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Pain mid abdomen above belly button: The request could not be satisfied


Abdominal Pain – Male

Is this your child’s symptom?

  • Pain or discomfort in the stomach or belly area
  • Male
  • Pain found between the bottom of the rib cage and the groin crease
  • The older child complains of stomach pain
  • The younger child points to or holds the stomach
  • Before 12 months of age, use the Crying care guides

Causes of Acute Stomach Pain

  • Eating Too Much. Eating too much can cause an upset stomach and mild stomach pain.
  • Hunger Pains. Younger children may complain of stomach pain when they are hungry.
  • GI Virus (such as Rotavirus). A GI virus can cause stomach cramps as well as vomiting and/or diarrhea.
  • Food Poisoning. This causes sudden vomiting and/or diarrhea within hours after eating the bad food. It is caused by toxins from germs growing in foods left out too long. Most often, symptoms go away in less than 24 hours. It often can be treated at home without the need for medical care.
  • Constipation. The need to pass a stool may cause cramps in the lower abdomen.
  • Strep Throat. A strep throat infection causes 10% of new onset stomach pain with fever.
  • Bladder Infection. Bladder infections usually present with painful urination, urgency and bad smelling urine. Sometimes the only symptom is pain in the lower abdomen.
  • Appendicitis (Serious). Suspect appendicitis if pain is low on the right side and walks bent over. Other signs are the child won’t hop and wants to lie still.
  • Intussusception (Serious). Sudden attacks of severe pain that switch back and forth with periods of calm. Caused by one segment of bowel telescoping into a lower piece of bowel. Peak age is 6 months to 2 years.

Causes of Recurrent Stomach Pains

  • Stress or Worries. The most common cause of frequent stomach pains is stress. Over 10% of children have a “worried stomach.” These children tend to be sensitive and too serious. They often are model children. This can make them more at risk to the normal stresses of life. Examples of these events are changing schools, moving or family fights. The pain is in the pit of the stomach or near the belly button. The pain is real.
  • Abdominal Migraine. Attacks of stomach pain and vomiting with sudden onset and offset. Often occur in children who later develop migraine headaches. Strongly genetic.
  • Functional Abdominal Pains. Functional means the stomach pains are due to a sensitive GI tract. The GI tract is free of any disease.
  • School Avoidance. Stomach pains that mainly occur in the morning on school days. They keep the child from going to school.

Pain Scale

  • Mild: Your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
  • Moderate: The pain keeps your child from doing some normal activities. It may wake him or her up from sleep.
  • Severe: The pain is very bad. It keeps your child from doing all normal activities.

When to Call for Abdominal Pain – Male

Call 911 Now

  • Not moving or too weak to stand
  • You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

  • Pain low on the right side
  • Pain or swelling in the scrotum
  • Constant pain (or crying) for more than 2 hours
  • Recent injury to the stomach
  • High-risk child (such as diabetes, sickle cell disease, recent stomach or abdomen surgery)
  • Age less than 2 years old
  • Fever over 104° F (40° C)
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Moderate pain that keeps from some normal activities
  • Mild pain that comes and goes (cramps), but lasts more than 24 hours
  • Fever is present
  • Bladder infection (UTI) suspected (passing urine hurts, new onset wetting)
  • You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Stomach pains are a frequent problem
  • You have other questions or concerns

Self Care at Home

Seattle Children’s Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Care Advice for Stomach Pain

  1. What You Should Know About Stomach Pain:
    • Mild stomach pain can be caused by something simple. It could be from gas pains or eating too much.
    • Sometimes, stomach pain signals the start of a viral infection. This will lead to vomiting or loose stools.
    • Watching your child for 2 hours will help tell you the cause.
    • Here is some care advice that should help.
  2. Lie Down:
    • Have your child lie down and rest until feeling better.
  3. Clear Fluids:
    • Offer clear fluids only (such as water, flat soft drinks or half-strength Gatorade).
    • For mild pain, offer a regular diet.
  4. Prepare for Vomiting:
    • Keep a vomiting pan handy.
    • Younger children often talk about stomach pain when they have nausea. Nausea is the sick stomach feeling that comes before they throw up.
  5. Pass a Stool:
    • Have your child sit on the toilet and try to pass a stool.
    • This may help if the pain is from constipation or diarrhea.
    • Note: For constipation, moving a warm wet cotton ball on the anus may help.
  6. Do Not Give Medicines:
    • Any drug (like ibuprofen) could upset the stomach and make the pain worse.
    • Do not give any pain medicines or laxatives for stomach cramps.
    • For fever over 102° F (39° C), acetaminophen (such as Tylenol) can be given.
  7. What to Expect:
    • With harmless causes, the pain is most often better or gone in 2 hours.
    • With stomach flu, belly cramps may happen before each bout of vomiting or diarrhea. These cramps may come and go for a few days.
    • With serious causes (such as appendicitis), the pain worsens and becomes constant.
  8. Call Your Doctor If:
    • Pain becomes severe
    • Constant pain lasts more than 2 hours
    • Mild pain that comes and goes lasts more than 24 hours
    • You think your child needs to be seen
    • Your child becomes worse
  9. Extra Help: Worried Stomach:
    • Help your child talk about events that trigger the stomach pain. Talk to your child about how to cope with these the next time around.
    • Help your child worry less about things he can’t control.
    • To treat the pain, help your child get very relaxed. Lying down in a quiet place and taking slow deep breaths may help. Make the belly go up and down with each breath. Then try to relax all the muscles in the body. Think about something pleasant. Listening to audios that teach how to relax might also help.
    • Make sure your child gets enough sleep.
    • Make sure that your child doesn’t miss any school because of stomach pains. Stressed children tend to want to stay home when the going gets rough.
    • Caution: Your child should see his doctor for an exam. Do this before concluding frequent stomach pains are from worrying too much.

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 11/12/2021

Last Revised: 10/21/2021

Copyright 2000-2021. Schmitt Pediatric Guidelines LLC.

Do you have a hernia? | Press

Do you have a hernia?

June is Hernia Awareness Month, and Dr. Tamer Aiti, General Surgeon with the Union County General Surgery Clinic in Anna, provides insight into types of hernias, symptoms, and treatment and prevention methods.

An estimated 20 million hernia repairs are performed globally every year according to the National Center for Biotechnology Information. Most people have heard of this common condition, but not everyone understands what a hernia is and how to recognize one. In the simplest terms, a hernia occurs when an organ pushes through something it shouldn’t, like muscle or tissue.

All hernias are caused by this combination of pressure and an opening, but hernias can appear in different parts of the body. Common places include the outer groin, belly button, upper stomach or through an abdominal incision or scar. However, more than 70 percent of hernias occur in the inner groin and are referred to as inguinal hernias, which are 25 times more likely to affect men than women.

Hernia symptoms can appear gradually or suddenly and cause varying degrees of pain or discomfort. Although symptoms may differ by individual or type of hernia, some frequent indicators include:

1.    A noticeable bulge or lump
A bulge is the most common hernia symptom. It can sometimes be pushed back in or disappear when lying down. Often located in the groin or scrotum, the bulge can increase in size over time and cause aches or pain at the site.

2.    Pain or discomfort when coughing, straining or lifting
Experiencing pain when coughing or sneezing, lifting heavy objects, or even when laughing or crying can be a sign of a hernia. Usually this discomfort will be felt in the lower abdominal area.

3.    Acid reflux or difficulty swallowing
Frequent heartburn, indigestion and regurgitation can be indicators of a hiatal hernia. This type of hernia occurs when part of the stomach protrudes up through the diaphragm and stomach acids leak into the esophagus.

4.    Feeling full or constipated
When a section of the intestine has become trapped, feeling bloated or full and being constipated can indicate a hernia caused by a bowel blockage. These symptoms usually develop rapidly and are accompanied by a feeling of heaviness in the abdomen.

5.    Severe pain, nausea and vomiting
When a portion of the intestine becomes so firmly wedged against the abdominal wall that it cuts off the blood supply, a strangulated hernia occurs. It is accompanied by severe pain, nausea, vomiting and constipation, and could be life-threatening. You should seek immediate medical attention if you experience these types of intense symptoms.

An untreated hernia in adults will not go away, but the good news is hernias are treatable. If you are not experiencing any pain or complications, your doctor may choose to simply watch the hernia to make sure it does not cause further problems. If your hernia is growing larger or causing pain; however, your doctor may recommend surgery to repair the opening.

To lessen your chances of getting a hernia, consider not smoking, maintaining a healthy body weight, avoid straining during bowel movements, using good form when lifting objects or heavy weights, and seeing a doctor for chronic coughs or constipation.

If you experience any of these hernia symptoms, make an appointment with your physician. With an early diagnosis or lifestyle changes, you can avoid serious complications.

Contact the Union County General Surgery Clinic for more information on hernias by calling 618-833-2872 or visit www.UCGeneralSurgery.com.

What Are the Causes of Abdominal and Stomach Pain?

Last updated on 23 February 2021

Causes of lower abdominal pain

The lower region of the abdomen is where your colon is located, and for women, your ovaries. Pain in this region may signal different types of health conditions arising from your intestines, urinary system or reproductive organs.

Pain located near the large intestine or colon may indicate:

  • Diverticulitis
  • Appendicitis
  • Irritable bowel syndrome (IBS)
  • Inflammatory bowel disease (IBD)
  • Hernia

Pain located in the lower abdomen could also indicate bladder issues such as:

  • Urinary tract infection (UTI)
  • Acute retention of urine
  • Bladder stones
  • Bladder cancer

In women, lower abdominal pain can be a symptom of:

  • Ovarian cyst
  • Uterine fibroids
  • Endometriosis
  • Pelvic inflammatory disease

In men, lower abdominal pain could indicate male-specific conditions such as:

  • Testicular torsion
  • Prostatitis

If the pain is persistent and increases in intensity, it is a sign you should see a doctor or go to the Accident & Emergency (A&E) department at a nearby hospital.

Is it your colon?

Your colon is also known as the large intestine. Some conditions that can occur in your colon include:


If you experience the following symptoms, it could be diverticulitis, an inflammation of pouches in the wall of your intestines.

