Abdominal pain can stem from many organs stomach, intestines, gallbladder, pancreas, or even the abdominal aorta. Most cases are benign, but about 15 percent involve life-threatening conditions (e.g., appendicitis, intestinal obstruction) that need urgent care.
Common Causes of Abdominal Pain
- Gastrointestinal: indigestion, gastritis, peptic ulcer, IBS, inflammatory bowel disease
- Hepatobiliary: gallstones, cholangitis, hepatitis
- Pancreatic: acute or chronic pancreatitis
- Genitourinary: kidney stones, urinary tract infection
- Vascular: abdominal aortic aneurysm, mesenteric ischemia
- Gynecologic (in women): ectopic pregnancy, ovarian torsion, dysmenorrhea
- Other: muscular strain, shingles, referred chest pathology (angina, pneumonia)
Signs & Symptoms
- Colicky or constant pain, often localized to one quadrant
- Nausea, vomiting, diarrhea, or bloating
- Abdominal tenderness, rigidity, or rebound pain
- Signs of shock: rapid weak pulse, low blood pressure, pale clammy skin, dizziness
Types of Abdominal Pain
| Type | Origin & Characteristics |
|---|---|
| Visceral | Aching, crampy, poorly localized pain from organ distention or ischemia |
| Parietal | Sharp, well-localized pain aggravated by movement or touch, arising from peritoneal lining inflammation |
| Referred | Pain felt in a different region than its source (e.g., gallbladder → right shoulder) due to shared spinal pathways |
| Colicky | Intermittent, wave-like pain from hollow-organ spasms (e.g., kidney stones, biliary colic) |
Visceral, parietal, referred, and colicky pain patterns help distinguish potential causes and guide further evaluation
When to Seek Medical Help
Call emergency services immediately if any of the following are present:
- Sudden severe pain or pain that worsens rapidly
- Blood in vomit, stool, or urine
- Rigid, board-like abdomen or rebound tenderness
- Persistent vomiting or inability to keep fluids down
- Signs of shock (rapid weak pulse, altered consciousness)
First Aid Steps
- Ensure scene safety and don protective gloves if available.
- Reassure the person and help them lie or sit in the position of greatest comfort (often on their back with knees bent).
- Avoid giving solid food; withhold oral fluids if obstruction or surgery is suspected.
- For minor cramps or colic without red-flag signs, small sips of water may be tolerated to prevent dehydration.
- Monitor and record vital signs (pulse, respiratory rate, blood pressure) and symptom changes.
- Stay with the person until professional help arrives, relaying your observations to EMS.
Severity Guide
| Severity | Key Features | Action |
|---|---|---|
| Mild | Intermittent cramping, tolerable pain, normal vitals | Rest, monitor, encourage sips of water |
| Moderate | Persistent pain, nausea/vomiting but stable vitals | Position of comfort, monitor closely |
| Severe | Intense pain, rigid abdomen, shock signs, bloody emesis | Call EMS immediately |
Do’s and Don’ts
| Do | Don’t |
|---|---|
| Keep the person calm and in a comfortable position | Give solid food or large volumes of fluids |
| Monitor vital signs and level of consciousness | Massage or apply heat packs to a rigid abdomen |
| Note onset, location, duration, and character of pain | Delay calling for emergency help if severe |
| Relay all observations clearly to arriving EMS personnel | Administer any medication without guidance |
Home Remedies
- Sip water or other clear fluids. You may have sports drinks in small amounts. People with diabetes must check their blood sugar often and adjust their medicines as needed.
- Avoid solid food for the first few hours.
- If you have been vomiting, wait 6 hours, and then eat small amounts of mild foods such as rice, applesauce, or crackers. Avoid dairy products.
- If the pain is high up in your abdomen and occurs after meals, antacids may help, especially if you feel heartburn or indigestion. Avoid citrus, high-fat foods, fried or greasy foods, tomato products, caffeine, alcohol, and carbonated beverages.
- DO NOT take any medicine without talking to your provider.
REFERENCES
- WebMD Editorial Contributors, How Do I Treat Stomach Pain?, Reviewed on June 25, 2024, https://www.webmd.com/first-aid/abdominal-pain-in-adults-treatment
- John Furst, First aid for Abdominal Pain,Updated December 13, 2023, https://www.firstaidforfree.com/first-aid-for-abdominal-pain/
- First Aid Handbook: Abdominal Pain, November 6, 2019, https://integrityuc.com/first-aid-handbook-abdominal-pain/
- Martinez JP. Abdominal pain. In: Walls RM, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2018:chap 23.
- McQuaid KR. Approach to the patient with gastrointestinal disease. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 118.
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