Brandimarte G. Moderate to severe and prolonged left lower-abdominal pain is the best symptom characterizing symptomatic uncomplicated diverticular disease of the colon: a comparison with fecal calprotectin in clinical setting. J Clin Gastroenterol. 2015 Mar;49(3):218-21. doi: 10.1097/MCG.0000000000000094. PMID: 24583746.
Q.
What are the possible causes of abdominal pain?
A.
Causes of abdominal pain run the gamut from benign to life-threatening. It may be a pulled or strained abdominal wall muscle, damaged nerve, broken bone or issues with internal organs.
References:
Govender I, Rangiah S, Bongongo T, Mahuma P. A Primary Care Approach to Abdominal Pain in Adults. S Afr Fam Pract (2004). 2021 Mar 10;63(1):e1-e5. doi: 10.4102/safp.v63i1.5280. PMID: 33764143; PMCID: PMC8378095.
Yew KS, George MK, Allred HB. Acute Abdominal Pain in Adults: Evaluation and Diagnosis. Am Fam Physician. 2023 Jun;107(6):585-596. PMID: 37327158.
Q.
What are the possible causes of stomach ache when lying down on your back facing up?
A.
Stomach pain in the back when lying down facing up can be a result of stomach gas/bloating, positional discomfort or less commonly a disease of the pancreas and surrounding organs.
References:
Sherman R. Abdominal Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 86.
https://www.ncbi.nlm.nih.gov/books/NBK412/
Mealie CA, Ali R, Manthey DE. Abdominal Examination. [Updated 2024 May 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.
Q.
When I feel pain in the left side of the abdomen, what are some possible causes?
A.
A wide ranges of diseases can cause left-sided abdominal pain that often involve the underlying organs in that area.
References:
Yew KS, George MK, Allred HB. Acute Abdominal Pain in Adults: Evaluation and Diagnosis. Am Fam Physician. 2023 Jun;107(6):585-596. PMID: 37327158.
Sabo CM, Grad S, Dumitrascu DL. Chronic Abdominal Pain in General Practice. Dig Dis. 2021;39(6):606-614. doi: 10.1159/000515433. Epub 2021 Feb 25. PMID: 33631744.
Q.
When should I see a doctor for an upset stomach?
A.
Generally, you should see a doctor if you are: 1. Unable to keep any liquids down for more than a day at a time 2. Develop fevers and intensely worsening abdominal pain 3. Notice blood in your stools or vomit.
References:
Viniol A, Keunecke C, Biroga T, Stadje R, Dornieden K, Bösner S, Donner-Banzhoff N, Haasenritter J, Becker A. Studies of the symptom abdominal pain--a systematic review and meta-analysis. Fam Pract. 2014 Oct;31(5):517-29. doi: 10.1093/fampra/cmu036. Epub 2014 Jul 1. PMID: 24987023.
Q.
How can daily habits improve an upset stomach?
A.
Eat in moderation, avoid heavy drinking and exercise moderately.
References:
Rinninella E, Cintoni M, Raoul P, Lopetuso LR, Scaldaferri F, Pulcini G, Miggiano GAD, Gasbarrini A, Mele MC. Food Components and Dietary Habits: Keys for a Healthy Gut Microbiota Composition. Nutrients. 2019 Oct 7;11(10):2393. doi: 10.3390/nu11102393. PMID: 31591348; PMCID: PMC6835969.
Garcidueñas-Fimbres TE, Paz-Graniel I, Nishi SK, Salas-Salvadó J, Babio N. Eating Speed, Eating Frequency, and Their Relationships with Diet Quality, Adiposity, and Metabolic Syndrome, or Its Components. Nutrients. 2021 May 15;13(5):1687. doi: 10.3390/nu13051687. PMID: 34063439; PMCID: PMC8156274.
Clauss M, Gérard P, Mosca A, Leclerc M. Interplay Between Exercise and Gut Microbiome in the Context of Human Health and Performance. Front Nutr. 2021 Jun 10;8:637010. doi: 10.3389/fnut.2021.637010. PMID: 34179053; PMCID: PMC8222532.
Q.
What are the possible causes of an upset stomach?
A.
Commonly, an upset stomach is caused by gas or bloating from benign causes like poor digestion of certain foods or additives.
References:
Hasler WL. Gas and Bloating. Gastroenterol Hepatol (N Y). 2006 Sep;2(9):654-662. PMID: 28316536; PMCID: PMC5350578.
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Sherman R. Abdominal Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 86. Available from: https://www.ncbi.nlm.nih.gov/books/NBK412/
https://www.ncbi.nlm.nih.gov/books/NBK412/