  • Cramping on the left side of your stomach
  • Bloody stools
  • Severe abdominal pain
  • Fever


This is an inflammation of the appendix at the end of your intestines. You may experience the following symptoms:

  • A dull pain that becomes sharp as it moves from upper to lower abdomen
  • Abdominal swelling
  • Loss of appetite, nausea and vomiting
  • Fever
  • Painful urination

Irritable bowel syndrome (IBS)

IBS is a common digestive problem that affects your bowel habits. It displays the following symptoms:

  • Diarrhoea or constipation
  • Bloating and gas
  • Stomach cramps
  • Irregular bowel movements

Inflammatory bowel disease (IBD)

IBD refers to conditions affecting different parts of your colon, including Crohn’s disease and ulcerative colitis. Their symptoms include:

  • Abdominal pain and bloating
  • Bloody stools
  • Weight loss
  • Visible damage to the colon when viewed internally


A hernia is the protrusion of your organs through the muscles or fat surrounding them. You may experience symptoms including:

  • An obvious lump or swelling
  • Pain when moving
  • A heavy feeling in your abdomen
  • Heartburn

Is it your urinary system?

Your bladder is located in the lower abdomen and stores urine. Some bladder problems can cause pain in your abdomen region. Common causes of bladder pain and their symptoms include:

Urinary tract infection (UTI)

UTI occurs when bacteria enter your urethra and infects your bladder, and can lead to kidney issues. Symptoms include:

  • Cloudy or dark urine
  • Pain or burning when urinating
  • Constant urge to urinate
  • Pain in your abdomen

Acute retention of urine

This occurs when you are unable to empty your bladder even if it’s full. You may experience the following symptoms:

  • Pain in the lower abdomen
  • Inability to urinate
  • Leaking urine, but not enough for relief

Bladder stones

These are hard masses made up of minerals in your urine. Look out for the symptoms:

  • Blood in urine
  • Pain or burning sensation when urinating
  • Trouble urinating or an uneven flow
  • Cloudy or dark urine

Bladder cancer

Bladder cancer occurs when unusual cells develop in the bladder. Symptoms of bladder cancer include:

  • Pink, orange or dark red blood in urine
  • Pain or burning sensation when urinating
  • Constant feeling of needing to urinate
  • Inability to urinate
  • Swollen feet and aching bones

When women experience lower abdominal pain

Generally, lower abdominal pain refers to pain below the belly button or lower down, which is called pelvic pain. It can arise from any tissues or organ systems in that area. In women, this includes reproductive organs, your ovaries, uterus (womb) or fallopian tubes. It may be a sign of ovarian cysts, uterine fibroids, endometriosis and pelvic inflammatory disease (PID).

Ovarian cyst

Ovarian cyst is a fluid-filled pocket on your ovary. You may experience these symptoms:

  • Pain in the abdomen around the cyst
  • Bloating or swelling
  • Dizziness or weakness

Uterine fibroids

Uterine fibroids are benign lumps that grow in the wall of the uterus. Symptoms include:

  • Particularly heavy periods
  • Bleeding between periods
  • Enlarged abdomen, resulting in pain
  • Pain during sexual intercourse


This condition occurs when the lining of your uterus grows outside the uterus, causing scar tissue and lesions. Signs of endometriosis may include:

  • Extremely heavy periods
  • Severe pain in your abdomen, or migraines
  • Painful bowel movements or diarrhoea
  • Nausea

Pelvic inflammatory disease (PID)

PID is an infection of your reproductive organs. Symptoms include:

  • Pain in your abdomen
  • Abnormally heavy or unpleasant discharge
  • Fever and chills
  • Pain during sexual intercourse
  • Painful urination

When men experience lower abdominal pain

Lower abdominal pain in men could be due to general or male-specific conditions. Pain around the belly button may indicate early appendicitis or stomach ulcers, while pain just above the pubic bone may point to bladder or testicular issues or prostatitis. When pain is felt just on one side, it might be an indication of appendicitis, kidney stones or infection or hernias. These issues are relatively common among men.

Testicular torsion

A condition where the spermatic cord becomes twisted around your testicle, affecting blood supply. You may experience:

  • Sudden and severe pain in the testicle
  • Enlarged testicle
  • Tenderness in the region
  • Bruising


This occurs when there is swelling or inflammation of the prostate, and can be due to a variety of factors. Symptoms to look out for:

  • Pain around the base of the penis
  • Difficulty urinating
  • Abdominal or back pain
  • Fever, chills, nausea or aches
  • Blood in your semen

What should you do next?

If you are suffering from severe abdominal pain, you should visit an A&E department.

If your pain is persistent but manageable, you should still make an appointment to see a doctor to uncover the possible causes of it. Your doctor may order tests and scans to determine your condition. You may be referred to a specialist who can help to diagnose and treat the cause of your pain.


During a medical emergency in Singapore, you can also call +65 6473 2222 for an ambulance that will transport you to the nearest hospital or a hospital of your choice. Learn more about Parkway Emergency services.


Infographic reviewed by

Dr Eric Wee, gastroenterologist at Mount Elizabeth Novena Hospital
Dr Tan Yung Khan, urologist at Mount Elizabeth Novena Hospital

Infographic brought to you by Health Plus


Appendicitis (n. d.). Retrieved August 16, 2018, from https://www.webmd.com/digestive-disorders/digestive-diseases-appendicitis#1

A visual guide to inflammatory bowel disease (IBD) (n.d.). Retrieved August 16, 2018 from https://www.webmd.com/ibd-crohns-disease/ss/slideshow-inflammatory-bowel-overview

Ellsworth, P. (2017, November 21) Inability to Urinate. Retrieved August 16, 2018, from https://www.emedicinehealth.com/inability_to_urinate/article_em.htm#when_should_someone_seek_medical_care_for_an_inability_to_urinate

Irritable Bowel Syndrome (n.d.). Retrieved August 16, 2018 from https://www.webmd.com/ibs/guide/digestive-diseases-irritable-bowel-syndrome#2

Testicular Torsion (n.d.) Retrieved August 16, 2018, from https://www.webmd.com/men/testicular-torsion

Lower Abdominal Pain in Men – Causes and Treatments (2020, January 2) Retrieved September 21, 2020, from https://www.netdoctor.co.uk/conditions/digestive-health/a30379953/lower-abdominal-pain-in-men/

Lower Abdominal Pain in Women: 15 Possible Causes and Treatments (2020, August 8) Retrieved September 21, 2020, from https://www. netdoctor.co.uk/conditions/digestive-health/a11617/lower-abdominal-pain-in-women/

Acute Abdominal Pain in Children


University of Calgary Faculty of Medicine, Calgary, Alberta

Am Fam Physician. 2003 Jun 1;67(11):2321-2327.

Acute abdominal pain in children presents a diagnostic dilemma. Although many cases of acute abdominal pain are benign, some require rapid diagnosis and treatment to minimize morbidity. Numerous disorders can cause abdominal pain. The most common medical cause is gastroenteritis, and the most common surgical cause is appendicitis. In most instances, abdominal pain can be diagnosed through the history and physical examination. Age is a key factor in evaluating the cause; the incidence and symptoms of different conditions vary greatly over the pediatric age spectrum. In the acute surgical abdomen, pain generally precedes vomiting, while the reverse is true in medical conditions. Diarrhea often is associated with gastroenteritis or food poisoning. Appendicitis should be suspected in any child with pain in the right lower quadrant. Signs that suggest an acute surgical abdomen include involuntary guarding or rigidity, marked abdominal distention, marked abdominal tenderness, and rebound abdominal tenderness. If the diagnosis is not clear after the initial evaluation, repeated physical examination by the same physician often is useful. Selected imaging studies also might be helpful. Surgical consultation is necessary if a surgical cause is suspected or the cause is not obvious after a thorough evaluation.

Abdominal pain is a common problem in children. Although most children with acute abdominal pain have self-limited conditions, the pain may herald a surgical or medical emergency. The most difficult challenge is making a timely diagnosis so that treatment can be initiated and morbidity prevented. This article provides a comprehensive clinical guideline for the evaluation of the child with acute abdominal pain.


Clinically, abdominal pain falls into three categories: visceral (splanchnic) pain, parietal (somatic) pain, and referred pain.

Visceral pain occurs when noxious stimuli affect a viscus, such as the stomach or intestines. Tension, stretching, and ischemia stimulate visceral pain fibers. Tissue congestion and inflammation tend to sensitize nerve endings and lower the threshold for stimuli. Because visceral pain fibers are bilateral and unmyelinated and enter the spinal cord at multiple levels, visceral pain usually is dull, poorly localized, and felt in the midline. Pain from foregut structures (e.g., lower esophagus, stomach) generally is felt in the epigastrium. Midgut structures (e.g., small intestine) cause periumbilical pain, and hindgut structures (e.g., large intestine) cause lower abdominal pain.

Parietal pain arises from noxious stimulation of the parietal peritoneum. Pain resulting from ischemia, inflammation, or stretching of the parietal peritoneum is transmitted through myelinated afferent fibers to specific dorsal root ganglia on the same side and at the same dermatomal level as the origin of the pain. Parietal pain usually is sharp, intense, discrete, and localized, and coughing or movement can aggravate it.

Referred pain has many of the characteristics of parietal pain but is felt in remote areas supplied by the same dermatome as the diseased organ. It results from shared central pathways for afferent neurons from different sites. A classic example is a patient with pneumonia who presents with abdominal pain because the T9 dermatome distribution is shared by the lung and the abdomen.1

View/Print Table


Causes of Acute Abdominal Pain in Children


Genitourinary causes

Drugs and toxins


Urinary tract infection



Urinary calculi




Lead poisoning

Mesenteric lymphadenitis




Pelvic inflammatory disease

Pulmonary causes

Abdominal trauma

Threatened abortion


Intestinal obstruction

Ectopic pregnancy



Ovarian/testicular torsion


Food poisoning



Peptic ulcer


Infantile colic

Meckel’s diverticulum

Metabolic disorders

Functional pain

Inflammatory bowel disease

Diabetic ketoacidosis


Lactose intolerance


Angioneurotic edema

Liver, spleen, and biliary tract disorders




Acute adrenal insufficiency

Mediterranean fever


Hematologic disorders


Sickle cell anemia

Splenic infarction

Henoch-Schönlein purpura

Rupture of the spleen

Hemolytic uremic syndrome



Causes of Acute Abdominal Pain in Children


Genitourinary causes

Drugs and toxins


Urinary tract infection



Urinary calculi




Lead poisoning

Mesenteric lymphadenitis




Pelvic inflammatory disease

Pulmonary causes

Abdominal trauma

Threatened abortion


Intestinal obstruction

Ectopic pregnancy



Ovarian/testicular torsion


Food poisoning



Peptic ulcer


Infantile colic

Meckel’s diverticulum

Metabolic disorders

Functional pain

Inflammatory bowel disease

Diabetic ketoacidosis


Lactose intolerance


Angioneurotic edema

Liver, spleen, and biliary tract disorders




Acute adrenal insufficiency

Mediterranean fever


Hematologic disorders


Sickle cell anemia

Splenic infarction

Henoch-Schönlein purpura

Rupture of the spleen

Hemolytic uremic syndrome



Table 1 lists many causes of acute abdominal pain in children. Information on rare entities can be found in a standard pediatric surgery textbook.2


Infantile colic affects 10 to 20 percent of infants during the first three to four weeks of life. Typically, infants with colic scream, draw their knees up against their abdomen, and appear to be in severe pain.3


Gastroenteritis is the most common cause of abdominal pain in children.4 Viruses such as rotavirus, Norwalk virus, adenovirus, and enterovirus are the most frequent causes.4,5 The most common bacterial agents include Escherichia coli, Yersinia, Campylobacter, Salmonella, and Shigella.


