Abdominal Pain
Correctly interpreting the cause of acute abdominal pain can be quite challenging, and because some of the causes can be serious it is quite important for any patient with significant acute abdominal pain to be evaluated in urgent care or ER to rule out serious cause.
Simple non serious causes of chronic or recurrent nature:
Disease |
Pain Quality |
Location |
Radiation |
| GERD/Esophagitis | Burning | Mid chest | Left arm and back |
| Stomach Ulcer | Gnawing | Upper center | Back |
| Gall Bladder stones | Colicky | Right upper | Back and right shoulder |
| Kidney stone | Colicky | R or L flank. | Anterior lower abdomen |
| Dyspepsia | Bloating and dull | Upper center | None |
| Irritable Bowel | Cramping | Lower abdomen | None |
| Bladder infection | Discomfort | Center of lower abdomen | None |
| Constipation | Colicky | Left lower abdomen | None |
Causes of more serious acute abdominal pain
Most of the conditions listed below present with more severe acute pain and should be evaluated in ER if the suspicion is high.
They can be divided into 2 categories:
- Focal infectious or inflammatory process (Appendicitis)leading to inflammation of the adjacent abdominal wall lining (peritonitis) this type of pain is usually achy and steady, aggravated by pressure or change in the abdominal wall tension and is accompanied by tonic reflex spasm in adjacent abdominal wall muscles
- Mechanical blockage of a hollow organ (kidney stones, Gall stones or bowel obstruction) leading to colicky pain
Disease | Pain Type | Location | Radiation | Associated Symptoms |
| Acute Appendicitis | Crampy steady | Umbilicus —> R lower abd | Back | Fever, Nausea and vomiting |
| Acute Cholecystistis | Pressure Crampy | R upper Abd | Right Shoulder | Fever, Nausea and vomiting |
| Acute Pancreatitis | Sever Steady | Umbilicus and upper Abd | Back | Fever, Nausea and vomiting |
| Bowel Perforation | Sudden and Severe | Upper Abd | Entire Abdomen | |
| Bowel Obstruction | Crampy | Periumbilical | Back | Nausea and vomiting |
| Bowel Infarction | Severe Diffuse | Periumbilical | Entire Abdomen | Fever, nausea and vomiting |
| Acute Diverticulitis | Cramping Aching | Left lower Abd. | To Lower Abdomen | Fever, vomiting and diarrhea |
I have abdominal pain, where shall I go ER or urgent care?
Most of abdominal pain cases seen in primary care are caused by minor causes such as stomach reflux , stomach ulcer , viral minor stomach flu or food poisoning and these are usually minor and can be addressed by your primary care doctor or in urgent care.
Please go to ER or get screened in urgent care if you have any of the following:
- If you have severe persistent or worsening abdominal pain
- If you have rectal bleeding (other than hemorrhoids)
- If you have fever
- If you have nausea and vomiting leading to dehydration
- If you are unable to have a bowel movement or unable to pass gas
- If you are pregnant or have vaginal bleed outside the period
- If you are older than 55 year of age
- If you have chronic medical illnesses such as heart disease, Hypertension or Diabetes
- If you have swelling in groin, scrotum or signs of hernia
- If you are alcoholic
- If you have weak immune system (Cancer)