Causes of Abdominal Pain

Learn to identify emergencies from pain in the gut

Abdominal pain is one of the most difficult symptoms to identify a cause. The causes of abdominal pain below range from relatively minor conditions to life-threatening emergencies.

Woman sitting on bed holding stomach, head bowed
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When to Call 911

It's important to call 911 when certain signs and symptoms accompany abdominal pain, regardless of the cause. If a victim of abdominal pain is also experiencing any of the following, call 911:

  • sudden, severe onset of abdominal pain
  • vomiting blood
  • bloody diarrhea
  • neck, chest, or shoulder pain
  • rigid (hard) and tender abdomen
  • not able to have a bowel movement, especially with vomiting
  • pain between shoulder blades
  • dizziness
  • weakness
  • sweating
  • confusion

Possible Causes

Abdominal aortic aneurysm (AAA) is caused by a weak spot in the largest blood vessel in the body, the aorta. When the vessel wall starts to bulge out, it often becomes painful. If undetected or left untreated, the AAA might rupture and lead to life-threatening bleeding and shock.

Appendicitis is an infection that develops in the appendix, a small pouch that sits on the small intestines. For a very long time, doctors thought the appendix didn't serve a purpose and that's why they named it that. It is now thought to provide a breeding ground for beneficial bacteria that we need in our gut to help with digestion. Unfortunately, the same conditions that make it a great place to grow beneficial bacteria also make it a great place to grow malicious bacteria. If that happens, it gets inflamed. In some cases, appendicitis can lead to a rupture of the appendix and life-threatening hemorrhage or shock. Yes, it's a theme in the abdomen.

Crohn's disease and irritable bowel syndrome can both lead to inflammation of the intestines, swelling, bleeding or blockage.

Diverticulitis comes from inflammation of diverticula (small bulges) in the large intestine.

Ectopic pregnancy is a pregnancy that occurs anywhere outside of the uterus. Usually, the fertilized egg attaches itself to the Fallopian tube, which is why these are sometimes called tubal pregnancies. An ectopic pregnancy can't usually survive because once the fetus gets too big to fit inside whatever niche it found itself in, it will rupture the surrounding tissue and start hemorrhaging.

Food poisoning is technically not poisoning but is instead a foodborne illness. There is an element of poison there if you want to get down to the nitty gritty. The pathogens that develop on food often release toxins as a result of their metabolic process. Those toxins cause the signs and symptoms of food poisoning: pain, vomiting, and diarrhea.

Gallstones are just what they sound like: stones in the gallbladder. The bile in the gallbladder will sometimes harden into stones of various sizes. As the gallstones try to get out of the gallbladder, they cause pain.

When a heart attack is centered on the bottom part of the heart, pain is referred downward and often ends up feeling like pain in the top part of the abdomen called the epigastric region, just below the breastbone.

Kidney stones or kidney trauma can lead to abdominal pain. More often, kidney related pain is located toward the flanks. But it can move down to the lower abdomen or groin area.

Ulcers are sores in the lining of the gastrointestinal system (all of the tubes including the esophagus, stomach and intestines) that can lead to bleeding. For many years doctors thought the cause of ulcers had to do with stress, but now we know that ulcers in the stomach are almost always from bacterial infections.

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