Appendicitis is the most common surgical condition in children who present with abdominal pain.2,6 Approximately one in 15 persons develop appendicitis.7 Lymphoid tissue or a fecalith obstructs the appendiceal lumen, the appendix becomes distended, and ischemia and necrosis may develop. Patients with appendicitis classically present with visceral, vague, poorly localized, periumbilical pain. Within six to 48 hours, the pain becomes parietal as the overlying peritoneum becomes inflamed; the pain then becomes well localized and constant in the right iliac fossa.


Mesenteric lymphadenitis often is associated with adenoviral infection. The condition mimics appendicitis, except the pain is more diffuse, signs of peritonitis often are absent, and generalized lymphadenopathy may be present.


Acute constipation usually has an organic cause (e.g., gastroenteritis, appendicitis), while chronic constipation usually has a functional cause (e.g., low-residue diet). Abdominal pain resulting from constipation is most often left-sided or suprapubic.


Abdominal trauma can be accidental or intentional. Blunt abdominal trauma is more common than penetrating injury. Abdominal trauma may cause musculocutaneous injury, bowel perforation, intramural hematoma, laceration or hematoma of the liver or spleen, and avulsion of intra-abdominal organs or vascular pedicles.


Intestinal obstruction produces a characteristic cramping. Causes of intestinal obstruction include volvulus, intussusception, incarcerated hernia, and postoperative adhesions.


Pelvic inflammatory disease (PID) usually is caused by Chlamydia trachomatis or Neisseria gonorrhoeae.7 Risk factors include multiple sexual partners, use of an intrauterine device (IUD), and a history of PID.

Clinical Evaluation

In evaluating children with abdominal pain, a thorough history is required to identify the most likely cause. An initial evaluation of the history is followed by a physical examination and a reassessment of certain points of the history. An algorithm is presented in Figure 1.8


Age of Onset

Age is a key factor in the evaluation of abdominal pain (Table 2).7,9–11

Pain History

Children who do not verbalize typically present with late symptoms of disease. Children up to the teenage years have a poor sense of onset or location of pain. The classic sequence of shifting pain usually occurs with appendicitis. In children who cannot verbalize, the initial 24-hour history of vague nausea or periumbilical pain may be unreported or go unnoticed, so these children more often present at the second stage of more visceral pain. However, any child with pain that localizes to the right lower quadrant should be suspected of having appendicitis. Thus, inquiry into the location, timing of onset, character, severity, duration, and radiation of pain are all important points but must be viewed in the context of the child’s age.

Recent Trauma

A history of recent trauma may indicate the cause of pain.

Precipitating or Relieving Factors

Parietal pain is aggravated by movement. Relief of pain after a bowel movement suggests a colonic source, and relief after vomiting suggests a source in the more proximal bowel.

View/Print Figure

Evaluation of Acute Abdominal Pain in Children


Algorithm for evaluating acute abdominal pain in children.

Adapted with permission from King BR. Acute abdominal pain. In: Hoekelman RA. Primary pediatric care. 3d ed. St. Louis: Mosby, 1997:188.

Evaluation of Acute Abdominal Pain in Children


Algorithm for evaluating acute abdominal pain in children.

Adapted with permission from King BR. Acute abdominal pain. In: Hoekelman RA. Primary pediatric care. 3d ed. St. Louis: Mosby, 1997:188.

Associated Symptoms

In the acute surgical abdomen, pain generally precedes vomiting, and the reverse is true in medical conditions. Any child presenting with bilious vomiting should be presumed to have a bowel obstruction. Diarrhea often is associated with gastroenteritis or food poisoning, but it also can occur with other conditions. Bloody diarrhea is much more suggestive of inflammatory bowel disease or infectious enterocolitis. The classic “currant-jelly stool” often is seen in patients with intussusception. Failure to pass flatus or feces suggests intestinal obstruction.

View/Print Table


Differential Diagnosis of Acute Abdominal Pain by Predominant Age

Birth to one year

Two to five years

Six to 11 years

12 to 18 years

Infantile colic Gastroenteritis Constipation Urinary tract infection Intussusception Volvulus Incarcerated hernia Hirschsprung’s disease

Gastroenteritis Appendicitis Constipation Urinary tract infection Intussusception Volvulus Trauma Pharyngitis Sickle cell crisis Henoch-Schönlein purpura Mesenteric lymphadenitis

Gastroenteritis Appendicitis Constipation Functional pain Urinary tract infection Trauma Pharyngitis Pneumonia Sickle cell crisis Henoch-Schönlein purpura Mesenteric lymphadenitis

Appendicitis Gastroenteritis Constipation Dysmenorrhea Mittelschmerz Pelvic inflammatory disease Threatened abortion Ectopic pregnancy Ovarian/testicular torsion


Differential Diagnosis of Acute Abdominal Pain by Predominant Age

Birth to one year

Two to five years

Six to 11 years

12 to 18 years

Infantile colic Gastroenteritis Constipation Urinary tract infection Intussusception Volvulus Incarcerated hernia Hirschsprung’s disease

Gastroenteritis Appendicitis Constipation Urinary tract infection Intussusception Volvulus Trauma Pharyngitis Sickle cell crisis Henoch-Schönlein purpura Mesenteric lymphadenitis

Gastroenteritis Appendicitis Constipation Functional pain Urinary tract infection Trauma Pharyngitis Pneumonia Sickle cell crisis Henoch-Schönlein purpura Mesenteric lymphadenitis

Appendicitis Gastroenteritis Constipation Dysmenorrhea Mittelschmerz Pelvic inflammatory disease Threatened abortion Ectopic pregnancy Ovarian/testicular torsion

Urinary frequency, dysuria, urgency, and malodorous urine suggest a urinary tract infection.12 Purulent vaginal discharge suggests salpingitis. Cough, shortness of breath, and chest pain point to a thoracic source. Polyuria and polydipsia suggest diabetes mellitus. Joint pain, rash, and smoke-colored urine suggest Henoch-Schönlein purpura.13

Gynecologic History

In girls, a thorough gynecologic history, including a menstrual history and a history of sexual activity and contraception, is essential. Amenorrhea may indicate pregnancy. A history of multiple sexual partners and the use of an IUD suggest PID. Use of an IUD and a history of PID or tubal ligation increase the risk of ectopic pregnancy. Sudden onset of midcycle pain of short duration suggests mittelschmerz.

Past Health

All previous hospitalizations or significant illnesses such as sickle cell anemia and porphyria should be noted. A history of surgery not only can eliminate certain diagnoses but also can increase the risk of others, such as intestinal obstruction from adhesions. A history of similar pain may suggest a recurrent problem.

Drug Use

A detailed drug history is important, because certain drugs (Table 1) may cause abdominal pain.

Family History

A family history of sickle cell anemia or cystic fibrosis may indicate the diagnosis. The patient’s ethnic background is important because sickle cell anemia is most common in blacks of African origin.


General Appearance

In general, children with visceral pain tend to writhe during waves of peristalsis, while children with peritonitis remain quite still and resist movement. The hydration status of the child should be assessed.

Vital Signs

Fever indicates an underlying infection or inflammation. High fever with chills is typical of pyelonephritis and pneumonia.12 Tachycardia and hypotension suggest hypovolemia. If a postmenarcheal girl is in shock, ectopic pregnancy should be suspected. Hypertension may be associated with Henoch-Schönlein purpura or hemolytic uremic syndrome.13,14 Kussmaul’s respiration indicates diabetic ketoacidosis.

Abdominal Examination

The breathing pattern should be observed, and the patient should be asked to distend the abdomen and then flatten it. After the child is asked to indicate, with one finger, the area of maximal tenderness, the abdomen should be gently palpated, moving toward (but not palpating) that area. The physician should examine for Rovsing’s sign (when pressure on the left lower quadrant distends the column of colonic gas, causing pain in the right lower quadrant at the site of appendiceal inflammation), then gently assess muscle rigidity. Gentle percussion best elicits rebound tenderness. Deeper palpation is necessary to discover masses and organomegaly.

Rectal and Pelvic Examination

These examinations should be used when significant information is sought or expected.2,10,15 A rectal examination may provide useful information about tenderness, sphincter tone, and presence of masses, stool, and melena. In boys, examination of the external genitalia may reveal penile and scrotal abnormalities. In girls, it may reveal vaginal discharge, vaginal atresia, or imperforate hymen. A bimanual pelvic examination may provide useful information about uterine or adnexal masses or tenderness. Purulent cervical discharge, cervical motion tenderness, and adnexal mass are signs of PID.

Associated Signs

Jaundice suggests hemolysis or liver disease. Pallor and jaundice point to sickle cell crisis. A positive iliopsoas test (passive extension of the right hip and flexion of the right thigh against resistance) or obturator test (rotation of the right flexed hip) suggests an inflamed retrocecal appendix, a ruptured appendix, or an iliopsoas abscess. A positive Murphy’s sign (interruption of deep inspiration by pain when the physician’s fingers are pressed beneath the right costal margin) suggests acute cholecystitis. Cullen’s sign (bluish umbilicus) and Grey Turner’s sign (discoloration in the flank) are unusual signs of internal hemorrhage. Purpura and arthritis suggest Henoch-Schönlein purpura.13


Laboratory studies should be tailored to the patient’s symptoms and clinical findings. Initial laboratory studies may include a complete blood cell count and urinalysis. A low hemoglobin level suggests blood loss or underlying hematologic abnormalities, such as sickle cell disease. However, a normal hemoglobin level does not exclude an acute massive hemorrhage for which the body has not yet compensated. Leukocytosis, especially in the presence of a shift to the left and toxic granulations in the peripheral smear, indicates an infection. Urinalysis can help identify urinary tract pathology, such as infection or stones. A pregnancy test should be considered in post-menarcheal girls.16

Plain-film abdominal radiographs are most useful when intestinal obstruction or perforation of a viscus in the abdomen is a concern. Chest radiographs may help rule out pneumonia. The most contentious issue in emergency medicine may be the usefulness of ultrasonography and computed tomography (CT) in patients with abdominal pain.17-20 CT likely is more accurate than ultrasonography.18 However, the experience of the operator and interpreter significantly affect the accuracy of both modes.19 In the emergency department, ultra-sonography probably is most useful in diagnosing gynecologic pathology such as ovarian cysts, ovarian torsion, or advanced periappendiceal inflammation.17,20 CT involves radiation exposure and may require the use of contrast agents. CT may be necessary if excessive bowel gas precludes ultrasonographic examination.

