Abdominal pain, pain or discomfort felt anywhere between the ribs and pelvis, is one of the most common reasons people seek medical care. It can range from a mild, short-lived cramp that resolves on its own to a sudden, severe pain that signals a surgical emergency. Most people experience abdominal pain at some point and while most cases are not serious, the challenge is in knowing which is which.
The abdomen contains the digestive organs (stomach, small and large intestine, liver, gallbladder, pancreas), the kidneys and ureters, the spleen, the aorta, and — in women — the reproductive organs. Any of these structures can produce pain when inflamed, obstructed, infected, ruptured, or otherwise compromised.
Abdominal pain is classified in several ways: by its character (cramping, sharp, dull, burning, colicky), by its pattern (constant, intermittent, worse after eating, worse on movement), and by its location. Location is particularly informative because it helps identify which organ system is most likely involved — though pain can radiate and the initial location of pain does not always correspond precisely to the origin.
Pain can also arise from structures outside the abdomen — the lungs (pneumonia or pulmonary embolism can cause referred upper abdominal pain), the heart (a heart attack can present with epigastric discomfort), the back (spinal conditions can refer pain to the abdomen), and the pelvic floor. This is why abdominal pain that is unexplained or atypical requires proper investigation rather than self-diagnosis.
The accompanying symptoms often matter as much as the pain itself. The combination of symptoms helps narrow the differential diagnosis significantly.
Symptom that commonly accompany abdominal pain
You can take note of the following details when describing your pain to your healthcare provider:
If you are unsure, it is always safer to seek medical advice. Farrer Park Hospital's 24-Hour Medical Urgency Clinic is available around the clock for acute presentations that need same-day assessment.
Abdominal pain has many causes — most are benign and self-limiting, but some require medical or surgical treatment. The most common conditions presenting with abdominal pain that our specialists see are covered below.
Gallstones are hardened deposits of bile that form in the gallbladder. They may be asymptomatic for years, or they may obstruct the gallbladder outlet or bile duct, causing pain. When the gallbladder becomes inflamed (cholecystitis), the pain is typically persistent and accompanied by fever.
Typical symptoms: Intermittent or constant pain in the right upper quadrant or epigastrium, often triggered or worsened by fatty meals. Pain may radiate to the right shoulder or back. Fever and jaundice if the bile duct is involved.
Appendicitis is inflammation of the appendix, a small finger-like structure attached to the large intestine in the right lower abdomen. It is one of the most common surgical emergencies worldwide. If the appendix perforates, the infection spreads throughout the abdomen (peritonitis) — a life-threatening complication.
Typical symptoms: Pain typically begins around the navel and shifts within hours to the right lower quadrant. Accompanied by loss of appetite, low-grade fever, and nausea. Pain worsens with movement, coughing, or deep breathing. Rebound tenderness at McBurney's point.
Peptic ulcers are open sores that develop on the lining of the stomach or the duodenum (the first part of the small intestine), most commonly caused by Helicobacter pylori infection or prolonged use of NSAIDs (ibuprofen, naproxen, aspirin).
Typical symptoms: Burning or gnawing epigastric pain (upper central abdomen), often relieved temporarily by eating or antacids. Stomach ulcer pain may worsen with food; duodenal ulcer pain often improves with food then returns 2–3 hours later. Nausea, bloating, and early satiety.
IBS is a functional disorder of the large intestine characterised by chronic abdominal pain or discomfort associated with changes in bowel habit (diarrhoea, constipation, or alternating between both), in the absence of structural disease. It is extremely common and significantly impacts quality of life.
Typical symptoms: Cramping abdominal pain, usually in the lower abdomen, that is relieved or worsened by bowel movements. Bloating, excess gas, alternating diarrhoea and constipation, urgency, and feeling of incomplete evacuation. Symptoms often worsen with stress and certain foods.
IBD refers to chronic inflammatory conditions of the gastrointestinal tract. Crohn's disease can affect any part of the GI tract from mouth to anus but most commonly affects the terminal ileum and colon. Ulcerative colitis is confined to the colon and rectum. Both cause significant symptoms and require long-term management.
Typical symptoms: Persistent or recurrent abdominal pain — often in the lower abdomen in UC, more variable in Crohn's. Bloody diarrhoea (more common in UC), weight loss, fatigue, fever during flares. Crohn's may cause fistulas, abscesses, and perianal disease.
A hernia occurs when tissue — usually part of the intestine — pushes through a weak spot in the surrounding muscle or connective tissue. Inguinal (groin), umbilical, incisional, and hiatus hernias are the most common types. Most are not immediately dangerous, but a hernia that becomes trapped (incarcerated) or loses its blood supply (strangulated) is a surgical emergency.
Typical symptoms: A bulge or lump at the hernia site, often more noticeable when standing, coughing, or straining. Aching or pain at the site, particularly with exertion. Hiatus hernia may cause heartburn and regurgitation rather than a visible bulge.
Kidney stones are hard mineral deposits that form in the kidneys and can cause severe pain as they pass through the urinary tract. The pain is typically in the flank (side) and radiates to the lower abdomen and groin as the stone moves.
Typical symptoms: Sudden, severe, colicky (wave-like) pain in the flank, radiating to the lower abdomen, groin, or genitalia. Blood in the urine (haematuria). Nausea and vomiting. Frequent or painful urination if the stone is in the lower ureter near the bladder.
Diverticula are small pouches that can form in the walls of the colon, most commonly the sigmoid colon (lower left). Diverticulitis occurs when these pouches become inflamed or infected. It is more common in people over 50 and in those with low-fibre diets.
Typical symptoms: Pain in the left lower quadrant — often constant rather than cramping — with fever, nausea, and change in bowel habits. The area may be tender to touch.
Gastroenteritis — commonly called stomach flu or food poisoning — is inflammation of the stomach and intestines, usually caused by viral or bacterial infection from contaminated food or water. It is typically self-limiting.
Typical symptoms: Cramping abdominal pain, usually diffuse or periumbilical. Nausea, vomiting, and diarrhoea — often occurring together. May be accompanied by fever. Symptoms usually develop within hours to a day of exposure and resolve within a few days.
Diagnosis begins with a thorough history and physical examination. The pattern of symptoms — combined with examination findings such as where the abdomen is tender, whether there is guarding or rigidity, and whether bowel sounds are normal — often points strongly to the most likely cause. Investigations confirm the clinical impression.
Treatment depends entirely on the underlying cause. The goal of assessment is to identify that cause — then treatment is directed at it, not at the pain alone. Here is how common causes are managed:
