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Symptoms and Signs of Abdominal Pain (Adults)

Doctor's Notes on Abdominal Pain in Adults

Abdominal pain in adults has many different causes. These can include infections of the gastrointestinal tract, peptic ulcer disease, pancreatitis, diverticulitis, appendicitis, hepatitis, gallbladder disease, and kidney stones. Sometimes, ovarian cysts or uterine fibroids in women, testicular problems in men, heart attack, skin rashes, or urinary tract infections can be causes of abdominal pain in adults.

Signs and symptoms associated with abdominal pain depend on the cause of the pain. Symptoms can include nausea, vomiting, diarrhea, weight loss, constipation, bloating, gas, and abdominal cramping or tenderness. Other possible symptoms include blood in the stool or urine, abdominal masses, testicular pain, back pain, pain with urination, pain with sexual intercourse, and discharge from the penis or vagina.

Medical Author:
Medically Reviewed on 3/11/2019

Abdominal Pain in Adults Symptoms

Abdominal pain is a symptom. It may mean that the person has a medical problem that needs treatment.

Abdominal pain may go along with other symptoms. Keep track of your symptoms because this will help the doctor find the cause of your pain. Make a special note if there is a sudden abdominal pain, severe abdominal pain after eating, or abdominal pain with diarrhea.

Abdominal Pain in Adults Causes

The patient's treatment will depend on what the doctor thinks is causing the abdominal pain.

The patient may be given IV (intravenous) fluids. The doctor may ask the patient not to eat or drink anything until the cause of the pain is known. This is done to avoid worsening certain medical conditions (for example adding food to the stomach if there is a ruptured ulcer) or to prepare the patient in case they need to have surgery. (An empty stomach is better when general anesthesia is needed.)

The patient may be given pain medication.

  • For pain caused by bowel spasm, they may be given a shot in the hip, arm, or leg.
  • If the patient is not throwing up, they may receive a drink that has antacid in it or pain medication.
  • Although the patient's pain may not go away completely, they have the right to be comfortable and should ask for pain medicine until they are made comfortable.

Abdominal pain can occur in any area of the abdomen. You might experience pain in one area of the abdomen although the cause for the pain is in a different area. Some diseases can cause pain in multiple areas of the abdomen. Below are the usual pain patterns associated with diseases, but please note that this does not include all diseases and conditions, and the below do not hold true all of the time.

Pain in the Upper Abdomen

  • Stomach Ulcers
  • Gastritis
  • Pancreatitis

Pain in the Upper Right Side

  • Gallbladder Disease
  • Liver Inflammation (Hepatitis)

Pain in the Upper Left Side

  • Enlarged Spleen

Pain in the Lower Right Side

  • Other diseases and conditions of the uterus
  • Appendicitis
  • Right Ovarian Inflammation or Torsion
  • Right Ovarian Cyst

Pain in the Lower Left Side

  • Diverticulitis
  • Left Ovarian Inflammation or Torsion
  • Left Ovarian Cyst

Pain in the Lower Abdomen

From the above it is apparent that abdominal pain can have many causes, some linked directly to the abdomen and others caused by a non-abdominal disease. Sometimes the cause of abdominal pain is not determined, and you may be asked to return the next day to recheck and you perhaps need more tests. In some cases, no specific cause is determined, and the pain gets better in hours or days.

Some types of abdominal pain require surgical treatment.

  • If the patient's pain comes from an infected internal organ, such as the appendix or gallbladder, hospitalization, observation, and possibly surgery are indicated.
  • Bowel obstruction sometimes requires surgery, depending on what is causing the obstruction, how much bowel is obstructed, and whether or not the obstruction is temporary.
  • If the patient's pain comes from a ruptured or perforated organ, such as the bowel or stomach, they will need immediate surgery and will be taken directly to an operating room.

Some types of abdominal pain require surgical treatment.

  • If the patient's pain comes from an infected internal organ, such as the appendix or gallbladder, hospitalization, observation, and possibly surgery are indicated.
  • Bowel obstruction sometimes requires surgery, depending on what is causing the obstruction, how much bowel is obstructed, and whether or not the obstruction is temporary.
  • If the patient's pain comes from a ruptured or perforated organ, such as the bowel or stomach, they will need immediate surgery and will be taken directly to an operating room.