View/Print Table


Indications for Surgical Consultations in Children with Acute Abdominal Pain

Severe or increasing abdominal pain with progressive signs of deterioration

Bile-stained or feculent vomitus

Involuntary abdominal guarding/rigidity

Rebound abdominal tenderness

Marked abdominal distension with diffuse tympany

Signs of acute fluid or blood loss into the abdomen

Significant abdominal trauma

Suspected surgical cause for the pain

Abdominal pain without an obvious etiology


Indications for Surgical Consultations in Children with Acute Abdominal Pain

Severe or increasing abdominal pain with progressive signs of deterioration

Bile-stained or feculent vomitus

Involuntary abdominal guarding/rigidity

Rebound abdominal tenderness

Marked abdominal distension with diffuse tympany

Signs of acute fluid or blood loss into the abdomen

Significant abdominal trauma

Suspected surgical cause for the pain

Abdominal pain without an obvious etiology


Treatment should be directed at the underlying cause. In many patients, the key to diagnosis is repeated physical examination by the same physician over an extended time.21  Indications for surgical consultations are listed in Table 3. Traditionally, the use of analgesics is discouraged in patients with abdominal pain for fear of interfering with accurate evaluation and diagnosis. However, several prospective, randomized studies have shown that judicious use of analgesics actually may enhance diagnostic accuracy by permitting detailed examination of a more cooperative patient.22-24 [References 22 and 23—Evidence level A, randomized controlled trials]

Stomach Cancer Symptoms | Stanford Health Care

Stomach Cancer Symptoms

The symptoms of stomach cancer are in two distinct stages:

  • Early stage stomach cancer symptoms
  • Advanced stomach cancer symptoms

Early Stage Stomach Cancer Symptoms

It is common for people with early stage stomach cancer to experience no symptoms. However, as stomach cancer grows and spreads, it exhibits some telltale signs and symptoms, even while still in the early stages.

Symptoms may include:

  • Unexplained weight loss
  • Abdominal pain or vague pain just above the belly button area
  • Indigestion, heartburn or vomiting
  • Loss of or decrease in appetite
  • Weakness or fatigue
  • Blood in vomit or stool
  • A feeling of fullness after small meals

Many symptoms of early stage stomach cancer are also the symptoms of less serious stomach issues. If you are experiencing any of these signs and symptoms, it is important to see your doctor. The earlier we diagnose the cancer, the more successfully we can treat it.

Advanced Stomach Cancer Symptoms

Symptoms of advanced stomach cancer are more serious than symptoms of early stage stomach cancer. Because advanced stage stomach cancer has grown and spread, it can also effect nearby organs including:

  • The liver
  • The large intestine (also known as the colon)

If stomach cancer has grown to create a blockage within the stomach or the large intestine, you may experience:

  • Loss of appetite
  • Significant weight loss
  • Uncontrolled vomiting

Signs that stomach cancer has spread to the liver include:

  • Jaundice (yellowing of skin or eyes)
  • Ascites (enlargement of stomach from fluid)

Stomach Cancer Diagnosis

If you experience any unexplained stomach or digestion symptoms, see your doctor for an expert diagnosis. Learn more about stomach cancer diagnosis.

Explaining Unexplained Abdominal Pain | Mid-Atlantic Emergency Medical Associates

Explaining Unexplained Abdominal Pain by Katie E. Golden, MD

Abdominal pain is a common symptom that brings patients to the emergency department (ED) for evaluation. It is also common that our ED workup does not find an identifiable cause, and patients are discharged home without a clear diagnosis. This requires the patient to closely monitor their symptoms, follow up with their regular doctor or a specialist, or even return to the ED if their symptoms worsen. This can be an understandably frustrating situation for patients. We thus want to take the time to explain precisely the tests we can run in the ED, the potential for conditions that require outpatient follow up for diagnosis, and guidance on when a patient should return to the ED for unexplained abdominal pain.

Let’s begin by reviewing the tests we perform for patients in the ED for abdominal pain.

While the list of conditions that cause abdominal or pelvic pain is infinite, the emergent conditions that require prompt diagnosis are more finite (fortunately for both ED doctors and patients). Testing in the ED typically begins with lab work: we check blood counts, electrolytes, kidney function, liver function, and perform an analysis of the urine. While this can sometimes be the only testing that is required to make a diagnosis or rule out an emergency, we typically also consider obtaining a CT scan of the abdomen and pelvis. This test gives us a detailed picture of all the organs from the lower part of the chest to the hips and allows us to efficiently diagnose the conditions requiring immediate treatment. This includes life-threatening infections, bowel obstructions, abnormal fluid or bleeding, kidney stones, masses or tumors, abnormalities of the blood vessels that run through the abdomen, the list goes on. We will also sometimes obtain an ultrasound instead of a CT scan, which is particularly useful at evaluating the gallbladder, ovaries and uterus, and testicles.

While these tests are designed to efficiently and accurately identify abdominal and pelvic emergencies, the list of non-life-threatening diagnoses that can cause pain is much longer, and unfortunately requires specialists and testing that we do not have in the ED. Examples of conditions that we would not diagnose on CT scan or ultrasound include viral infections (‘the stomach flu’), inflammation or ulcers in the stomach lining, inflammatory bowel disease (such as Crohn’s Disease or Ulcerative Colitis), irritable bowel syndrome or maldigestion, pelvic floor dysfunction, strains and spasms of the muscles in the back and abdomen, to name just a few. It is also worth mentioning that it is common for psychological stress to manifest in real, severe, and debilitating abdominal pain. Many patients do not realize that the same chemicals that regulate our brain and response to stress (dopamine, serotonin, and norepinephrine or ‘adrenaline’) are the same chemicals that regulate our intestinal function. So just the same way a difficult circumstance in our lives can trigger feelings of stress and anxiety, it can just as easily cause pretty significant abdominal pain instead.  Research suggests this may be a more frequent cause of abdominal pain than we currently appreciate, especially when a patient has persistent symptoms and extensive testing does not reveal any obvious cause.

When our ED workup does not reveal a clear explanation for abdominal pain, the ED clinician can sometimes provide some guidance on other potential causes of the pain and the necessary specialists and testing needed for further evaluation. If a patient’s symptoms are suggestive of inflammatory bowel disease, for example, we may provide a referral to a gastroenterologist, who can perform a colonoscopy for evaluation. One of the most useful diagnostic tools that we do not have at our disposal in the emergency room, however, is time. Many cases of unexplained abdominal pain will resolve on their own and are likely due to a transient period of maldigestion. Other conditions will progress and evolve over time, hopefully revealing symptoms that can help doctors identify the problem. Every ED clinician hopes to be able to diagnose and treat the cause of a patient’s pain, providing immediate relief and a resolution to the patient’s discomfort. More often, unfortunately, it takes time to identify the root cause of a patient’s symptoms.

In the meantime, we want to make sure our patients understand that following points if they are leaving the emergency department with unexplained abdominal pain:

  • Please consider the clinicians’ recommendations regarding follow-up, whether it be a primary care doctor or a specialist. Ongoing and repeated evaluation is often necessary to reach a diagnosis, and we give these recommendations sincerely and in the patient’s best interest.

  • It is important the patient consider returning for repeat evaluation if they have worsening symptoms, especially if the pain is accompanied by a new fever, repeated episodes of vomiting and inability to keep down fluids, frequent diarrhea, or bleeding from the intestine. As mentioned, some diagnoses cannot be made initially, but the evolution of the underlying condition and the resultant development of new symptoms requires re-evaluation. Appendicitis is a good example of a condition that can sometimes require re-evaluation . . .

  • Your clinician may speak to you about the possibility of early appendicitis. An appendix, in the early stages of appendicitis, can appear normal on an initial CT scan (the way we diagnose this condition). If the patient presented for pain in the right lower abdomen or around the belly button, and after going home the pain continues to worsen (or is accompanied by the symptoms mentioned above) then they must please pay attention to their clinician’s warning and come back for re-evaluation. A repeat CT scan may be required to make the diagnosis.

  • Patients often ask about a prescription medication when going home with ongoing symptoms. Prescription pain medication, more specifically opioid medications, are rarely advisable for abdominal pain. While they may provide temporary relief, these medicines work by binding to receptors in the intestine that can ultimately worsen, rather than help, the pain (not to mention cause severe constipation, nausea, vomiting, etc). Additionally, if there is no clear diagnosis for a patient’s pain, we do not want them to stay at home with worsening symptoms, relying on strong pain medication to avoid a repeat visit. If the pain advances to the point that standard, over the counter medications, are ineffective, we hope the patient will seek urgent re-evaluation at their nearest ED.


Doctors Share a Belly Map That Reveals What Can Make Your Stomach Hurt / Bright Side

Abdominal pain is one of the most common health conditions — we all experience it from time to time. There are plenty of different reasons for pain in this area which is why it’s crucial to properly identify the problem in order to treat it in the best way possible.

Bright Side wants to share the belly map with you to help you figure out what’s making your stomach hurt.

1. The right upper abdomen

This part of your belly contains your gallbladder and liver, so the most common causes of pain in this area are usually connected with these organs.

  • If you experience sudden, severe pain that radiates into your right shoulder and appears after eating a heavy, fatty meal, you probably have gallstones.
  • Sharp pains or dull cramps that spread to your right shoulder or back and last for several hours may indicate cholecystitis or the inflammation of your gallbladder.
  • A dull ache or a sharp pain that might come and go usually indicates that you suffer from hepatitis, an inflammatory condition of your liver.

2. The middle upper abdomen

This part of your belly includes your duodenum, the first section of the small intestine, and a large part of your pancreas.

  • If you often experience pain that radiates into your back and gets aggravated by eating, especially foods that are high in fat, this may be a sign of pancreatitis.
  • Severe pain and tenderness in this area accompanied by nausea, vomiting, diarrhea, and abdominal swelling may be due to an epigastric hernia.
  • A burning feeling in your chest along with symptoms like a cough, sore throat, an acidic taste in your mouth, excessive gas, nausea, vomiting, and bloating usually indicates heartburn or dyspepsia.
  • If you suffer from heartburn that gets worse when you lean over or lie down along with chest pain and belching, you probably have a hiatal hernia.
  • Pain that can get worse between meals or in the middle of the night and can be eased by eating may be a symptom of duodenal ulcers.

