When Abdominal Pain or Discomfort Strikes

Causes, treatments, and reasons not to wait it out

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You probably don't think about the internal workings of your belly much -- unless they're red-flagging you with sharp pain, aches, or cramping. Even then, you may dismiss the discomfort or pain as just transient gas -- or some other minor intestinal disturbance -- and simply wait for it to go away.

But you don't have to live with the pain. Whether your abdominal pain or discomfort is a sharp, short-term annoyance or a chronic hurt that dogs you regularly, you have options for making it go away. The first step is figuring out what's causing the pain so that you can treat the source.

What's Going On in There?

Sometimes it's difficult to determine the root cause of a bellyache. The source of the pain could be any one of a number of structures and organs within your abdomen, including your appendix, kidneys, liver, reproductive organs, and aorta;, or it could be caused by any of the organs involved in digestion, such as your stomach, pancreas, gallbladder, or intestines. You also have a myriad of muscles, tendons, and other connective tissue located in this region of the body. Abdominal pain could even be caused by problems completely unrelated to the abdomen, such as a heart attack or pneumonia.

So if you have abdominal pain, and it's chronic, moderate to severe, or in any way worrisome to you, it's best to get a doctor's opinion on what might be amiss. Otherwise, it's just a guessing game.

Your doctor will ask you questions about your pain -- questions that, combined with your medical history and physical exam, are designed to help pinpoint the possible causes of your symptoms.

Tell Your Doctor...

• When the pain began
• Where the pain is located
• What kind of pain it is (sharp, dull, throbbing, etc.)
• How severe the pain is
• Whether the pain is in a specific location or all over
• How frequently you feel the pain
• What makes it worse
• What makes it better
• How the pain is affecting your life

Is It Serious?

Abdominal pain can vary greatly, from minor to excruciating. But here's the kicker: Sometimes excruciating pain can result from something pretty harmless. For example, most people know what it's like to be doubled over with gas pain. Yet some serious problems, such as celiac disease or colon cancer, may not cause you too much discomfort in the early stages.

So don't judge your problems solely by the severity of your pain. Severe, incapacitating pain is always a reason to see your doctor right away. But for mild to moderate pain, consider the following red flags as well, and call your doctor if you experience them:

• Abdominal discomfort that lasts a week or longer
• Abdominal swelling
• Bloating that lasts longer than 2 days (not associated with PMS)
• Diarrhea for more than 3 days
• Fever with your pain
• Pain that develops during pregnancy (or possible pregnancy)
• Prolonged poor appetite
• Tenderness of the abdomen
• Unexplained weight loss
• Black, tarry stool
• Thin, ribbon-like stool

Signs that you need to see a doctor immediately include a rigid abdomen; a high fever with your pain (over 101°F); bloody diarrhea or vomit; an inability to pass stool, gas, or urine; or pain that is incapacitating, lasts several hours, is accompanied by vomiting, or might be symptomatic of a medical emergency, such as a heart attack.

Learn about some unusual heart attack symptoms here.

Use this tabbed chart to see what could go wrong with the various structures of the gastrointestinal tract and lead to pain.

Your intestines are the part of your digestive tract that extends from the stomach to the anus, and are composed of two main sections: the large intestine and the small intestine. Appendicitis -- inflammation of the appendix, a small pocket connected to the large intestine Constipation -- infrequent bowel movements; hard, lumpy stool; straining; feeling of incomplete evacuation Chronic constipation -- constipation symptoms that last longer than 6 months and have no known cause Crohn's disease -- an inflammatory bowel disease most commonly affecting the small intestine Diarrhea -- watery stool that passes through the intestines too quickly Gas -- air produced in the gut during break down of food Irritable bowel syndrome (IBS) -- a functional GI disorder that affects the way the bowel works, resulting in abdominal pain or discomfort, bloating, and altered bowel function (constipation or diarrhea) Lactose intolerance -- the inability to sufficiently digest lactose Ulcer (duodenal) -- a sore in the lining of the small intestine Stomach flu (viral gastroenteritis) -- inflammation of the stomach and intestines, usually caused by a virus Tumors -- uncontrolled cell growth Ulcerative colitis -- an inflammatory bowel disease most commonly affecting the lining of the rectum and colon Your gallbladder is an organ that stores a special digestive fluid (bile) produced by the liver. This fluid helps break down fat as it moves through the intestines. Cholecystitis -- inflammation of the wall of the gallbladder Gallstones -- a collection of crystals that form a stone that may cause inflammation or may block bile ducts Tumors -- uncontrolled cell growth Your stomach is the pouch into which food enters through the esophagus. The stomach holds the food, mixes it with digestive juices, and then empties the contents into the small intestine. Your esophagus is the pipe that transmits food from your throat to your stomach. Gastritis -- a group of conditions all characterized by inflammation of the stomach lining gastroesophageal reflux disease (frequent heartburn caused by a weak esophageal sphincter, the ring of muscle the prevents stomach acid from spilling back up into the esophagus) Heartburn -- a burning sensation caused by stomach acid moving back up into the esophagus Indigestion -- uncomfortable fullness or bloating, typically caused by eating too fast or too much Ulcer (gastric) -- a sore in the lining of the stomach, caused by a bacterial infection Tumors -- uncontrolled cell growth

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