Key takeaways:
Abdominal pain is a common symptom that can be hard to figure out on your own. The location of the pain and how it feels can help you narrow down what might be causing it.
Testing for abdominal pain can include blood and urine tests and imaging studies like a CT scan or ultrasound. But you may not need all of these tests to figure out the cause.
It’s best to seek immediate care if your abdominal pain is so severe that you can’t sleep, stand, eat, or drink. The emergency room (ER) is usually the best place to go first.
Most people experience episodes of abdominal pain that go away on their own. But it can be scary if the pain doesn’t go away or gets worse. That’s usually the time to ask for help.
Many of the more serious causes of abdominal pain follow a predictable pattern. Healthcare professionals know how to spot these patterns and order the right tests to figure out the problem. We’re here to help you understand how they think about the possible causes of abdominal pain. This way, you’ll know when it’s time to get medical help.
Causes of abdominal pain
To figure out the cause of your pain, a good starting clue is where it’s happening on your abdomen. The location alone isn’t a diagnosis though. That’s because your organs sit close together. And pain can show up somewhere other than its source — especially in your belly.
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Still, where your pain is located is a reasonable place to start. Healthcare professionals work through the possibilities by region, then narrow things down with an exam and testing.
Upper abdominal pain
Common causes of upper abdominal pain include:
Gastroesophageal reflux disease (GERD) and heartburn: This usually feels like a burning pain behind your breastbone or in your stomach that’s worse after meals or when lying flat.
Gastritis and peptic ulcers: This pain is gnawing or burning, centered above the belly button, and often tracks with eating. Sometimes, it’s better with food, and sometimes it’s worse.
Gallstones and gallbladder infection: Gallstones cause pain in the upper right part of your abdomen. The pain comes in waves, often an hour or so after a fatty meal, and can move to your right shoulder blade.
Pancreatitis: Inflammation of the pancreas causes severe upper-middle belly pain that feels like it goes straight through to your back, often with vomiting.
Kidney infection or stones: Kidney stones or kidney infection can cause pain in this area, usually toward your back (also called the “flank”).
Hepatitis: Inflammation of the liver can cause right-sided, upper-belly pain.
It’s important to note that heart-related conditions can sometimes cause upper belly pain. A heart attack can show up as upper abdominal pain, pressure, or nausea rather than classic chest pain. This is more common in women, older adults, and people with diabetes.
A tear or bulge in your aorta (called an aortic dissection or aneurysm) can also cause abdominal pain. This typically feels like a sudden, tearing, upper-belly pain that moves to the back.
Heart-related belly pain is a medical emergency, and these symptoms should prompt you to go to the emergency room (ER).
Lower abdominal pain
Common causes of pain in the lower belly include:
Appendicitis: This can start as vague pain around your belly button, and then settles into the lower right part of your abdomen.
Diverticulitis: This is an infection of small pouches in the colon and usually causes steady pain in the lower-left part of your abdomen.
Urinary tract infection (UTI): A bladder infection causes pressure or cramping in the lower abdomen along with frequent and burning urination.
Gynecologic causes: Pregnancy, ovarian cysts, menstrual cramping, and uterine infections can all cause lower abdominal pain.
Testicular causes: Testicular infection or torsion can cause lower abdominal or groin pain.
Generalized or diffuse pain
Some causes of abdominal pain aren’t localized to any particular area. Common causes of diffuse belly pain include:
Constipation and diarrhea: Constipation causes crampy, dull pain that often eases after a bowel movement. Diarrhea can cause waves of cramping.
Irritable bowel syndrome (IBS): IBS causes recurring cramping tied to bowel habits.
Inflammatory bowel disease (IBD): IBD — like Crohn's disease and ulcerative colitis — often brings weight loss, blood in the stool, or fever along with belly pain.
Hernia: A hernia is a gap in the abdominal wall or groin that tissue can push through — causing a bulge and a belly ache.
Bowel obstruction: A blockage in the intestine can cause crampy pain that comes in waves, along with vomiting, bloating, and no passage of gas or stool.