3. The left upper abdomen

The biggest part of your stomach is concentrated in your left upper abdomen, so any unusual feelings in this area typically indicate problems with this organ.

  • Severe, nagging pain that is accompanied by nausea or vomiting may be a sign of gastritis or the inflammation of your stomach.
  • Burning pain that is usually more intense when your stomach is empty may be caused by stomach ulcers.

4. The right and left abdomen

Your kidneys are located in the right and left parts of your belly on each side of the spine. Sometimes pain in these areas can also be caused by problems with your large intestine.

  • Pain in your side that radiates into your back and is accompanied by fever, chills, diarrhea, and nausea can be a sign that you’re suffering from a kidney infection.
  • Severe pain that radiates into your lower abdomen and comes in waves indicates kidney stones. You may also experience nausea, vomiting, fever, a persistent need to urinate, and blood in your urine.
  • Pain with or without bloating appearing along with hard and dry stool that’s difficult to pass may be a symptom of constipation.

5. The middle abdomen

Any uncomfortable feelings in this part of your belly are closely connected to the problems in your small and large intestines.

6. The left abdomen

Besides your left kidney, this area also contains your descending colon that can get infected or inflamed because of an unhealthy diet, aging, and some other common causes.

  • Constant and persistent pain along with abdominal tenderness, fever, nausea, and vomiting are the most typical symptoms of diverticulitis or the inflammation of your descending colon.

7. The right lower abdomen

This part of your abdomen includes the appendix, a small organ that stores useful bacteria, promotes good digestion and supports your immune system.

  • Sharp pain, loss of appetite, nausea, vomiting, and fever are the most common symptoms of appendicitis or the inflammation of your appendix which requires immediate medical treatment.

8. The middle lower abdomen

Your bladder and reproductive organs are located in this part of your belly.

  • Abdominal cramping, a burning feeling when you pee, and changes in the color of your urine may indicate a bladder infection.
  • Sudden and severe pelvic pain that can last for months is also a common symptom of some problems with your reproductive organs.

9. The left lower abdomen

A huge part of your large intestine is located here, that’s why if you have some problems with this organ, you’ll most likely experience pain in your left lower abdomen.

  • Abdominal pain that is accompanied by cramping, bloating, excess gas, diarrhea or constipation could be symptoms of irritable bowel syndrome.

The information presented in the article is for informative purposes only. Don’t forget to consult your doctor first if you experience any kind of abdominal pain.

Have you ever suffered from a stomach ache? Did you have a medical examination? Share your experience with us in the comments!

90,000 reasons for women and men “- Yandex.Q

Most people who experience abdominal pain in the navel area do not understand how dangerous it can be for their health. Someone scolds themselves for overeating, others blame a busy day, stress or colds. Complicating the situation is that cramps and pains can cover the entire area of ​​the abdomen and create false desires for pain.

Many of us have experienced such pain at least once in our lives and know how unbearable it is – it occurs with any movement, so all that remains is to lie down and not move.And if a person who, for example, has a severe toothache, is able to independently get to the dentist, a person with abdominal pain in the navel area is forced to suffer lying on the bed, being literally “twisted” by it.

In this case, the only thing that remains is to call a doctor. And this is likely to be followed by hospitalization.

Causes of pain in the navel area

In women and men, pain in the navel can be sudden and burning or chronic, sometimes like colic.Before you start worrying, you need to analyze when discomfort occurs.

After all, the cause of pain in the navel can be very prosaic – too tight clothes press on the stomach, which causes pain. A metal buckle belt can cause painful swelling and rashes, and this is not only possible for people with allergies.

However, dangerous diseases can also cause pain in the navel in women and men, some of which require urgent intervention.

  1. Appendicitis

    … If a person is suddenly overtaken by pain, pains appear just above the navel, around the navel, under the stomach or in the abdomen, it can be assumed that you have appendicitis. As a rule, such pains become more intense over time, their localization goes to the right side of the body. There is not always a sharp rise in body temperature, but usually the tongue becomes dry, and the heart beats unevenly and often.

  2. Enteritis, or inflammation of the small intestine, and gastroenteritis (inflammation of the stomach and small intestine) are common causes of abdominal pain in the navel area.In addition to pain, patients with enteritis may experience nausea, vomiting, stool disturbances (more often diarrhea, but there may be constipation). Another symptom characteristic of enteritis is rumbling, bloating, and frequent, profuse passing of gas (flatulence). Acute enteritis is most often infectious and is accompanied by an increase in temperature. Chronic enteritis is caused by errors in the diet or the presence of chronic helminthic invasion, giardiasis.
  3. Small intestine diverticulitis. This disease can be diagnosed primarily by a bulge in the abdomen, in particular, the navel.These protrusions – diverticula – look like an inflated bag up to about three cm in diameter, and in rare cases up to 15 centimeters (and the minimum size can be from 3 mm). The intestinal mucosa protrudes through the muscles of the intestine. Diverticula can spread anywhere in the intestines. These places are very painful and radiate to the left side of the abdomen. In addition to visible signs, the temperature may also rise – up to about 38 degrees.
  4. Malabsorption syndrome. This is a chronic disease of the digestive tract, caused by impaired digestion of food masses.This may be due to defects in the enzymatic breakdown of nutrients into less complex compounds; lack of full absorption and subsequent transport of substances. A person complains of various discomfort in the abdomen. Painful sensations are quite varied, but nonspecific, while they persist (without treatment) for a long time.
  5. Intestinal colic. The causes of this syndrome can be constipation, and diarrhea, and indigestion, and dysbiosis, and much more.The belly in the navel area in this case hurts due to spasms of the intestinal muscles. The more it contracts, the stronger and more excruciating the pain.
  6. Umbilical hernia. In addition to painful sensations in the navel, you will encounter a visual manifestation of the disease – an elongated formation. The pain is always sharp. If you suspect you have a hernia, immediately call an ambulance, otherwise you will not avoid dire consequences. Self-medication is inappropriate here – you have a really serious problem.
  7. Chronic jejunit is a long-term inflammation of the jejunum.The development of the disease is facilitated by past intestinal infections, parasitic lesions, unbalanced nutrition, excessive consumption of alcohol, spicy and fatty foods, chronic hepatitis, metabolic disorders and immunodeficiency states. The most pronounced spastic pain in the umbilical region due to spasm of the intestinal wall. Pains against the background of flatulence are also characteristic, caused by the stretching of the intestinal mucosa with accumulating gases. Inflammation of the mesenteric lymph nodes develops – mesentery, which is manifested by soreness below and to the right of the navel, in the navel and left hypochondrium.
  8. Small bowel cancer does not have a specific pain pattern. As with many other intestinal diseases, with cancer, pain can be localized in the navel and be cramping in nature, intensified when the intestines are full. Dyspepsia is almost always observed with cancer: belching, heartburn, bloating, diarrhea or constipation. Sometimes feces have a tarry appearance and black color, which indicates the presence of blood in it. Other symptoms include weight loss, general weakness for many weeks or even months, and a loss of taste for life.
  9. Abdominal migraine. Children are most susceptible, as a rule, of preschool age. The disease is manifested by severe paroxysmal pain in the navel area, as well as nausea, vomiting, flatulence, bloating, diarrhea.

Based on the above, it becomes clear that painful sensations around the navel or to the sides of it could indicate a variety of diseases, some of which are life-threatening.

Whatever the cause of the pain in the umbilical zone, it must be diagnosed.After all, any pain that appears in the abdomen near the navel is a kind of signal from the body about the course of the disease. You should not self-medicate and take all kinds of pain relievers, you need a comprehensive medical examination.

Abdominal pain in the navel area and temperature

If you experience pain in the navel area, which is accompanied by an increase in temperature, this may indicate a number of intestinal diseases – appendicitis, pancreatitis, cholecystitis, peritonitis, stomach ulcer or intestinal obstruction.In women, these symptoms may indicate ovarian problems.

For setting a more accurate symptom, you need to tell the doctor exactly where you are experiencing pain, above the navel or below.

What to do with pain in the navel area?

It is important to recognize a critical situation and call a doctor in time. This should be done immediately if you notice the following symptoms in yourself:

  • severe constant pain, vomiting, loose stools;
  • pain on the right side of the abdomen in the area of ​​the appendix;
  • 90,017 blood in vomit and feces.

So, in case of severe abdominal pain, call an ambulance and lie on your back in bed with your knees and hip joints bent, and put a high pillow under your head. The position should be such that the abdominal muscles are as relaxed as possible.

Well, and on the stomach itself, put either a warm, but not hot, heating pad, or your own palm. And remember, amateur performance in such cases is not appropriate, the doctor must diagnose and prescribe treatment.

Material provided


Pain in the stomach (abdomen) – what to do if the stomach hurts

It often happens that after a meal, the stomach suddenly begins to ache. Sometimes pain occurs without any apparent reason. Perhaps you just overeat, but it is possible that something more serious.

If you feel pain, sharp cuts in the stomach, there is a burning sensation – this is not only discomfort, but also a possible signal that it is time for you to see a doctor. How urgent – our short guide to abdominal pain, which professional doctors helped us to compile, will give you the opportunity to understand:

  • Natalia Gordienko, gastroenterologist, therapist of the highest qualification category, MC Doctor Sam
  • Viktoria Forosenko, therapist-cardiologist of the medical clinic “Boris”

Test yourself, because it is important to know what to do if your stomach hurts: a quick reaction helps to avoid unpleasant consequences.

Contents of article

Why there is pain in the stomach

Intense cutting or stabbing pain in the center of the abdomen

Constricting pain in the stomach with a feeling of numbness or nausea

Pain in the right hypochondrium, bitter taste in the mouth or vomiting with bile

Pain in the upper abdomen with concomitant dry mouth, diarrhea or vomiting

Pain in the navel with great weakness and coldness of the limbs

Sudden severe pain at the level of the navel on the left or right, radiating to the lower back or lower abdomen

Pain in the epigastric or umbilical region

Constant pulling pain in the lower abdomen in the center, radiating to the lower back

Pain above the pubis in women

Intense abdominal pain with shortness of breath, dizziness and panic attacks

Main causes of stomach pain

Proper nutrition if your stomach hurts

Why the stomach got up

What pills for stomach pain can be taken

How to treat severe stomach pain

Why there is pain in the stomach

Often we call completely different symptoms pain in the stomach and they may not have any relation directly to the stomach.The abdominal cavity is where a large number of internal organs are located. And besides the stomach, you may be bothered by the liver, pancreas, gallbladder, spleen, intestines, bladder, organs of the reproductive system. Complaints of abdominal pain can be the cause of impaired blood circulation in the abdominal cavity, as well as problems with the spine and nervous system. Stomach pain sometimes indicates a more serious condition, such as heart or lung disease. To understand what is the cause of the ailment, you need to find out the nature of the pain.It can be acute and stabbing, when it arises quite sharply and only intensifies over time, or bothers for a while, passes and repeats again, resembles a feeling of hunger or heaviness in the stomach, and possibly covers with an acute attack of cutting and burning pain. All these are symptoms of various diseases and there is no universal cure for them. Let’s look at the reasons in more detail.

