Abdominal Pain & Symptoms Chart

Abdominal pain -- a dull ache, a burning sensation, or a sharp, stabbing pain -- is one of the most common complaints in all of medicine. Most people can blame abdominal pain on their stomachs, but the stomach is just one potential trouble spot. Any organ in your midsection can cause pain, including your appendix, gallbladder, pancreas, kidneys, and intestines.

Whenever abdominal pain strikes, it shouldn't be ignored. By heeding symptoms early, you can spot the difference between a minor problem and a medical emergency.

Here's one simple guideline: If the pain is intense, get help right away.

You should also call your doctor or get to a hospital immediately if your abdominal pain is accompanied by bloody diarrhea, bloody vomit, black stools, or a fever above 101 degrees F.

Even when it doesn't signal an emergency, abdominal pain definitely sends a message. It could be telling you to make a change in your lifestyle or to schedule an appointment with your doctor. Either way, it could be a blessing in disguise.

What message is your body sending? Here's a chart to help you break the code. Remember: Only a doctor can diagnose the source of abdominal pain. If you have any questions, be sure to make that appointment.

Symptoms	Possible Cause	Action to Take
Intense pain in the lower right side of the abdomen, possibly starting as a vague, uncomfortable feeling around the navel. You may also have nausea, vomiting, or a slight fever.	Appendicitis	Go to an emergency room now
Severe pain that starts in the upper abdomen and often spreads to the sides and the back. The pain may flare up soon after a large meal, or six to 12 hours after an episode of heavy drinking. You may also have nausea, vomiting, fever, yellowish skin, and a racing heartbeat.	Pancreatitis	Call 911 or go to an emergency room right away. Acute pancreatitis can cause shock, which may result in death if not treated quickly.
Extremely sharp abdominal pain, perhaps with other acute symptoms.	*Pelvic inflammatory disease *Heart attack *Perforated stomach ulcer *Shock, from allergy *Diabetic emergency *Poisoning	Call 911 or go to an emergency room right away.
Pain in upper right side of abdomen; may spread to right upper back, chest, or right shoulder; nausea; vomiting; or gas.	Gallstones	If this is your first attack, call a doctor for emergency advice. If you can't reach one, go to an emergency room. Don't eat or drink anything.
In a woman who might be pregnant: severe pain that arises suddenly in the lower right or lower left abdomen, usually without vomiting or fever.	Ectopic pregnancy	Call the doctor for a prompt appointment. If you experience severe abdominal pain or bleeding, call 911 or go to the emergency room right away.
Moderate to severe cramps that wax and wane, or occasional cramps that flare up after meals, and vomiting, especially if the vomit smells like stool. Other possible signs include watery or ribbon-like stools, or no stools at all.	Intestinal obstruction	Go to the emergency room right away.
Pain or tenderness in the lower left side of the abdomen, along with fever. You may also have nausea, vomiting, chills, stomach cramps, and either diarrhea or constipation.	Diverticulitis	See a doctor immediately. If you have sharp abdominal pain along with fever, chills, swelling, or nausea and vomiting, call 911 or go to an emergency room right away. You may have peritonitis, a life-threatening infection of the abdominal cavity.
Chronic abdominal pain along with dark urine and yellowish skin and eyes.	Viral hepatitis	See a doctor promptly.
Pain in the back that usually spreads under the rib cage, around the front, and into the groin.	Kidney stones	See a doctor promptly
Searing, stabbing pain in the upper abdomen; pain in the back between the shoulder blades; pain under the right shoulder; nausea, vomiting, and indigestion.	Gallstones or an infection of the gallbladder.	See your doctor promptly. If you also experience sweating, chills, and fever, see a doctor right away
Chronic abdominal pain in the upper right quadrant, along with a fever, sore throat, and extreme fatigue.	Mononucleosis or other viral infection	See a doctor promptly. In addition to taking medications, you'll need to get plenty of rest.
