Abdominal pain

Abdominal pain means discomfort anywhere between your lower ribs and groin. You may call it stomach ache or tummy ache, although the pain can come from organs other than the stomach.

The abdomen contains the stomach, bowel, liver, gallbladder, pancreas, kidneys, bladder, and reproductive organs. Muscles and nerves can also cause pain in this area. Occasionally, pain from the chest, back, or pelvis is felt in the abdomen.

Most abdominal pain is short-lived and is related to digestion. However, the location and strength of pain do not always show how serious the cause is. Pay attention to how the pain changes and whether you have other symptoms.

Abdominal pain can be dull, burning, sharp, or sore. It may feel like pressure, bloating, or cramps that come in waves. It can stay in one place, move, or spread into your back, shoulder, chest, or groin.

The pattern may provide useful clues. Pain might appear after eating, improve after a bowel movement, or occur around a menstrual period. It may come on suddenly or build over several hours.

Other symptoms can include:

• Bloating, burping, nausea, vomiting, or reduced appetite
• Diarrhoea, constipation, or a change in stool
• Fever, painful urination, or blood in urine
• Vaginal bleeding or discharge
• A swollen or unusually firm abdomen

These features can have many causes. They do not confirm a diagnosis on their own.

Common digestive causes include trapped gas, indigestion, constipation, and a stomach or bowel infection. A bowel infection, sometimes called gastroenteritis, often causes cramps with diarrhoea, nausea, or vomiting.

Irritable bowel syndrome can cause recurring pain linked with constipation, diarrhoea, or both. Menstrual cramps are another common cause of lower abdominal pain.

Less common causes include stomach ulcers, gallstones, kidney stones, urinary infections, coeliac disease, inflammatory bowel disease, hernias, endometriosis, and ovarian cysts. Muscle strain can cause pain after lifting, exercise, or prolonged coughing.

Causes needing urgent assessment include appendicitis, inflammation of the gallbladder or pancreas, a blocked or perforated bowel, and internal bleeding. Pregnancy-related problems, including an ectopic pregnancy outside the uterus, can also cause urgent abdominal pain. Sudden testicular or ovarian pain may be felt in the lower abdomen and needs prompt assessment.

You cannot reliably identify these conditions from pain location alone.

Call emergency services or go to an emergency department if abdominal pain is severe or sudden, particularly if you also:

• Faint, feel very weak, become confused, or have trouble breathing
• Have chest pressure or pain spreading to your chest, jaw, or arm
• Vomit blood or material resembling coffee grounds
• Pass black, tar-like stool or a large amount of blood
• Have a rigid, very swollen, or extremely tender abdomen
• Cannot pass stool or gas and have swelling with vomiting
• Could be pregnant and have severe pain, heavy bleeding, or faintness

Seek same-day medical advice if the pain is worsening or comes with fever, repeated vomiting, dehydration, yellow skin or eyes, blood in urine or stool, or difficulty urinating. You should also seek prompt advice for persistent one-sided pain or bleeding during pregnancy.

Book a routine appointment if pain lasts several days, keeps returning, wakes you regularly, affects eating or daily activities, or comes with unexplained weight loss or a lasting change in bowel habits.

Young children, older adults, and people with weakened immune systems may show less typical symptoms. If you are concerned that someone is becoming more unwell, seek advice.

A healthcare professional will ask where the pain started, whether it moved, and what makes it better or worse. They may ask about meals, bowel movements, urination, medicines, alcohol use, menstrual periods, previous surgery, and the possibility of pregnancy.

They may examine your abdomen by listening and gently pressing different areas. Depending on your symptoms, tests might include urine, blood, or stool tests. A pregnancy test may be offered when relevant.

Ultrasound, CT, or another scan may be used if the examination suggests a problem with an organ or a blockage. Many mild, improving episodes do not need imaging.

Treatment depends on the cause. A bowel infection may mainly need fluids and rest, while problems such as appendicitis, gallstones, or a urinary infection may need specific medical treatment.

For mild pain without warning signs, you can try:

• Resting and drinking small, frequent amounts of fluid
• Eating smaller meals if you feel able
• Using gentle warmth for cramps
• Noting food, bowel, urinary, or menstrual patterns

A pharmacist can advise whether an antacid, constipation treatment, or nonprescription pain medicine is suitable. Follow the product label and avoid taking several products containing the same ingredient.

Do not start laxatives for severe, unexplained pain, especially if you are vomiting or cannot pass gas. Anti-inflammatory medicines such as ibuprofen or naproxen can irritate the stomach and may worsen ulcers or bleeding, so ask for advice before using them for unexplained abdominal pain.

Pain from gas, indigestion, or a minor bowel infection often improves within hours or a few days. Constipation-related discomfort may improve after bowel movements return to normal.

If pain does not follow this pattern, keeps returning, or new symptoms appear, arrange medical review. Even after an initial assessment, seek further help if the pain becomes stronger or your overall condition worsens.

Does the location show the cause?

It can provide clues, but it is not exact. For example, appendicitis pain may begin near the middle before moving to the lower right, but not everyone has this pattern. Gallbladder, kidney, bowel, and reproductive-organ pain can also overlap.

Can stress cause abdominal pain?

Stress can affect how the gut moves and how strongly you feel digestive sensations. It may worsen indigestion or irritable bowel symptoms. New or persistent pain should not automatically be attributed to stress.

Should I stop eating?

You do not usually need to fast for mild pain. Try small amounts of food and fluid if you feel able. If vomiting prevents you from keeping fluids down, seek medical advice.

What information should I track?

Note when the pain began, its location, meals, bowel movements, urination, menstrual timing, medicines, and any fever or vomiting. This can help during an appointment.