Cutting or stabbing sharp pain in the center of the abdomen

This is a sign that gas has accumulated in the intestines (from soda, talking while eating, not chewing food enough, etc.)etc.).

A warm heating pad or a preparation based on simethicont (simikol, espumisan, almakol) will help to relieve pain in the intestines.

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Constricting pain in the stomach with a feeling of numbness or nausea

Stomach cramps often signal poisoning (food or alcohol). You should not wait until it feels better – toxins quickly enter the bloodstream and spread throughout the body, provoking weakness, headache and fever.

Rinse the stomach with salt water (1 tablespoon per liter of water) and take a sorbent (activated carbon, atoxil, white coal).

Pain in the right hypochondrium, bitter taste in the mouth or vomiting with bile

This is a sign of malfunctioning of the gallbladder. Perhaps the cause was overeating fatty fried foods or acidic foods (pickles, fresh juices, etc.).

Take an antispasmodic (no-shpa, drotaverin, papaverine) and a digestive enzyme (mezim, pancreatin, festal).If such pain occurs three times a month or more often, contact a gastroenterologist and do an ultrasound of the gastrointestinal tract.

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Pain in the upper abdomen with concomitant dry mouth, diarrhea or vomiting

This is how the pancreas makes itself felt. Possibly acute pancreatitis.

In this case, you cannot take the funds yourself – some drugs load the pancreas even more, which is fraught with a deterioration in the condition.Better to call an ambulance and not refuse hospitalization.

Pain in the navel with severe weakness and cold extremities

Intestinal colic occurs – spasms of the muscles of the intestines after overeating, excess caffeine or stress.

Take an antispasmodic (drotaverine, papaverine, no-shpa) and lie on your stomach with your knees tucked in. If you can’t lie down, squat with your knees pressed to your stomach. In these positions, the spasms go away faster.

Sudden severe pain at the level of the navel on the left or right, radiating to the lower back or lower abdomen

These symptoms are characterized by the movement of a kidney stone through the ureter.

An antispasmodic will help relieve pain. But even when the pain subsides, you need to consult a urologist and do an ultrasound scan – large stones can block the ureter or injure it.

Twisting pain in the epigastric or umbilical region

This pain is often indicative of an inflammation of the appendix.

You cannot take painkillers – the pain will dull, and the inflammation will not go away and the appendix will burst. Call an ambulance and lie down until the medics arrive.

Constant aching, pulling pain in the lower abdomen in the center, radiating to the lower back

Pain in the lower abdomen, which radiates to the back, may be a symptom of gynecological diseases or inflammation in the genitourinary system.

Dull pain is often bearable, so you should not take pain relievers. But it is necessary to go to the urologist / gynecologist so as not to bring the cause of the pain to a chronic form.

Which means pain in the back of the head and temples. Headache Map

Pain above the pubis in women

This is very similar to a ruptured ovarian cyst. This also happens during pregnancy (ectopic).

Until the ambulance arrives, you cannot accept anything on your own. Get into a position that dulls the pain and try not to get up.

Intense abdominal pain with shortness of breath, dizziness and anxiety attacks

Such a symptom may warn of the onset of an attack of myocardial infarction.

Call an ambulance, put a nitroglycerin tablet under your tongue and lie down so that your chest and head are raised.

Main causes of stomach pain

You have changed your diet. In early spring and late autumn, we eat more foods with vinegar, preservatives and high salt content (homemade products).Fruits and vegetables are mostly imported (a lot of chemicals and nitrates). Such food provokes inflammation and, as a result, paroxysmal pain in the stomach.

You are not sleeping well. Lack of sleep disrupts the hormonal balance, which directly affects the condition of the gastric mucosa.

You are nervous. Our digestive system is closely connected with the nervous, and the stomach is rightfully considered the most “stress-dependent” organ after the heart. In many people, emotional fluctuations increase the production of the gastric enzyme gastrin-17 (G-17) and the concentration of hydrochloric acid.

Symptoms of seasonal exacerbation of gastritis

  1. Recurrent stomach pain;
  2. After eating you feel sick;
  3. You are full too quickly;
  4. You do not tolerate certain types of food, especially “heavy” – potatoes or meat, for example;
  5. You constantly feel heaviness and bloating in the abdomen, regardless of meals;
  6. Hunger pains in the stomach come in the morning immediately after waking up or at hours when you forgot to eat on time.

Proper nutrition if your stomach hurts

  • The stomach often hurts after eating due to spicy additives that damage the mucous membrane – hot spices and sauces, dishes with the addition of vinegar, soy sauce and mayonnaise-based sauces.
  • During the period of stomach inflammation, give up fresh vegetables, especially on an empty stomach – this will only aggravate the situation. Give preference to boiled or steamed vegetables.
  • If you feel cramps, stomach bakes or any other “discomfort signals”, refrain from fruit juices – they have too many acids and sugar, which are not needed at all now.
  • By the way, it is better to limit sugar altogether: when there is a lot of it, the mucous membrane suffers.
  • For a while, give up legumes – peas, beans, chickpeas, as well as mushrooms in any form. It is a heavy vegetable protein that takes a long time to digest and can provoke cramps.
  • During an exacerbation of gastritis, your worst enemy is alcohol. Vodka or alcoholic tincture that can cure gastritis is no more than a dangerous myth. You risk further damage to the mucous membrane.
  • Aim to eat small meals 5-6 times a day to get your stomach up and running.Do not wash down food with strong coffee and tea – it is better with plain water at room temperature.
  • In order not to irritate the stomach once again, avoid foods that are too cold or too hot.
  • It is important to understand that sparing nutrition will only temporarily relieve symptoms, but will not cure gastritis itself.

The stomach has risen. What to do?

Disruption of the digestive system is called atony , and is accompanied by bloating, belching, heaviness and decreased appetite.The doctors explained when it was time to seek help and why the stomach was in general. Among the reasons, the following are distinguished:

  • gastric emptying;
  • overwork – physical and mental;
  • sudden weight loss;
  • alcoholism, smoking;
  • dental problems – for example, tooth decay;
  • sedentary work or sedentary lifestyle;
  • serious infectious diseases: pneumonia, flu, dysentery;
  • taking medications that have a bad effect on the digestive tract.

Which stomach pain pills can I take?

Atony is treated with different groups of drugs, each of which has its own function to start the stomach.

  1. Enzymes . Mezim, Festal, Creon – these drugs will quickly launch the stomach, eliminate heaviness and pain. But they are contraindicated in jaundice, diabetes mellitus, during an exacerbation of gastritis.
  2. Activated carbon . Safe and affordable way to eliminate toxins.One tablet should be taken for every 10 kg of weight.
  3. Pancreatin . One of the best drugs for normalizing the digestion process. 1 tablet is enough for a child, 2-3 pills for an adult. The medicine should be taken with meals.
  4. Regulax and other laxatives.
  5. No-Shpa, Drotaverin . Antispasmodic, adults take 1-2 tablets, for children one is enough.
  6. Espumisan will help with bloating and flatulence.
  7. Vitamin and mineral complexes , which contain potassium, calcium – will help restore immunity, eliminate the deficiency of useful microelements.
  8. Cerucal, Metoclopramide . Antiemetic, improve peristalsis.

How to treat severe stomach pain

If the pain is strong and prolonged enough, it is imperative to take an antispasmodic agent (Spazmalgon, No-Shpa from the list above). And after that, even if the pain subsides or stops altogether, be sure to consult a doctor.Analgesics for pain in the stomach cannot be taken – pain relievers of this effect are harmful to the gastric mucosa. The same applies to non-steroidal anti-inflammatory drugs (for example, this “harmless” ibuprofen). Even a healthy person should be careful with them, because uncontrolled intake may well provoke a stomach ulcer.

If your stomach hurts unbearably and you can’t even find a position that would relieve suffering, it may be caused by appendicitis, intestinal thrombosis, rupture of the gallbladder, or perforation of an ulcer.When concomitant symptoms appear – fever, low blood pressure, bouts of nausea or vomiting, headache, you need to urgently call an ambulance. It is categorically impossible to take any medications – they will “smear the picture” of pain, and it will be very difficult to establish the correct diagnosis. Better not to waste precious time. Take care of yourself and be healthy.

Our experts:

90,000 Stomach hurts: What do different pains talk about and what to do about it – Archive of Tula news

Everyone has experienced abdominal pain at least once.It can hurt in different places and in different ways. “Sloboda” will help you navigate the symptoms.

Elena Lebedeva.
Fotolia / PhotoXPress.ru

1 Acute, cutting, unbearable pain in the right side
Possible causes:

– If the pain radiates upwards – to the shoulder or neck – acute cholecystitis or hepatic colic.
– If the pain radiates to the lower abdomen, to the genital area – renal colic.
– If severe pain is located at the bottom – perhaps acute appendicitis or “female” pain.
– Acute twisting pains in the abdomen, which subside after a bowel movement and are accompanied by diarrhea (without blood) – irritable bowel syndrome.
– Recurrent abdominal pain on the right or left with bloody diarrhea – Crohn’s disease or ulcerative colitis.
It is necessary to call an ambulance as soon as possible.

1 Dull, aching pain in the right side
Possible causes: chronic cholecystitis, urolithiasis or pyelonephritis on the right.
You need to see a doctor .

Sharp pain
Possible causes: Acute intestinal infection, poisoning, appendicitis.
Call an ambulance .

2 Drawing or dull pain in the lower abdomen
Possible causes:
– In women: ectopic pregnancy, inflammation of the fallopian tubes or ovaries.
– In women and men: cystitis, urethritis.
You need to see a doctor .

3 Back pain
Possible causes: pyelonephritis, kidney tumors, urolithiasis.
You need to see a doctor .

4 Dull, aching pain in the left side
Possible causes: urolithiasis on the left.
You need to see a doctor .

4 Acute, cutting, unbearable pain in the left side
Possible causes: renal colic, problems with the spleen.
It is necessary to call an ambulance as soon as possible.

