Treating abdominal pain

We’ve all had that awful feeling: a stomach ache so intense that you stay motionless, worried that any movement will only increase your nausea. As waves of cramps come and go, you stay frozen, waiting for the pain in your abdomen to subside. But what is it how should you go about treating your abdominal pain?

What Is Abdominal Pain?

Abdominal pain is discomfort felt anywhere in your belly region, located from beneath your ribs to your pelvis. This area is home to many important parts of your body, including the stomach, liver, pancreas, abdominal wall, and major blood vessels.

Although abdominal pain can be uncomfortable, it is often harmless and usually stops within a couple hours or a few days.

The pain can range from mild to severe, but it’s important to remember that the severity may not reflect the seriousness of the problem causing it. For example, someone with a common stomach virus may experience intense pain. Yet more serious conditions may only cause mild pain or none at all.

Abdominal pain can be temporary (acute) or occur over weeks, months, or years (chronic).

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What Causes Abdominal Pain?

A variety of conditions, spanning from benign to life-threatening, can trigger abdominal pain.

Acute abdominal pain

Most common causes of abdominal discomfort, including gas pains, indigestion, or a pulled muscle, are not cause for concern. Other common causes of short-term pain in the abdomen include:

  • Constipation.
  • Post-viral irritable bowel syndrome.
  • Food allergies.
  • Lactose intolerance.
  • Food poisoning.
  • Stomach viruses.
  • Appendicitis.
  • Bowel obstruction.
  • Cholecystitis.
  • Diverticulitis.

Abdominal pain can also be provoked by issues impacting another part of your body, such as your lungs, heart or pelvic area. These ailments include:

Chronic abdominal pain

Ongoing pain in your abdomen or pelvis can last weeks or months. Chronic abdominal pain can be due to one of the following reasons, assuming your doctor or another specialist has ruled out other causes:

  • Chronic pancreatitis (inflammation of your pancreas).
  • Abdominal surgery (pain at the incision site or internal organ pain).
  • Endometriosis.
  • Ovarian cysts.
  • Gallstones.
  • Gastritis or other gastrointestinal diseases including inflammatory bowel disease.
  • Pelvic inflammatory disease.
  • GERD (gastroesophageal reflux disease or acid reflux).
  • Irritable bowel syndrome.
  • Some cancers.
  • Recurring indigestion with no obvious cause (functional dyspepsia).

Types of Abdominal Pain

Abdominal pain can feel completely different based upon the underlying issue. You may experience discomfort in your abdomen that feels sharp, dull, burning hot, crampy, or achy, among others.

Though there are many ways to characterize abdominal pain, it can be classified into two main types: neuropathic or nociceptive.

Neuropathic pain

Typically chronic, neuropathic pain can be caused by nerve disease, injury, or infection. This pain can flare up at any time without any obvious cause and tends to get worse over time.

Neuropathic pain may feel like shooting, burning discomfort in your abdomen. You may also experience numbness or loss of sensation in the affected area. This chronic pain can be constant or come and go in random waves.

Nociceptive pain

The most common type of pain people experience, nociceptive pain is caused by physical damage to your body. Examples include a hit to your abdomen during a sports game. It tends to subside as the abdomen heals from the injury.

Nocicepters are special nerves in your body that pass pain signals through your nervous system as warnings to your brain. Nocicpeters make it so that you yank your hands away after touching a hot oven, or take weight off of an injured ankle.

Locations of abdominal pain

Dozens of ailments lead to abdominal pain. Symptoms of discomfort are similar, making the cause of the pain difficult to pinpoint.

Your abdomen can be broken down into smaller portions: left, right, and center, and upper, middle, and lower. The location of the pain in your abdomen may be a clue for the potential cause.

When Should I go to the Emergency Room?

Seek care for abdominal pain if you experience:

  • Sudden, severe pain.
  • Pain that gradually increases in severity.
  • Vomiting blood or passing bloody or tar-like stool.
  • Abdominal pain accompanied by a fever or chest, shoulder or neck pain.
  • Weight loss.

If your pain doesn’t go away after a few days, you should visit your doctor.

How is Abdominal Pain Diagnosed?

In most cases, abdominal pain resolves itself within hours. But, if the discomfort persists, the next step is to investigate and identify the issue that is causing the pain.

