Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps
Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.
Almost everyone experiences pain in the abdomen at one time or another. Most of the time, it is not caused by a serious medical problem.
There are many organs in the abdomen. Pain in the abdomen can originate from any one of them, including:
However, the pain may start from somewhere else -- like your chest or pelvic area. You may also have a generalized infection, such as the flu or strep throat, that affects many parts of your body.
The intensity of the pain does not always reflect the seriousness of the condition causing the pain. Severe abdominal pain can be from mild conditions, such as gas or the cramping of viral gastroenteritis. On the other hand, relatively mild pain or no pain may be present with life-threatening conditions, such as cancer of the colon or early appendicitis.
Other ways of describing pain in your abdomen include:
Many different conditions can cause abdominal pain. The key is to know when you must seek medical care right away. In many cases you can simply wait, use home care remedies, and call your doctor at a later time only if the symptoms persist.
Possible causes include:
When an inflamed organ (such as the appendix) in the abdomen ruptures or leaks fluid, the pain is not only excruciating, but the abdomen becomes stiff and very tender to the touch. There is also a fever. This occurs as peritonitis (inflammation and infection of the lining of the abdominal cavity) develops and spreads from the site of the rupture. This is a medical emergency.
In infants, prolonged unexplained crying (often called "colic") may be caused by abdominal pain that may end with the passage of gas or stool. Colic is often worse in the evening. Cuddling and rocking the child may bring some relief.
Abdominal pain that occurs during menstruation may be from menstrual cramps or it may indicate a problem in a reproductive organ. This includes conditions such as endometriosis (when tissue from the uterus is displaced to somewhere else like the pelvic wall or ovaries), or pelvic inflammatory disease (PID) (infection of the reproductive organs, usually from a sexually transmitted disease). An ectopic pregnancy, or a pregnancy outside the normal location in the uterus, may mimic menstrual cramping and bleeding. However, symptoms are usually more intense than those usually experienced during a menstrual period.
Abdominal pain may actually be caused by an organ in the chest, like the lungs (for example, pneumonia) or the heart (like a heart attack). Or, it may stem from a muscle strain in the abdominal muscles.
Cancers of the colon and other gastrointestinal areas are serious but uncommon causes of abdominal pain.
Other more unusual causes of abdominal pain include a type of emotional upset called somatization disorder, reflected as physical discomfort (including recurrent abdominal pain). Strep throat in children can cause abdominal pain.
Sickle cell disease crisis may cause abdominal pain. It sometimes may be mistaken for the pain of appendicitis or conditions of other abdominal organs.
Shingles (an infection of the nerves associated with a skin rash, which is caused by the chicken pox virus) may cause pain in the abdomen. However, because the rash comes several days after the start of the pain, it can be mistaken for appendicitis or other conditions of the abdominal organs.
For mild pains:
Seek immediate medical help or call your local emergency number (such as 911) if you:
Call your doctor if you have:
From your medical history and physical examination, your doctor will try to determine the cause of your abdominal pain. Knowing the location of pain and its time pattern will help, as will the presence of other symptoms like fever, fatigue, general ill feeling, nausea, vomiting, or changes in stool.
During the physical examination, the doctor will test to see if the pain is localized to a single area (point tenderness) or whether it is diffuse. He or she will be checking to see if the pain is related to inflammation of the peritoneum (called peritonitis). If the health care provider finds evidence of peritonitis, the abdominal pain may be classified as an "acute abdomen," which may require surgery right away.
Your doctor may ask the following questions about your abdominal pain:
Diagnostic tests that may be performed include:
For prevention of many types of abdominal pain:
For prevention of symptoms from heartburn or gastroesophageal reflux disease:
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Ohge H. Levitt MD. Intestinal Gas. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: WB Saunders; 2006: Chap. 10.
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