Treatment and home care for abdominal pain
The treatment for abdominal pain depends on the cause. Serious causes of abdominal pain often require a hospital stay and one or more of the following treatments:
Bowel rest: Some conditions causing abdominal pain get worse with eating and drinking. So, it’s a common treatment to avoid eating or drinking as your gut recovers.
Intravenous (IV) fluids: Since you may not be able to eat or drink, IV fluids can help treat or prevent dehydration in these cases.
Antibiotics: If bacterial infection is causing your abdominal pain, it’s typically treated with antibiotics. More severe infections often require IV antibiotics.
Surgery: Some causes of abdominal pain need surgery. Examples include appendicitis, gallbladder infections, severe bowel obstructions, perforated bowel, and any serious bleeding.
Pain and nausea medication: Different medications can help keep you comfortable while being treated for abdominal pain. These can often be taken by mouth or through an IV, depending on the situation.
At-home treatment for abdominal pain
Everyone has abdominal pain now and then. Most of the time, it goes away with time and rest. Here are some options for what you can take at home for abdominal pain:
Acid reflux and indigestion: Over-the-counter (OTC) medicines like antacids and H2 blockers can provide fast relief. More frequent cases of acid reflux may be from GERD or an ulcer, which need long-term treatment.
Constipation: There are many different laxatives available OTC. Each one works a little differently, so choose one that feels right for you.
Diarrhea: Loperamide (Imodium) and other OTC medicines can help. But this isn’t the best choice for all types of diarrhea. If you have fever or bloody diarrhea, it’s important to see a healthcare professional.
Menstrual cramping and other gynecology-related pain: Nonsteroidal anti-inflammatory drugs (NSAIDS) like Advil and other OTC medicines like Tylenol are good choices for this kind of tummy pain.
For pain that doesn’t fit these common conditions, it’s a good idea to see a healthcare professional. This is especially true if you aren’t sure what’s causing your pain and if it’s getting worse.
When should I go to the hospital for abdominal pain?
Some causes of abdominal pain are serious or require hospital care. You should go to the ER if you have:
Pain that’s worse than anything you’ve ever felt
Pain that’s so severe you can’t stand up straight
Pain that gets worse even with minor movements, like walking or riding in a car
Pain when you try to take a deep breath
Continual vomiting or you can’t keep fluids down
Diarrhea with large amounts of blood
A fever along with pain
What tests are used to diagnose abdominal pain?
Your medical history and physical exam usually narrow the list of what’s causing your abdominal pain, and testing helps to confirm what's most likely. Here are some of the possible tests a healthcare professional may use to diagnose abdominal pain:
Blood tests: A complete blood cell count (CBC) can show signs of infection or internal bleeding. An electrolyte panel checks your kidney function — as well as for any signs of liver inflammation — and dehydration. Lipase (another blood test) helps check for pancreatitis.
Urine tests: A urinalysis can find a UTI, or traces of blood that point toward a kidney stone.
Ultrasound: When evaluating belly pain, this imaging test is best for looking at the gallbladder, uterus, and ovaries. Unlike an X-ray or CT scan, an ultrasound uses no radiation, which is especially important in children. In the ER, healthcare professionals can often do a bedside ultrasound for a diagnosis in minutes.
CT scan: This test offers a detailed 3D picture that helps to diagnose some abdominal problems needing prompt treatment like appendicitis, kidney stones, bowel infections, aortic problems, and internal bleeding.
Frequently asked questions
Abdominal pain that occurs right after eating can be caused by conditions like:
Acid reflux and gastroesophageal reflux disease (GERD)
Stomach ulcers
Gastritis (inflammation of the stomach lining)
Gastroparesis
Gallstones
Pancreatitis
Irritable bowel syndrome (IBS)
Inflammatory bowel disease (IBD)
Food allergies and food intolerances
Talk to a healthcare professional for help evaluating your symptoms if you have recurring belly pain with meals.
Yes, stress can cause abdominal pain. Your brain and intestines are connected through something called the brain-gut connection. Chemicals that affect your mood — like serotonin and dopamine — also play an important role in gut function. Hormones released into your blood when you’re stressed also impact blood flow to your stomach and intestines. This means that increased stress can lead to a variety of digestive symptoms, like:
Abdominal pain
Bloating
Diarrhea
Constipation
Abdominal pain often doesn’t show up in standard tests like blood work or CT scans — especially for conditions like ulcers, gastritis, or irritable bowel syndrome (IBS). More detailed tests — like endoscopy or colonoscopy — may be needed to look inside your stomach or intestines.