Physical Examination

Physical examination will include a careful examination of the patient's abdomen, heart, and lungs in order to pinpoint the source of the pain.

  • The doctor will touch different parts of the abdomen to check for tenderness or other signs that indicate the source of the pain.
  • The doctor may do a rectal exam to check for small amounts of blood in the stool or other problems, such as a mass or internal hemorrhoids.
  • If the patient is a man, the doctor may check the penis and testicles.
  • If the patient is a woman, the doctor may do a pelvic exam to check for problems in the uterus, Fallopian tubes, and ovaries.
  • The doctor also may look at the patient's eyes for yellow discoloration (jaundice) and in the mouth to be sure the patient is not dehydrated.

Laboratory Tests

Laboratory tests may or may not help to determine the cause of the abdominal pain. Combined with the information gained from the questions the patient was asked and the physical examination performed by the doctor, certain blood or urine tests may be ordered and could assist in determining the diagnosis.

  • One of the most important tests is to see if a woman is pregnant.
  • A raised white blood cell count may mean infection or may just be a reaction to the stress of pain and vomiting.
  • A low red blood count (hemoglobin) may mean that a patient is bleeding internally, but most conditions that involve bleeding are not painful.
  • Blood in the urine, which may not be visible to the eye, suggests that a patient may have a kidney stone.
  • Other blood tests, such as liver enzymes and pancreas enzymes, can help determine which organ is the cause of the pain, but they do not point to a diagnosis.

Radiology Tests

Radiology studies of the patient's abdomen can be useful, but are not always necessary or helpful.

  • Occasionally, an X-ray will show air outside of the bowel, meaning that something has ruptured or perforated.
  • An X-ray also can help diagnose bowel obstruction.
  • Sometimes X-rays can show a kidney stone.

Ultrasound is a painless procedure useful in finding some causes of abdominal pain.

  • This may be done if the doctor suspects problems with the gallbladder, pancreas, liver, or the reproductive organs of women.
  • Ultrasound also assists in the diagnosis of problems with the kidneys and the spleen, or the large blood vessels that come from the heart and supplies blood to the lower half of the body.

Computerized tomography (CT scan) provides useful information about the liver, pancreas, kidneys and ureters, spleen, and small and large intestine.

The patient and doctor should discuss the need for an X-ray or CT scan and their associated radiation exposure before proceeding with any radiological examination.

MRI is usually less helpful than a CT scan when the abdomen is examined, although with certain problems and symptoms your healthcare professional may order an MRI rather than a CT scan or in follow up to any of the above examinations.

The doctor may perform no tests at all. The cause of the patient's pain may be clear without any tests and may be known not to be serious. If the patient does undergo tests, the professional should explain the reason for the test and any contraindications. When the results are available, the professional should discuss them with the patient, as well as whether the results impact the treatment.

Physical Examination

Physical examination will include a careful examination of the patient's abdomen, heart, and lungs in order to pinpoint the source of the pain.

  • The doctor will touch different parts of the abdomen to check for tenderness or other signs that indicate the source of the pain.
  • The doctor may do a rectal exam to check for small amounts of blood in the stool or other problems, such as a mass or internal hemorrhoids.
  • If the patient is a man, the doctor may check the penis and testicles.
  • If the patient is a woman, the doctor may do a pelvic exam to check for problems in the uterus, Fallopian tubes, and ovaries.
  • The doctor also may look at the patient's eyes for yellow discoloration (jaundice) and in the mouth to be sure the patient is not dehydrated.

Laboratory Tests

Laboratory tests may or may not help to determine the cause of the abdominal pain. Combined with the information gained from the questions the patient was asked and the physical examination performed by the doctor, certain blood or urine tests may be ordered and could assist in determining the diagnosis.

  • One of the most important tests is to see if a woman is pregnant.
  • A raised white blood cell count may mean infection or may just be a reaction to the stress of pain and vomiting.
  • A low red blood count (hemoglobin) may mean that a patient is bleeding internally, but most conditions that involve bleeding are not painful.
  • Blood in the urine, which may not be visible to the eye, suggests that a patient may have a kidney stone.
  • Other blood tests, such as liver enzymes and pancreas enzymes, can help determine which organ is the cause of the pain, but they do not point to a diagnosis.