If it hurts rarely …

In healthy people, abdominal pain is most often associated with overeating.In addition to short-term sharp pains, they usually complain of bloating, a feeling of fullness, and stomach discomfort. In case of overeating, abdominal pain goes away on its own within a few hours or one day. This pain does not require any special treatment. But if bloating is repeated often and is not associated with overeating or the use of “wrong” food – then you need to see a doctor and undergo treatment.

… and if often

Lyudmila Atyasheva , gastroenterologist, says:

– If you have a stomach ache, then there must be a reason explaining the appearance of pain.Stomach pain is always a reason to see a doctor. Self-medicate, you can’t wait for improvement! This can be dangerous to health and life. Abdominal pain can occur not only as a result of “problems” in the gastrointestinal tract, but can also be a symptom of other diseases, such as kidney disease, infectious or surgical.

It is advisable to visit a general practitioner for preventive appointments once a year.

It would be very useful to learn from the experience of the Japanese, from whom it is customary to fully examine the body at least once a year.

Timely identification of problems is the key to their successful treatment. The end result will be low morbidity and mortality, which is what Japan has achieved.

“Gives” to the back

In case of diseases of the internal organs, pain can, as people say, “give” to different areas of the body. And in order to make a diagnosis, it is important to determine the place where the pain is localized.

Thus, pain concentrated in the upper abdominal cavity is usually caused by disorders in the esophagus, intestines, biliary tract, liver, and pancreas.The pain that occurs with gallstone disease or inflammation in the liver is localized in the upper right part of the peritoneum (and can be given under the right shoulder blade).

With ulcers and pancreatitis, the entire back may hurt.

Pain caused by disturbances in the small intestine is concentrated around the navel. Colon pains are recognized in the middle of the peritoneum and below the navel.

Pelvic pain is usually felt as pressure and discomfort in the anus.

Like a table, like a chair

The food we eat is the most common cause of stomach pain.

Salty, too hot or cold food causes irritation of the esophagus (pressing pains).

Certain foods (eg, fatty, cholesterol-rich) can stimulate the formation or movement of gallstones, causing bouts of biliary colic. In addition, many people are popularly said to suffer from indigestion (intolerance to foods such as milk, milk sugar or lactose). If such a person does not follow a diet, the result is abdominal pain, bloating and diarrhea.

The simpler the food, the healthier we are!

Try to minimize the consumption of drugs, alcohol, sweets. Do not eat dry food, and use fast food and sushi extremely rarely, while paying special attention to their quality. It is important to eat regularly, in small portions more often. You must admit that during the working day we often limit ourselves to eating on the go and only “take our souls away” at night. Such a diet is dangerous. It is more correct to finish eating 2-2.5 hours before bedtime.

Pay attention to what you buy. The stores are full of canned foods, GMO foods and long shelf life. It is better to eat simple, natural foods instead. And you will be healthy!

What to check?

What tests are recommended for abdominal pain:

  • Complete blood count;

  • Biochemical blood test;

  • Helicobacter antibodies test;

  • Ultrasound of the kidneys and abdominal organs, pelvic organs;

  • Colonoscopy;

  • Analysis for markers of viral hepatitis;

  • Analysis of feces for dysbiosis;

  • X-ray contrast studies of the gastrointestinal tract.

Is it time to see a doctor?

Answer the questions. If even one answer is yes, you should definitely see a doctor.

  • Do you often experience abdominal pain?

  • Does pain affect your daily activities and work duties?

  • Are you experiencing weight loss or decreased appetite?

  • Is your pain accompanied by vomiting or nausea?

  • Do you observe changes in the condition of the intestines?

  • Are you waking up with intense abdominal pain?

  • Have you suffered in the past from diseases such as ulcers, gallstone disease, inflammatory bowel disease, have you undergone surgery?

  • Is there a negative effect of your medications on the gastrointestinal tract (aspirin, non-steroidal anti-inflammatory drugs)?

By the way
Why does it hurt in babies

Most often, severe abdominal pain in children is associated with acute intestinal infection or poisoning.

Important: if within 2-4 hours the child’s abdominal pain intensifies, you need to call an ambulance.

In infants, a common cause of pain is bloating. Hold the baby in a “column” after eating, massage the tummy, give special preparations, and everything will go away.

In 4-5% of cases, severe abdominal pain in children with nausea and vomiting (not associated with poisoning) may be the result of abdominal migraine (spasm of intestinal vessels). In case of such pain, the child should be shown to a neurologist.

Dear readers!

Have you defeated the disease? Tell your coping story! Call tel. 23-55-99.

Galina Kuzina.

90,000 Abdominal pain as symptoms of diseases

Abdominal pain

Abdominal pain is one of the most common complaints, because there are more than a dozen different organs, each of which manifests itself in a different way.By the location of the epicenter of pain, its nature and intensity, one can assume the cause of the ailment. In most cases, abdominal pain occurs for a short time and goes away without requiring special treatment. This happens, for example, when overeating or after stress. But sometimes abdominal pain is an alarming signal of the body and requires urgent medical attention. To make it easier to deal with the symptoms, we divided the abdomen into three floors: upper, middle and lower, in each of which we designated the most typical zones of pain localization (see.drawing). Using this diagram and explanations in the text, you can understand why your stomach hurts, and what to do at the same time.

Notes (go from the section “The effectiveness of probiotics and synbiotics in the prevention of surgical infections”)

Upper abdomen hurts

Most often, pain occurs in the upper abdomen: in the epigastrium (1), right (2) and left (3) hypochondrium. Usually, these pains are somehow associated with food intake, often accompanied by nausea and vomiting.The intensity and nature of pain can vary significantly.

Epigastric pain (1)

Epigastric or epigastric region refers to the upper central zone of the abdomen, just below the sternum. Epigastric pain is usually associated with diseases of the stomach or esophagus. The most common causes may be:

  • Gastritis or dyspepsia – a stomach disease associated with indigestion, accompanied by heartburn, belching, nausea and decreased appetite.The pains can be aching, pulling in nature, sometimes they become burning or sharp, associated with food intake. If the cause that caused the dyspepsia is short-term (infection, error in diet, stress, etc.), then the pain disappears within a few days. If the disease is caused by more serious factors, you will need to consult a doctor.
  • Peptic ulcer of the stomach and duodenum – the formation of ulcers on the mucous membrane of the stomach or the initial sections of the intestine, which leads to increased pain in the epigastrium.The pain takes on the character of burning, gnawing, can be given to the navel, neck and occur even at night, on an empty stomach.

Pain in the hypochondrium on the right (2)

Pain under the ribs on the right side is usually associated with diseases of the liver and gallbladder:

  • Biliary dyskinesia ( DGVP ) – this disease is associated with impaired contractility of the gallbladder and bile ducts. Bile is excreted from the gallbladder irregularly, which, on the one hand, leads to its overflow and pain, and on the other hand, to indigestion in the intestines, since bile is needed to activate digestive enzymes.

Depending on the form of dyskinesia, dull prolonged pain in the hypochondrium on the right or, conversely, short-term acute cramping pains in the same area may prevail. Pain with dyskinesia occurs when eating fatty foods or in violation of the diet, is not accompanied by a deterioration in general well-being, but is associated with frequent upset stools, a taste of bitterness in the mouth. For the treatment of dyskinesia, agents that stimulate the work of the gallbladder or antispasmodics are used, depending on the form of the disease.Find a gastroenterologist for diagnosis and treatment.

  • Cholecystitis – inflammation of the gallbladder. It is accompanied by acute cutting pain in the hypochondrium on the right, often, nausea, vomiting, fever.
  • Stones in the gallbladder – the formation in the gallbladder of hard stones of various sizes, which can block the lumen of the bile duct. As a result, there is a sharp, acute pain in the hypochondrium on the right of high intensity, increased heart rate and respiration, and sometimes vomiting.Requires urgent medical attention.
  • Hepatitis is an inflammatory disease of the liver, in which there may be pulling pains in the hypochondrium on the right, of low intensity, aggravated by deep breathing, tilting the body forward and backward. In the first place, as a rule, there is a feeling of general malaise, weakness, loss of appetite, and sometimes yellowing of the skin.

Pain in the hypochondrium on the left (3)

  • Pain in the left hypochondrium , appearing during intense physical activity without preliminary warm-up, especially after eating, occurs as a result of irrational redistribution of blood in the internal organs, including the spleen.If you slow down, the pain goes away. No special treatment is required.
  • Spleen abscess – a rare disease associated with the formation of an abscess in the spleen – an abscess. This condition is characterized by growing pains in the hypochondrium on the left (pain in the side), deterioration in general health, weakness, temperature rise from 37 to 39 about C and above. Requires surgical treatment.

Girdle abdominal pain

  • Pancreatitis acute and chronic – inflammation of the pancreas is accompanied by a deterioration in general health, often with fever, nausea, vomiting.Pain in the epigastrium (1), right (2) and left (3) hypochondria comes to the fore. The pain can be given to the side, back. This pain is called shingles.
  • Abdominal myocardial infarction is a life-threatening illness often mistaken for simple food poisoning, indigestion, indigestion, or other temporary abdominal problems. Some types of infarction (heart attack) are manifested by pain in the epigastrium and right hypochondrium. The predisposing factors of a heart attack are: age over 40, heart and vascular diseases such as angina pectoris and hypertension, obesity, stress preceding anxiety, smoking.The pain in the abdomen during a heart attack is intense, acute, increases with physical exertion, is not relieved by conventional analgesics, and may decrease at rest. The pain may be accompanied by repeated vomiting that does not bring relief, weakness, shortness of breath (feeling short of breath), pallor, cold sticky sweat, heart rhythm disturbances (irregular pulse), and a decrease in blood pressure. If you suspect a heart attack, immediately call an ambulance.

