Abdominal problems

What causes abdominal pain?

Most abdominal pain are not anything serious. Common causes include:

• trapped wind
• indigestion, heartburn or acid reflux
• constipation
• a stomach bug or food poisoning
• a food intolerance, such as difficulty digesting lactose.

Pain can also come from inflammation or infection affecting an organ inside your abdomen, such as:

• appendicitis
• gallstones or an inflamed gallbladder
• a stomach ulcer or an inflamed stomach lining
• an inflamed pancreas (pancreatitis)
• irritable bowel syndrome or inflammatory bowel disease
• a urinary tract infection or kidney stones.

If you have a womb or ovaries, period pain, endometriosis, ovarian cysts or an ectopic pregnancy can also cause abdominal pain.

Less often, abdominal pain is a sign of something more serious, such as a bowel blockage, an abdominal aortic aneurysm (swelling in the aorta, the artery that carries blood from the hear to the tummy), diverticulitis, or cancer of the stomach or bowel.

Strained abdominal muscles and, rarely, a heart attack can also cause pain in this area.

Are there different types of abdominal pain?

Abdominal pain can feel different depending on what's causing it. It may be constant or come and go, and you might feel it in one small spot or all over your tummy.

• Generalised pain, felt across more than half of your tummy, often linked to a stomach bug, indigestion or wind
• Localised pain, felt in one spot, which is more likely to point to a problem with a specific organ such as your appendix, gallbladder or stomach
• Cramp-like pain, which comes and goes and is usually linked to wind or bloating.
• Colicky pain, which comes in waves and can be severe, such as with kidney stones or gallstones.

Where you feel the pain matters too. Doctors often divide the abdomen into four quarters:

• upper right, which may point to your liver or gallbladder
• upper left, which may point to your stomach or pancreas
• lower right, which may point to your appendix
• lower left, which may point to your bowel
• lower abdominal pain may point to the uterus and ovaries.

How is abdominal pain diagnosed?

Your doctor will examine your tummy and ask questions to help work out what's causing your pain. They'll want to know exactly where it hurts, whether it's sharp, cramping or dull, and whether it's constant or comes and goes. They may also ask when the pain started, what makes it better or worse, and whether you've had similar pain before. Be ready to mention any other symptoms, medicines you're taking, and whether you could be pregnant. If your doctor needs more information, they might arrange tests such as:

• blood, urine or stool sample tests
• an ultrasound scan, which uses sound waves to picture your organs
• a CT or MRI scan for more detailed images
• an endoscopy (a thin tube with a camera, passed into your stomach) or a colonoscopy (the same, but into your bowel)
• an ECG (heart tracing), if a heart problem needs to be ruled out.

How is abdominal pain treated?

Treatment depends entirely on what's causing your pain. Some causes settle by themselves, some need medicine, and a few need surgery. For mild pain linked to digestion, you can often ease things yourself at home:

• Cut down on tea, coffee, cola or alcohol
• Avoid eating 3 to 4 hours before going to bed
• Try propping your head and shoulders up in bed – this can stop stomach acid coming up while you sleep
• Lose weight if you're overweight
• Avoid having rich, spicy or fatty foods
• Do not take ibuprofen or aspirin – this can make indigestion worse
• Reduce or stop smoking
• Eat smaller, more frequent meals
• Find ways to relax
• Speak to your local pharmacist for help: Your local pharmacist can recommend medicines that will ease the burning feeling or pain and discomfort that can come with indigestion. These medicines make your stomach less acidic. They're called antacids. It's best to take these with food or soon after eating.

See a GP for heartburn if:

• Lifestyle changes and pharmacy medicines are not helping
• You have heartburn most days for 3 weeks or more
• You have other symptoms, like food getting stuck in your throat, frequently being sick or losing weight for no reason keep getting indigestion.

For pain caused by infection or inflammation, your doctor may prescribe antibiotics, medicine to reduce stomach acid, or fluids given through a drip. Some conditions, such as appendicitis or gallstones, may need surgery. If pain becomes long-term and doesn't settle with these approaches, a pain specialist may offer procedures such as nerve-blocking injections or a spinal cord stimulator, a small implanted device that eases pain signals.

When should I see a doctor?

Most abdominal pain gets better on its own, but certain warning signs mean you need help quickly. Call 999 or go to A&E if:

• the pain came on very suddenly or is severe
• it hurts when you touch your tummy, or your tummy feels rigid or swollen
• you're vomiting blood, or your vomit looks like ground coffee
• your poo is bloody, or black, sticky and very smelly
• you can't pee, poo or fart
• you have chest pain or breathing difficulty
• you have diabetes and you're being sick
• you've had a recent injury to your tummy
• someone has collapsed.

Contact a GP or call 111 if:

• the pain gets worse, doesn't go away, or keeps coming back
• you have bloating that doesn't go away or keeps coming back
• you have problems swallowing food
• you're pregnant, or could be pregnant
• you have unusual bleeding or abnormal discharge from your vagina
• you're losing weight without trying to
• you notice a change in how often you pee, or pain when peeing
• you have blood in your pee, poo or vomit
• you are bleeding from your bottom
• you have yellowing of your skin or eyes (jaundice)
• you have a fever that won't settle, or nausea and vomiting that won't stop
• diarrhoea lasts longer than 5 days, or discomfort lasts 1 week or more
• you feel short of breath, especially if it's worse with activity.