Abdominal pain

Alternative names:

abdominal cramps; belly ache; pain in the abdomen; stomach pain

Home care:

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.

Call your health care provider if:

• 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

What to expect at your health care provider's office:

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.