But you can have conditions like IBS and still have normal test results. If your tests are normal but the pain persists, don’t get discouraged. Follow up with your healthcare team, as it may take time and further evaluations to figure out the cause.
The term “differential diagnosis” refers to a list of the possible causes for any symptom or group of symptoms. When you see a healthcare professional for your abdominal pain, they'll create a list of all the things that could be causing your pain. This list helps them think through all possibilities and decide what tests and treatments to prioritize.
Your differential diagnosis is unique to you and will be different from someone else’s. It’s based on what your symptoms feel like, along with your medical conditions, past surgeries, and a physical exam.
“Acute abdomen” is the term for abdominal pain that needs emergency surgery. It includes:
Bowel obstructions that cut off blood flow to the intestine
A hole in the intestine (perforation)
Severe intestinal infections and abscesses
Hernias with tissue trapped inside
Heavy internal bleeding
These are uncommon, but they're the reason severe or sudden abdominal pain should be evaluated quickly rather than watched at home.
Abdominal pain that occurs right after eating can be caused by conditions like:
Acid reflux and gastroesophageal reflux disease (GERD)
Stomach ulcers
Gastritis (inflammation of the stomach lining)
Gastroparesis
Gallstones
Pancreatitis
Irritable bowel syndrome (IBS)
Inflammatory bowel disease (IBD)
Food allergies and food intolerances
Talk to a healthcare professional for help evaluating your symptoms if you have recurring belly pain with meals.
Yes, stress can cause abdominal pain. Your brain and intestines are connected through something called the brain-gut connection. Chemicals that affect your mood — like serotonin and dopamine — also play an important role in gut function. Hormones released into your blood when you’re stressed also impact blood flow to your stomach and intestines. This means that increased stress can lead to a variety of digestive symptoms, like:
Abdominal pain
Bloating
Diarrhea
Constipation
Abdominal pain often doesn’t show up in standard tests like blood work or CT scans — especially for conditions like ulcers, gastritis, or irritable bowel syndrome (IBS). More detailed tests — like endoscopy or colonoscopy — may be needed to look inside your stomach or intestines.
But you can have conditions like IBS and still have normal test results. If your tests are normal but the pain persists, don’t get discouraged. Follow up with your healthcare team, as it may take time and further evaluations to figure out the cause.
The term “differential diagnosis” refers to a list of the possible causes for any symptom or group of symptoms. When you see a healthcare professional for your abdominal pain, they'll create a list of all the things that could be causing your pain. This list helps them think through all possibilities and decide what tests and treatments to prioritize.
Your differential diagnosis is unique to you and will be different from someone else’s. It’s based on what your symptoms feel like, along with your medical conditions, past surgeries, and a physical exam.
“Acute abdomen” is the term for abdominal pain that needs emergency surgery. It includes:
Bowel obstructions that cut off blood flow to the intestine
A hole in the intestine (perforation)
Severe intestinal infections and abscesses
Hernias with tissue trapped inside
Heavy internal bleeding
These are uncommon, but they're the reason severe or sudden abdominal pain should be evaluated quickly rather than watched at home.
The bottom line
Abdominal pain is a common symptom. Often, the cause isn’t serious, and the pain goes away on its own. But there are some situations when you should see a healthcare professional to help figure out what’s going on. If your symptoms feel severe or worrying, it’s best to go to the nearest emergency room (ER). Some causes of abdominal pain are life-threatening if not treated. But even if all your testing is normal, don’t get discouraged. Sometimes, it takes time to find the cause of abdominal pain.
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References
Brenner, D. M., et al. (2023). Rare, overlooked, or underappreciated causes of recurrent abdominal pain: A primer for gastroenterologists. Clinical Gastroenterology and Hepatology.
MedlinePlus. (2023). Differential diagnosis.
Silverio, L. (2019). Abdominal pain. Society for Academic Emergency Medicine.