Pain in the middle of the abdomen

The middle floor of the abdomen is mainly occupied by the intestines, so pain in this area is most often associated with indigestion:

  • Bloating and gas ( flatulence ) often causes dull, sometimes cutting and intense pain in the middle abdomen (4) or pain in the side (5,6).In severe cases, pain can spread to the entire abdomen, without clear localization. The stomach is swollen, rumbling, there is a discharge of gases with a bad smell.
  • Intestinal infection or food poisoning is often accompanied by pain in the middle abdomen (4) and diarrhea (diarrhea). Pain can be sharp and cramping, decrease or disappear for a while after bowel movement. Additional symptoms are sometimes nausea, vomiting, epigastric pain (1), fever.
  • Ulcerative colitis and Crohn’s disease are chronic inflammatory bowel diseases (IBD), symptoms of which are: prolonged bowel distress, frequent loose stools, sometimes streaked with blood and mucus. Pain in the side is characteristic (5,6), may occur in the navel (4), and also descend to the lower abdomen (7,8). In addition to abdominal pain, there is a deterioration in general well-being, sometimes a wave-like increase in temperature, loss of weight and appetite.
  • Irritable Bowel Syndrome ( IBS ) is a functional bowel disorder usually associated with stress. Characterized by unpleasant sensations of low intensity in the middle of the abdomen (4), pain in the right (5) and left (6) sides. Possibly bloating, flatulence. The main symptom is the alternation of constipation and diarrhea without connection with food intake.
  • Constipation can also give pain in the middle part of the abdomen, more often in the left side (6), which is accompanied by bloating and gas.

In addition to the intestines, the urinary system is the culprit of pain in the middle part of the abdomen:

  • Renal colic with urolithiasis – accompanied by a sudden, sharp, cramping, unbearable, cutting pain in the side (5 or 6), usually on one side. The pain spreads to the lower abdomen and groin area, and can radiate to the back. At the peak of pain, nausea and vomiting may occur. Pain in the side appears for no apparent reason, sometimes after a sudden movement, getting out of bed.
  • Pyelonephritis and other inflammatory kidney diseases – cause a dull, pulling, sometimes cramping pain in the side (5 or 6), more often on one side. The pain radiates to the lower back, as a rule, it is not very intense, but very intrusive. May be accompanied by an increase in temperature.

Lower abdominal pain

Pain in the lower abdomen can also be associated with a malfunction of the intestines, for example, with intestinal infections, irritable bowel syndrome, Crohn’s disease or ulcerative colitis, constipation and flatulence.However, in these cases, the process usually involves the middle part of the abdomen (4,5,6). The most dangerous of the intestinal pain in the lower abdomen is pain with appendicitis:

  • Appendicitis is an inflammation of the appendix of the cecum, which is usually located in the right iliac region (7). The disease requires urgent medical attention. A feature of appendicitis is the migration of pain: it can begin with weak pulling sensations in the epigastrium (1), and then, during the day, descend into the iliac region (7) and acquire an acute, intense, constant character.

If you have pain only in the lower abdomen, perhaps this is a sign of pathology in the reproductive or urinary system:

  • Prostatitis – inflammation of the prostate gland in men. With prostatitis, the lower abdomen in the center often hurts (8), pain or discomfort in the abdomen is of low intensity, but constant and intrusive, aggravated by urination or ejaculation, given to the rectum and genitals.
  • Cystitis – inflammation of the bladder in men and women.With cystitis, the lower abdomen hurts in the center (8), the pain is acute, cramping, accompanied by frequent urge to urinate, sometimes with cuts in the genital area.
  • Inflammation of the female genital organs (ovaries and fallopian tubes) is associated with infection, sometimes sexually transmitted diseases. The lower abdomen hurts on the right (7) or on the left (9), sometimes on both sides. Pain is often accompanied by discharge from the genital tract and infertility.
  • Endometriosis , uterine fibroids , inflammatory diseases of the uterus cause pain in the lower abdomen in the center (8), which can spread to the rectum and genitals.
  • Ectopic pregnancy is a condition requiring urgent medical attention. Pain in the lower abdomen, right (7) or left (9) of high intensity, aching, cramping or sharp, dagger. An additional symptom is usually bleeding, sometimes loss of consciousness. Abdominal pain occurs against the background of a delay in the menstrual cycle.

Pain throughout the abdomen

Pain throughout the abdomen most often occurs with flatulence and bloating, which occurs after overeating, experiments with non-traditional cuisine, against the background of intestinal upset, etc.In these cases, the pain is minor or moderate in intensity and disappears on its own within a few days.

  • A dangerous symptom is diffuse pain throughout the abdomen, without a clear border, which is of high intensity, forcing the patient to take a forced position. The abdominal muscles are sharply tense, any touch to the abdomen and attempts to feel it cause increased pain. The skin is pale, breathing is rapid, nausea and vomiting are possible. Dry mouth is common. These symptoms are characteristic of peritonitis .Typically, peritonitis is life threatening and requires urgent medical attention.

In conclusion, it is worth noting that this information on pain symptoms of possible diseases is purely informational, very brief, and posted for preventive purposes. “Forewarned is forearmed!” But an accurate diagnosis can only be made by a medical specialist (doctor), therefore, if the pain persists, you should immediately contact the clinic or, in case of acute pain, immediately call an ambulance.

Be healthy!


  48. NEWS

How to distinguish between dangerous types of abdominal pain

The doctor examined each of the types of abdominal pain and told what to do with them

“Stomach hurts from time to time for several days.The pains are infrequent and mild. Do not run after every sneeze to the doctor. How to understand that a condition requires a doctor’s consultation and what kind of profile? It also depends on the cause of the pain “, – Oksana Gorbal.

Answers Natalia Gordienko , therapist of the highest category:

If it hurts periodically, then this is a reason to understand the cause of the ailment. It is worth starting with the family doctor. But , of course, you can preliminarily evaluate your condition you can try on your own: depending not only on the location of pain, but also on their nature.It is defined as follows. Lie on your back, place your palm on your stomach and slowly, deeply press on it with your fingers. Remember where pressing causes the most discomfort. Listen to the pain, it can be: bursting (as if you are being inflated), dull, squeezing, aching, sharp and dagger. The difference between the last two is that in the first – like an electric shock, in the second – a knife. Note whether the pain increases when coughing, walking, bending over, nausea, upset stools (constipation or diarrhea), fever, or if the pain radiates elsewhere.

Remember the beginning of pain and its metamorphosis. Let’s say she could appear: suddenly, after stress, hypothermia, physical exertion. Be immediately acute or intensify later, be in one place or go to another. Remember how much time has passed since then.


If the pain in the stomach is dull or sharp, bursting or aching (it can give for the sternum where the esophagus is), then it is possible that the cause is gastritis or gastric ulcer. In favor of this assumption, vomiting will speak with increased pain, flatulence.Such pain does not depend on physical activity, but it can appear after eating spicy, acidic foods, strong coffee, or severe stress in the recent past.

Please note that the indicated dislocation and nature of pain can be caused by conditions that are not at all of a gastroenterological order: myocardial infarction, especially in the presence of nausea and vomiting, as well as pneumonia. If the vomit is the color of coffee grounds, call 103 immediately: you have bleeding. Or if the pain radiates to the left arm, this may mean an acute heart problem.

If an attack of pain without the specified “special effects”, apply a warm heating pad to the sore spot, drink a glass of hot water or weak tea in small sips. And in the next few hours see a gastroenterologist.

Sharp, compressing pain in the right hypochondrium (may radiate to the lower back on the right), most likely caused by cholecystitis or hepatic colic. Concomitant symptoms are fever, bitterness in the mouth, vomiting of bile (while relief comes after it), as well as heaviness, nausea, bloating.Typically, this kind of pain occurs after eating spicy or fatty foods, after shaking in transport, doing aerobics, washing floors with your head down, or during sex. This is also how myocardial infarction manifests itself. In this case, the pain is localized in the region of the gallbladder, but it radiates to the right shoulder, under the right shoulder blade or the right half of the chest. First aid: take a drug based on drotaverine or papaverine (drotaverin, no-shpa, no-x-sha, paraverin, spazoverin, papazol, andipal) – this will relieve spasm, and any enzymatic drug (mezim, pancreazim, pancreatin) will accelerate digestion of food and relieve the burden on the gallbladder.If a heart attack is suspected, call the ambulance as if the pain has not gone away within 40 minutes. Gone – in the coming days you must get an appointment with a hepatologist or gastroenterologist to exclude cholelithiasis.


Sharp (no longer than an hour) or mild, dull, sometimes bursting (prolonged) pain in the right hypochondrium may indicate biliary dyskinesia (bile does not flow normally into the duodenum). In this case, it gives pain, as a rule, to the lower back on the right.Such pain can be accompanied by diarrhea or constipation, loss of appetite and libido, insomnia, and menstrual irregularities. As a rule, such pain occurs after quarrels, unrest, eating fatty foods. Hepatitis A or B can manifest itself in a similar way, less often – hepatitis C (it is fraught with cirrhosis of the liver).

First aid is the same as for suspected cholecystitis or hepatic colic.
Aching (increasing over time and, as a rule, radiating to all organs above the waist and lower back) pain in the left hypochondrium may indicate acute pancreatitis.Associated symptoms: a strange taste in the mouth, vomiting without relief, headache and bloating caused by intoxication due to inadequate digestion of food. Those who have problems with the cardiovascular system may have high blood pressure. Such pain occurs most often after eating fatty or spicy foods, alcohol. Internal bleeding with gastric and / or duodenal ulcers manifests itself in a similar way. Therefore, this type of pain requires an ambulance call.

Intestinal colic or gastroduodenitis (inflammation of the duodenum) may be the cause of pain near the navel (pain is sudden, sharp, cramping, severe).Often this condition is accompanied by chills, weakness, and increased gas production. It occurs after eating foods rich in fiber (all types of cabbage, carrots, beets, all types of legumes), strong coffee and products containing cocoa (chocolate, cocoa, sweets). Another possible cause of such pain is inflammation of the lymph nodes in the intestine. With such pain, it is worth taking an antispasmodic. Colic disappears in 15-20 minutes. But if there is gas formation, then the antispasmodic will not help, but, on the contrary, will aggravate the condition.You can further help yourself by gently loosening your stool. To do this, warm up a glass of choleretic mineral water (“Polyana Kupel”, “Luzhanskaya”, “Polyana Kvasova”). Drink slowly – in 2-3 minutes.

If the pain persists, take an analgesic that has the least irritating effect on the gastrointestinal mucosa: tempalgin, ibuprofen, nimesulide. Severe cutting (rolling in waves) pain at the waist (radiating to the lower back or perineum) can be caused by a kidney stone or renal colic.Frequent urination is usually present. Such pain occurs most often after a sharp weight loss or uncontrolled intake of diuretics and “herbs”. This is also the manifestation of adnexitis (inflammation of the ovaries), osteochondrosis (especially if the pain radiates to the lower back), appendicitis. Do not drink antispasmodics – they will not help, pain relievers – can mask the true source of pain, making diagnosis difficult. Call an ambulance immediately.

Pain in the lower right (dull aching, initially in the solar plexus region) can be caused by appendicitis, renal colic or the onset of gastritis.Call an ambulance right away: pain relievers can mask a ruptured appendix, making it difficult to diagnose. There is no exact cause of the pain.

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