Causes of Abdominal Pain

Most abdominal pain is linked to common problems such as emotional distress, overeating, or the flu. However, it can also point to more serious illness. The type and location of the pain often gives a clue to its cause.

Appendicitis

Pain that starts at the navel and moves to the lower right side of the abdomen can signal appendicitis, an inflammation of the appendix. Other symptoms of appendicitis can include:

• Nausea, vomiting, or loss of appetite
• Tenderness in the lower right side of abdomen
• Inability to walk upright
• Fever ranging from 100 to 102°F

If it is detected early, mild appendicitis can sometimes be treated with antibiotics. More serious cases require surgery to remove the appendix. If left untreated, appendicitis can cause the appendix to burst. If you have any symptoms of this condition, you should talk to your doctor immediately.

Diverticulitis

Pain in the lower left-hand side of the abdomen could be a sign of diverticulitis. Diverticulitis occurs when small, balloonlike sacs called diverticula develop in the walls of the colon and become infected and inflamed. Other symptoms of diverticulitis include fever, nausea, vomiting, chills, cramping, and constipation.

Treatment of diverticulitis usually includes clearing up the infection and inflammation, resting the colon, and preventing or minimizing complications. Your doctor may give you antibiotics and recommend a pain reliever, a diet of only liquids, and several days of bed rest. In some cases, diverticulitis may require a hospital stay. If complications develop, surgery may be needed.

The best way to prevent diverticulitis is to eat a high-fiber diet. The fiber in foods such as vegetables and whole grains aids in digestion and helps reduce pressure in the colon. As you add fiber, it is important to do it gradually (to prevent gas, bloating, and cramps) and to drink plenty of liquids. You can also help prevent diverticulitis by having bowel movements when you feel the urge to do so. Putting it off can increase pressure in the colon.

Gallbladder Disease

Sharp pain under the right rib cage that worsens after eating points to gallbladder disease. Types of gallbladder disease include gallstones and inflammation of the gallbladder.

If complications develop, gallbladder disease can cause other symptoms along with the abdominal pain. These include jaundice (yellowing of the skin and the whites of the eyes), high fever, and chills. Sometimes people with gallstones do not experience any symptoms at all.

Gallstones and attacks of gallbladder pain may be managed in a variety of ways, ranging from “watchful waiting” (watching the symptoms over time with no treatment) to medications to surgery. A person who has had gallstone pain only once may not need surgery or medications, because in some cases the condition does not recur. However, for those who have more persistent or frequent attacks, removal of the gallbladder is recommended. Reducing fat in the diet can also help reduce the symptoms caused by gallbladder disease.

Irritable Bowel Syndrome

Abdominal pain that is relieved by bowel movements and is accompanied by diarrhea or constipation may mean irritable bowel syndrome. Irritable bowel syndrome is a common disorder of the intestine that has no known cause. When irritable bowel syndrome occurs, the walls of the intestine are contracting too forcefully, too weakly, too slowly, or too rapidly. Other symptoms of irritable bowel syndrome include bloating, gas, mucus-covered stools, and a strong urge to have a bowel movement after you have already had one.

Irritable bowel syndrome cannot be treated with surgery or medication. However, you can take steps to help prevent the symptoms from getting worse.

• Drink plenty of water.
• Gradually increase your fiber intake by eating more high-fiber foods, such as fruits, vegetables, and whole grains, or by taking bulk laxatives containing psyllium.
• Keep a diary of what you eat to identify foods that make you feel worse. Avoid these foods and others that cause gas, such as onions, broccoli, cabbage, and beans. You may also want to avoid chocolate, milk products, and large amounts of alcohol because they may cause spasms and delay passage of stools.
• Limit caffeine, which can cause diarrhea.
• Get plenty of exercise. Physical activity reduces stress and aids digestion.
• Follow self-care steps to manage stress.

Ulcers

A sharp, burning pain in the upper middle part of your stomach (between the breastbone and the navel) could be an ulcer. An ulcer is a sore that forms in the lining of the stomach or the upper part of the small intestine. Ulcers can develop for many reasons. Smoking cigarettes and using aspirin, ibuprofen, or other nonsteroidal anti-inflammatory medication may play a role. Ulcers can also form when the stomach cannot protect itself from powerful digestive fluids. Helicobacter pylori, a bacteria found in the stomach, can also lead to an ulcer. Contrary to popular belief, emotional stress or spicy foods do not cause ulcers.

Heartburn alone is not a sign of an ulcer. Intense, heartburnlike pain could also be caused by a less serious condition called gastroesophageal reflux disease.

In the past, people with ulcers were told to avoid spicy, fatty, or acidic foods. However, eating a bland diet is no longer thought to be effective in treating or preventing ulcers. Today ulcers are usually treated with medications. Because smoking can prevent ulcers from healing, people with ulcers should not smoke.

Conditions of the Reproductive System

In women, abdominal discomfort may signal a problem with the reproductive system. Pelvic pain that occurs each month just before a woman’s period suggests endometriosis. Tenderness in the lower abdominal area may mean pelvic inflammatory disease. For women of childbearing age, an ectopic pregnancy can produce a sudden sharp, stabbing abdominal pain along with vaginal bleeding, a history of missed or light periods, or pain radiating to the shoulder. Ovarian cysts and uterine fibroids can also cause abdominal pain in women.

Other conditions that can cause abdominal pain include urinary tract infections, food poisoning, food allergy, hernia, kidney stones, and lactose intolerance.

Treating Abdominal Pain

Abdominal pain is difficult to diagnose because it can mean so many things. To determine the cause of your pain, your doctor may ask you these questions:

• What type of pain is it? (Is it crampy, sharp, or dull? Is it steady or is it off and on?)
• Where is the pain?
• When did it begin? How long does it last?
• How severe is the pain?
• When does it occur? (Does it occur with your period? Does it become worse after eating?)

By taking time to think about answers to these questions, you can help your doctor to diagnose the problem. The type of treatment will depend on the cause of the abdominal pain.

Caring for Abdominal Pain

Mild abdominal pain that is not caused by ulcers, diverticulitis, or gallbladder disease can usually be treated at home. Follow these steps:

• Rest as needed.
• Use acetaminophen for pain relief. Do not use aspirin or anti-inflammatory medications, such as ibuprofen.
• Avoid things that irritate the lining of the stomach, such as alcohol, caffeine, aspirin, and ibuprofen.
• Do not use laxatives or enemas.
• Take warm baths or apply a warm water bottle to the area to ease pain.