Your doctor, a gastroenterologist, or another specialist can identify, address, and treat the cause. They may order a series of tests to discover the origins of your abdominal pain.

The information provided by these tests, in addition to information about the type and location of your pain, can assist in diagnosis.

Tests and examinations may include:

  • A rectal exam to check for hidden problems.
  • For male patients, the doctor may examine your penis and scrotum.
  • For female patients, the doctor may do a pelvic exam to check for uterine problems, or issues in your fallopian tubes and ovaries.
  • A blood test to determine if there is an infection.
  • Blood tests of the liver, pancreas, and heart to sort out which organ may be involved.
  • A urine test to investigate a potential urine infection.
  • An ultrasound and/or CT scan.
  • An ECG to check for a possible heart attack.

Treatment Options for Abdominal Pain

Treatment options for abdominal pain vary depending on what is causing it. Some common treatment options for abdominal pain include:

  • Pain medicine.
  • Drinking lots of fluids.
  • Antacids.
  • Stomach-soothing medications to combat nausea.
  • Fasting.

Home remedies for abdominal pain

Abdominal pain often subsides before medical treatment is necessary. While you are waiting for discomfort to subside, there are things you can do to at home help remedy the pain.

  • Place a hot water bottle or light heating pad on the area.
  • Soak in a warm bath.
  • Drink plenty of water.
  • Avoid coffee, tea, and alcohol, as they are known to increase pain.
  • Avoid solid foods for a few hours. Once you begin eating again, start with bland foods such as crackers, applesauce, rice, or toast.
  • Sip clear fluids.
  • Get plenty of rest.
  • Try over-the-counter antacids to combat pain that occurs after meals.
  • Avoid NSAID medications, including aspirin, ibuprofen, and naproxen.

Treating chronic abdominal pain with pain medicine

If doctors don’t succeed in treating your abdominal pain, you may be referred to a pain medicine specialist.

Pain medicine to treat chronic abdominal or pelvic pain is usually not the first step in the process. Trent Emerick, MD, a pain medicine doctor at UPMC, says he usually sees people after their condition is diagnosed and the cause of their pain is addressed. Pain medicine specialists treat the symptoms of your pain, not the condition that causes the pain.

At UPMC, our pain medicine specialists use a multi-modal approach to treating abdominal pain.

“It’s a challenging type of pain to treat, because oftentimes there is no cure, per se,” Dr. Emerick says. “It’s managing symptoms and trying to reduce portions of the patient’s pain.”

Dr. Emerick works to reduce people’s abdominal pain through a combination of different treatments. Treatment can include:

  • Injections.
  • Nerve pain pills (research shows that narcotic pills don’t work well on abdominal pain).
  • Physical therapy to strengthen core muscles.
  • Referrals for cognitive-based therapy and pain psychology.

Dr. Emerick says that people who incorporate as many treatment options as possible see the best results. However, there’s no “quick fix” for most chronic abdominal pain, he says.

“Oftentimes it becomes about lifestyle management, which is why it’s so important to incorporate all of those different things,” Dr. Emerick says.

Pain medicine treatment can reduce some people’s pain by a significant percentage. Some people may always have some baseline pain, but they are much more functional as their pain is reduced.

How to Prevent Abdominal Pain

Due to the wide variety of ailments that can cause abdominal pain, not all abdominal discomfort is preventable. To lower your chances of developing abdominal discomfort, you can do the following:

  • Maintain a healthy diet of fiber-rich foods.
  • Drink plenty of water.
  • Exercise regularly and participate in stress-reduction activities.
  • Avoid overeating.
  • Attain and maintain a healthy weight.
  • See your primary care provider regularly.
  • Have a screening colonoscopy as directed by your provider.
  • Limit alcohol and NSAIDs.

Experiencing abdominal pain? The experts at the UPMC Digestive Disorders Center can help. Call 1-866-442-7876 or fill out our appointment request form.

Editor's Note: This article was originally published on , and was last reviewed on .

About Digestive Disorders

The UPMC Digestive Disorders Center cares for a wide range of gastrointestinal (GI) conditions and diseases, from diagnosis to treatment. Whether your digestive condition is common or complicated, our experts can help. Upon referral from your physician, we coordinate your testing and treatment. If you have a complicated condition, we can refer you to one of UPMC’s digestive health centers of excellence. Find a GI doctor near you.