Radiology Tests

Radiology studies of the patient's abdomen can be useful, but are not always necessary or helpful.

  • Occasionally, an X-ray will show air outside of the bowel, meaning that something has ruptured or perforated.
  • An X-ray also can help diagnose bowel obstruction.
  • Sometimes X-rays can show a kidney stone.

Ultrasound is a painless procedure useful in finding some causes of abdominal pain.

  • This may be done if the doctor suspects problems with the gallbladder, pancreas, liver, or the reproductive organs of women.
  • Ultrasound also assists in the diagnosis of problems with the kidneys and the spleen, or the large blood vessels that come from the heart and supplies blood to the lower half of the body.

Computerized tomography (CT scan) provides useful information about the liver, pancreas, kidneys and ureters, spleen, and small and large intestine.

The patient and doctor should discuss the need for an X-ray or CT scan and their associated radiation exposure before proceeding with any radiological examination.

MRI is usually less helpful than a CT scan when the abdomen is examined, although with certain problems and symptoms your healthcare professional may order an MRI rather than a CT scan or in follow up to any of the above examinations.

The doctor may perform no tests at all. The cause of the patient's pain may be clear without any tests and may be known not to be serious. If the patient does undergo tests, the professional should explain the reason for the test and any contraindications. When the results are available, the professional should discuss them with the patient, as well as whether the results impact the treatment.

Many acute (short-duration) and chronic (long-duration) diseases cause abdominal pain.

The diseases that most people are concerned about having are gastritis, appendicitis, kidney stones, gallbladder pain disease, duodenal and gastric ulcers, infections, and pregnancy-associated problems since these are the most common. Doctors also are concerned about ruptured blood vessels, heart attacks, liver and pancreas inflammation, kidney stones, problems with the blood circulation to the intestine, diverticulitis, cancers, and other diseases.

Abdominal pain may not arise from the abdomen.

  • Some heart attacks and pneumonia can cause abdominal pain and even nausea.
  • Diseases of the pelvis or groin can also cause abdominal pain in adults.
  • Testicular problems often can cause lower abdominal pain.
  • Certain skin rashes, such as shingles, can feel like abdominal pain, even though the person has nothing wrong inside their body.
  • Even some poisonings and bites, such as a black widow spider bite, can cause severe abdominal pain.

Many acute (short-duration) and chronic (long-duration) diseases cause abdominal pain.

The diseases that most people are concerned about having are gastritis, appendicitis, kidney stones, gallbladder pain disease, duodenal and gastric ulcers, infections, and pregnancy-associated problems since these are the most common. Doctors also are concerned about ruptured blood vessels, heart attacks, liver and pancreas inflammation, kidney stones, problems with the blood circulation to the intestine, diverticulitis, cancers, and other diseases.

Abdominal pain may not arise from the abdomen.

  • Some heart attacks and pneumonia can cause abdominal pain and even nausea.
  • Diseases of the pelvis or groin can also cause abdominal pain in adults.
  • Testicular problems often can cause lower abdominal pain.
  • Certain skin rashes, such as shingles, can feel like abdominal pain, even though the person has nothing wrong inside their body.
  • Even some poisonings and bites, such as a black widow spider bite, can cause severe abdominal pain.

What's Causing Your Abdominal Pain? Slideshow

What's Causing Your Abdominal Pain? Slideshow

The abdomen is an anatomical area that is bounded by the lower margin of the ribs and diaphragm above, the pelvic bone (pubic ramus) below, and the flanks on each side. Although abdominal pain can arise from the tissues of the abdominal wall that surround the abdominal cavity (such as the skin and abdominal wall muscles), the term abdominal pain generally is used to describe pain originating from organs within the abdominal cavity. Organs of the abdomen include the stomach, small intestine, colon, liver, gallbladder, spleen, and pancreas. Abdominal pain can range in intensity from a mild stomach ache to severe acute pain. The pain is often nonspecific and can be caused by a variety of conditions.

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

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