Abdominal Pain

What is abdominal pain?

Abdominal pain is discomfort felt anywhere between the chest and the groin. Almost everyone experiences it at some point, and in most cases it settles within a few hours without any specific diagnosis being made. The abdomen holds many organs, so the same sensation can come from the gut, the liver and gallbladder, the kidneys, the reproductive organs, or occasionally from the heart or lungs. Because of that range, the useful clinical questions are where the pain sits, how quickly it came on, what it feels like, and what else is happening alongside it.

Causes

• No identifiable cause, which is the most common outcome
• Indigestion, trapped wind and constipation
• Gastroenteritis and food poisoning
• Irritable bowel syndrome
• Acid reflux and peptic ulcers
• Gallstones, appendicitis, diverticulitis and pancreatitis
• Urinary tract infection and kidney stones
• Period pain, endometriosis and ovarian cysts
• Anxiety and panic, which produce genuine physical pain

Symptoms

• Cramping pain that comes and goes in waves
• Constant dull ache or pressure
• Sharp localised pain in one area
• Bloating and a feeling of fullness
• Nausea or vomiting
• Diarrhoea or constipation
• Pain that changes with eating, movement or passing stool
• Pain that wakes you from sleep

Risk factors

• Diet high in fat, alcohol or foods you tolerate poorly
• Irregular eating and low fibre intake
• High stress or anxiety
• Regular use of anti inflammatory painkillers
• Previous abdominal surgery causing adhesions
• Existing digestive, gynaecological or urinary conditions

Diagnosis

• History covering site, onset, character, radiation and timing
• Abdominal examination for tenderness, guarding and masses
• Urine dipstick, and a pregnancy test where relevant
• Blood tests including full blood count, inflammatory markers, liver and kidney function
• Ultrasound as the usual first line imaging
• CT scan for suspected acute surgical causes
• Endoscopy or colonoscopy when the pattern suggests it

Treatment

• Treating the underlying cause once identified, which resolves most cases
• Simple analgesia, usually paracetamol first
• Antacids or acid suppression for reflux and indigestion
• Laxatives for constipation, or antispasmodics for cramping
• Rehydration for pain accompanying vomiting or diarrhoea
• Antibiotics only where a bacterial infection is confirmed
• Surgery for causes such as appendicitis, obstruction or gallstones
• Dietary and stress based management for functional pain

Self care

• Rest and let the pain settle rather than pushing through it
• Sip fluids steadily, especially if there is vomiting or diarrhoea
• Eat small, plain, low fat meals as appetite returns
• Try a covered warm compress or hot water bottle on the abdomen
• Gentle walking, which helps trapped wind and constipation
• Paracetamol for pain, avoiding anti inflammatories if the stomach is irritated
• Keep a short diary of foods, timing and symptoms if pain recurs
• Reduce alcohol and caffeine while symptoms settle

When to see a doctor

Book an appointment if:

• The pain lasts more than a few days or keeps coming back
• It steadily worsens rather than easing
• You are losing weight without trying
• Your bowel habit has changed and stayed changed
• You are over 50 with new abdominal pain
• Swallowing is painful or difficult
• You feel a lump in the abdomen
• Pain regularly wakes you at night

Some symptoms need emergency care rather than an appointment. See the warning signs listed above.

Prevention

• Eat regular balanced meals with enough fibre and fluid
• Identify and limit foods that reliably upset you
• Limit alcohol and stop smoking
• Stay physically active, which supports normal bowel function
• Manage stress, since the gut and brain are closely linked
• Use anti inflammatory painkillers sparingly and with food
• Treat known conditions such as reflux or constipation consistently

Outlook

Most abdominal pain is short lived and settles within hours to a couple of days without treatment or a specific diagnosis. Where a cause is found it is usually treatable, and conditions such as constipation, indigestion and infection resolve fully. Pain that recurs over months without an identified cause is often functional, meaning the gut is working normally but signalling pain more readily, and this responds to dietary changes, stress management and targeted treatment rather than repeated scans.

Related conditions

Common questions