Abdominal Pain – Possible Causes

Abdominal pain is a common clinical symptom. Abdominal pain is often caused by some strong stimulation or damage to the tissues or organs of the abdomen. It can also be caused by chest diseases and systemic diseases. In addition, abdominal pain is a subjective feeling. The nature and intensity of abdominal pain are not only affected by the condition of the lesion and the degree of stimulation, but also by factors such as nerves and psychological factors. Simply speaking, different people may have different feeling about the same level of pain on the same spot with the same cause.


Acute abdominal pain

  • Abdominal organ acute inflammation, such as acute gastroenteritis, acute corrosive gastritis, acute cholecystitis, acute pancreatitis, acute appendicitis, acute cholangitis
  • Perforation or rupture of abdominal organs, such as perforation of gastric and duodenal ulcers, perforation of typhoid intestines, rupture of liver, rupture of spleen, rupture of kidney, rupture of ectopic pregnancy, rupture of ovary, etc.
  • Obstruction or expansion of abdominal organs, such as gastric mucosal prolapse, acute intestinal obstruction, inguinal hernia incarceration, intussusception, biliary ascariasis, cholelithiasis, kidney and ureteral stones.
  • Abdominal organ torsion, such as acute gastric torsion, torsion of ovarian cysts, omental torsion, and intestinal torsion.
  • Intra-abdominal vascular obstruction, such as acute obstruction of mesenteric artery, acute portal vein thrombosis, dissection of abdominal aortic aneurysm, etc.
  • Abdominal wall disease, such as adominal wall contusion, abdominal wall abscess and abdominal wall herpes zoster.
  • Thoracic diseases, including acute myocardial infarction, acute pericarditis, angina, pneumonia, and pulmonary infarction.
  • Systemic diseases and others, including rheumatic fever, uremia, acute lead poisoning, hematoporphyrin, abdominal anaphylactoid purpura, abdominal epilepsy, etc.

Chronic Abdominal Pain

  • Chronic inflammation, such as reflux esophagitis, chronic gastritis, chronic cholecystitis, chronic pancreatitis, tuberculous peritonitis, and inflammatory bowel disease.
  • Gastrointestinal diseases, including stomach, duodenal ulcer, and gastrinoma.
  • Torsion or obstruction of intra-abdominal organs, such as chronic gastrointestinal torsion, intestinal adhesions, and omentum adhesion syndrome.
  • Increased envelope tension, such as hespatic congestion, hepatitis, liver abscess, liver cancer, and splenomegaly.
  • Gastrointestinal motor dysfunction, including gastroparesis, functional dyspepsia, hepatic flexure and splenic flexure syndrome.


The nature of abdominal pain is related to the nature of the organs and lesions in which the lesions are located. For example, colic often indicates obstruction of a hollow organ; pain is often caused by an increase in the tension of the visceral capsule, stretching of the mesentery, or expansion of the hollow organs. The degree of pain is sometimes consistent with the severity of the lesion, but due to individual differences, sometimes the degree of pain does not reflect the extent of the lesion.

The location of abdominal pain is often related to the segmental distribution of the spinal cord. Usually the site of pain is the site of the lesion, but there are some lesions caused by pain radiation to a fixed area, such as acute cholecystitis can be radiated to the right shoulder and back, the pain caused by appendicitis can be transferred from the umbilical to the right lower quadrant.
Abdominal pain is associated with fever, inflammation, connective tissue disease, malignancy, etc.; vomiting indicates esophageal, gastric, or biliary tract diseases; vomiting is more likely to indicate gastrointestinal obstruction; diarrhea is associated with intestinal inflammation, malabsorption, pancreatic disease, and shock, while Anemia prompted abdominal organ rupture (such as liver or spleen rupture or rupture of ectopic pregnancy), myocardial infarction, pneumonia can also have abdominal pain with shock, should be particularly vigilant; with urgency, frequent urination, dysuria, hematuria, etc., indicate possible urinary Department of infection or stones; with gastrointestinal bleeding, such as tarry stool or vomiting blood prompted peptic ulcer or gastritis; such as blood or dark red bloody stool, often prompted ulcerative colitis, colon cancer, intestinal tuberculosis.
Necessary tests may include:
  • blood panel
  • urine test
  • liver & kidney function
  • ultrasound
  • imaging test
  • ECG when necessary


Treatment will be subject to diagnosis. However, it’s important to remind patients with abdominal pain that pain reliever isn’t recommended before diagnosis is made.


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