Bloody stools or bleeding from the rectum. In some cases, abdominal pain.	Bleeding hemorrhoids, colon polyps, or (rarely) colorectal cancer. (Hemorrhoids and polyps rarely cause abdominal pain.)	See a doctor promptly.
In a woman: dull, constant pain in the lower abdomen along with vaginal discharge and fever.	Pelvic inflammatory disease.	See a doctor promptly.
Dull, gnawing stomach pain that comes and goes. The pain is often worse when the stomach is empty and goes away after eating. You may also have indigestion, nausea, vomiting, heartburn, gas, and dark stools.	*Stomach ulcer (peptic ulcer) *Gastritis (inflammation of the stomach lining)	Take an antacid or acetaminophen if necessary, but avoid aspirin, ibuprofen, and other nonsteroidal anti-inflammatory drugs. Don't drink alcohol or smoke. If pain persists or quickly comes back, see your doctor. Call 911 or go an emergency room right away if you throw up blood or anything that looks like coffee grounds; if you feel faint, chilly, or sweaty; if you have black or bloody stools, or if you feel lightheadedness, as if you would faint. See a doctor right away if you have sharp back pain with ulcer symptoms.
Frequent burning pain in the upper abdomen or chest, possibly accompanied by a sour taste in the mouth, a lump in the throat, or trouble swallowing.	Gastroesophageal reflux disease (GERD)	Suck on an antacid lozenge at the first sign of pain. Over-the-counter acid blockers can help prevent future attacks. If pain persists or quickly comes back, see your doctor. See your doctor promptly if you have trouble swallowing, especially if solid food gets stuck.
Vague, widespread, cramp-like pain, accompanied by bloating, tiredness, gas, and occasional nausea. You may also have diarrhea, constipation, or bouts of both.	Irritable bowel syndrome	Try cutting back on stress. Reducing fat in your diet may also help. If you have constipation, try eating more fiber and drinking more water. If problems persist, see your doctor.
Pain in the lower abdomen. You may also have blood or mucus in your stools, fever, unexplained weight loss, skin rashes, tiredness, or joint pain.	Crohn's disease (pain in the right side) or ulcerative colitis (with pain in the left side). Dysentery is also a possibility.	See your doctor promptly. Be sure to tell your doctor if you may be at risk for dysentery, or diarrhea containing blood, which is often caused by exposure to water contaminated by bacteria or protozoa. If diagnosed with ulcerative colitis or Crohn's disease, you should eat nutritious meals, get plenty of rest, and cut back on stress. Avoid alcohol and aspirin.
Pressure in your upper abdomen, especially associated with heartburn.	Hiatal hernia	Make an appointment with your doctor. You can also help yourself by avoiding large meals (especially within three hours of bedtime), raising the head of your bed by 4 to 6 inches, and not lying down for three hours after eating.
Pain in the lower abdomen, often combined with burning or stinging when urinating; yellow discharge; difficulty urinating; strong-smelling, murky, or bloody urine; and in women, pain during intercourse	Urinary tract infection	See your doctor promptly. You can help yourself by drinking at least eight to 10 glasses of water or clear liquids a day. Some physicians advise avoiding alcohol, caffeine, and spicy foods. Don't have intercourse until you're cured.
Stomach discomfort or bloating after drinking or eating dairy products, such as cow's milk and ice cream.	Lactose intolerance	Avoid dairy products or take medicine to help you digest lactose.
Bloating along with fewer than three bowel movements a week, abdominal pain, or hard, dry stools that are difficult to pass.	Constipation	Eat a high-fiber diet, drink plenty of liquids, and walk or exercise each day if possible. If problems persist, call your doctor for advice.

References:

• American Academy of Family Physicians. Self-care on Familydoctor.org. Abdominal pain.
• Kelso LA and M Kugelmas. Nontraumatic abdominal pain. AACN Clinical Issues. 1997. 8(3): 437-448.