• ovarian cancer
• colon cancer or other abdominal cancer
• appendicitis
• diverticulitis
• bowel obstruction
• peritonitis

Note: There are many other causes of abdominal pain. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as location, quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for abdominal pain, occurring alone or in combination with other problems.

Abdominal pain is a nonspecific symptom that may be associated with a multitude of conditions. Some do not occur within the abdomen itself but cause abdominal discomfort; an example would be the abdominal pain associated with strep throat. Some originate within the abdomen but are not related to the gastrointestinal tract, such as a dissecting aortic aneurysm. Other pain is related directly to the gastrointestinal tract.
The severity of the pain does not always reflect the severity of the condition causing the pain. Severe abdominal pain can be associated with mild conditions such as gas or the cramping of viral gastroenteritis, while relatively mild pain (or no pain) may be present with severe and life-threatening conditions such as cancer of the colon or early appendicitis.
Abdominal pain can be cause by toxins, infection, biliary tract disease, liver disease, renal disease, bladder infections, menstruation, ovulation, female and male genitourinary disease, vascular problems, malignancy, ulcers, perforation, pancreatic disease, hernias, trauma, and metabolic diseases. The list is so extensive that it would be impossible to name all the possible diseases in each of the above groups.
Because abdominal pain is nonspecific, the health care provider will require much more information regarding the time of onset, duration of pain (minutes, hours, days, or even months), location of pain, nature of pain (dull, sharp, steady, crampy, off and on), severity of pain and relationship to normal functions such as menstruation and ovulation.
The location of pain and its time pattern may be helpful in suggesting its cause. During physical examination, the health care provider will try to determine if the pain is localized to a single area (point tenderness) or diffuse and if the pain is related to inflammation of the peritoneum or of the abdomen. If the health care provider finds evidence of peritoneal inflammation, the abdominal pain may be classified as an "acute abdomen" which often requires prompt surgical intervention.
In addition the health care provider will try to relate the abdominal tenderness to other general symptoms such as fever, fatigue, general ill feeling (malaise), nausea, vomiting, or changes in stool. Then the provider will ask about increasingly specific symptoms as the diagnostic considerations are narrowed.
In infants, prolonged unexplained crying (often called "colic") may be caused by abdominal pain that often ends with the passage of gas or stool. Usually, colic begins around the 3rd week of life and peaks at about 3 to 4 months. Colic is often worse in the evening. Cuddling and rocking the child may bring some relief.
Severe abdominal pain that occurs during menstruation may indicate a problem in a reproductive organ. This includes conditions such as endometriosis, uterine fibroids, ovarian cysts, ovarian cancer (rare), or pelvic inflammatory disease (PID).
Abdominal pain that may indicate a potential emergency condition includes:

• severe abdominal pain with nausea and a fever
  • it may indicate appendicitis or complications of diverticulitis
• abdominal pain, nausea, fever, and bloating or constipation
  • may indicate a bowel obstruction
• abdominal pain that is accompanied by a stiff ("board-like") abdomen
  • may indicate peritonitis
• abdominal pain is accompanied by bloody stools or vomiting blood
  • gastrointestinal bleeding from any cause can be dangerous

• the pain is very severe.
• there has been an abdominal injury in the last 2 or 3 days.
• there is pain during pregnancy (or possible pregnancy).
• the pain persists for a prolonged period of time.
• there is a high fever, and nausea, or an inability to keep down food or liquids for several days.
• there is nausea, fever, and bloating or constipation.
• the abdomen is tender to touch, or it feels rigid or hard.
• vomiting blood or there are bloody stools

The medical history will be obtained and a physical examination performed.
Medical history questions documenting abdominal pain in detail include:

• type
  • Is the pain all over (diffuse or generalized) or in a specific location?
• location (What part of the abdomen is affected?)
  • lower abdomen
    • right-lower quadrant
    • left-lower quadrant
  • upper abdomen
    • left-upper quadrant
    • right-upper quadrant
    • upper-middle of abdomen (epigastric)
  • around the navel (periumbilical)
  • initially around the navel, later shifted to the right lower quadrant (this is highly indicative of appendicitis)
• quality
  • severe
  • sharp or cramping
  • persistent or constant
  • periodic and changing intensity over minutes (colicky)
• time pattern
  • Does the pain awaken you at night?
  • Is the pain recurrent--has there been similar pain in past?
    • How long does each episode last (how many hours)?
    • How often does the pain appear (at how many days interval)?
    • How long have you been having these pains (how many months in duration?)
  • Does it occur within minutes following meals?
  • Does it occur within 2 to 3 hours after meals?
  • Is it getting increasingly more severe?
  • Did it begin suddenly?
  • Does it occur during menstruation (dysmenorrhea)?
  • How long has the pain been present?
• radiation
  • Does the pain go into your back?
  • Does the pain go below the right shoulder blade (right scapular area)?
  • Does the pain go through to the middle of the back?
  • Does the pain go into your groin, buttocks, or legs?
• aggravating factors
  • Does the pain get worse after lying on the back (supine position)?
  • Does the pain get worse after eating or drinking?
  • Does the pain get worse after greasy foods?
  • Does the pain get worse after milk products?
  • Does the pain get worse after alcohol?
  • Does the pain get worse after fasting?
  • Does the pain get worse after stress?
  • Does the pain get worse after straining efforts?
• relieving factors
  • Does the pain get better after you eat food?
  • Does the pain get better after bowel movement?
  • Does the pain get better after milk or antacids? Does this relieve the pain in a few minutes?
  • Does the pain get better after withdrawal of milk products?
• medications
  • What medications are you taking?
  • Have you changed medications recently?
• other
  • Has there been a recent injury?
  • Are you pregnant?
  • What other symptoms are occurring at the same time?
  • Is there a fever?
  • Is there vomiting?
  • Is there diarrhea?
  • Are there hives?
  • Is there difficulty breathing?
  • Is there blood in the stools?
  • Are you vomiting blood?

A physical examination with a focus on the abdomen will be performed. Observation in the hospital may be required in severe cases. If pain persists, re-evaluation will be necessary.
Diagnostic tests that may be performed include:

• barium enema
• upper GI and small bowel series
• blood, urine, and stool tests
• endoscopy of upper GI (gastrointestinal) tract (EGD)
• lower gastrointestinal series
• ultrasound of the abdomen
• X-rays of the abdomen

After seeing your health care provider:
You may want to add a diagnosis related to abdominal pain to your personal medical record.

For mild pains, sip water or other clear fluids. Avoid solid food. Antacids may provide some relief. AVOID narcotic pain medications, aspirin, and NSAIDs unless the health care provider prescribes them.