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Abdominal Pain, Age 12 and Older

Topic Overview

The cause of abdominal problems can be hard to pinpoint. Sometimes minor and serious abdominal problems start with the same symptoms. Fortunately, most abdominal problems are minor, and home treatment is all that is needed.

Many times the exact cause of abdominal pain is hard to find. The severity of your pain, its location, and other symptoms you have may help determine what is causing the pain.

  • Generalized pain occurs in half of the abdomen or more. Generalized pain can occur with many different illnesses and will usually go away without medical treatment. Indigestion and an upset stomach are common problems that can cause generalized pain. Home treatment may help relieve some of the discomfort. Generalized mild pain or crampy pain that becomes more severe over several hours may be a symptom of a blockage of the intestines (bowel obstruction).
  • Localized pain is located in one area of the abdomen. Localized pain that comes on suddenly and gets worse is more likely to be a symptom of a serious problem. The pain of appendicitis may start as generalized pain, but it often moves (localizes) to one area of the abdomen. The pain from gallbladder disease or peptic ulcer disease often starts in one area of the abdomen and stays in that same location. Localized pain that gradually becomes more severe may be a symptom of inflammation of an abdominal organ.
  • Cramping is a type of pain that comes and goes (intermittent) or that changes in position or severity. Cramping is rarely serious if it is relieved by passing gas or a stool. Many women have cramping pain with their menstrual periods. Generalized cramping pain is usually not a cause for concern unless it gets worse, lasts for longer than 24 hours, or localizes. Cramping that starts suddenly with diarrhea or other minor health problems can be quite painful but is usually not serious.

Occasionally, severe pain that comes on suddenly may be a symptom of a rupture of the stomach or intestines (perforation), torsion of the testicle or ovary, a kidney stone, gallbladder disease, or blood vessel problems, such as an aortic aneurysm. The pain caused by appendicitis or gallbladder disease may increase when you move or cough. Pain that increases with movement or coughing and does not appear to be caused by strained muscles is more likely to be a symptom of a serious problem. A visit to a doctor is usually needed when severe abdominal pain comes on suddenly, or when new and different mild pain slowly becomes more severe over several hours or days.

After a minor abdominal injury, pain, nausea, or vomiting may occur but often gets better in a few minutes. Pain and other symptoms that continue, increase, or develop following an injury may mean an abdominal organ has been damaged.

Many medicines can cause abdominal pain. Some medicines also cause side effects, such as constipation, that can make abdominal pain worse.

Abdominal symptoms can also occur from an infection passed on by animals or while traveling to a foreign country.

Specific abdominal symptoms have been linked to ovarian cancer. These symptoms include abdominal or pelvic pain, increased abdominal size or bloating, and trouble eating or feeling full quickly. If you have one or more of these symptoms, and it occurs almost daily for more than 2 or 3 weeks, talk with your doctor.

Check your symptoms to decide if and when you should see a doctor.

Check Your Symptoms

Do you have pain or cramping in your belly?
This also includes injuries to the belly.
Yes
Abdominal pain
No
Abdominal pain
How old are you?
11 years or younger
11 years or younger
12 to 55 years
12 to 55 years
56 years or older
56 years or older
Are you male or female?
Male
Male
Female
Female
Have you had surgery on your chest, belly, or pelvic area in the past 2 weeks?
Yes
Recent abdominal surgery
No
Recent abdominal surgery
Are you pregnant?
Yes, you know that you're pregnant.
Pregnancy
No, you're not pregnant, or you're not sure if you're pregnant.
Pregnancy
Have you had a baby in the past 3 months?
Yes
Had baby within past 3 months
No
Had baby within past 3 months
Could you be having symptoms of a heart attack?
If you're having a heart attack, there are several areas where you may feel pain or other symptoms.
Yes
Symptoms of heart attack
No
Symptoms of heart attack
Do you have symptoms of shock?
Yes
Symptoms of shock
No
Symptoms of shock
Do you think you may be dehydrated?
Yes
May be dehydrated
No
May be dehydrated
Are the symptoms severe, moderate, or mild?
Severe
Severe dehydration
Moderate
Moderate dehydration
Mild
Mild dehydration
Are you having trouble drinking enough to replace the fluids you've lost?
Little sips of fluid usually are not enough. You need to be able to take in and keep down plenty of fluids.
Yes
Unable to maintain fluid intake
No
Able to maintain fluid intake
Do you have pain in your belly?
Yes
Belly pain
No
Belly pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
Has the pain:
Gotten worse?
Pain is getting worse
Stayed about the same (not better or worse)?
Pain is unchanged
Gotten better?
Pain is getting better
How long have you had pain?
Less than 4 hours
Pain for less than 4 hours
At least 4 hours but less than 1 full day (24 hours)
Pain for 4 to 24 hours
At least 1 full day but less than 2 days (48 hours)
Pain for more than 24 hours
At least 2 days but less than 1 week
Pain for more than 48 hours
1 week or more
Pain for more than 1 week
Does the belly hurt all over or mostly in one area?
Pain that is most intense in just one area is likely to be more serious than a bellyache that hurts all over.
Mostly in one area
Localized pain
All over
Generalized pain
Is the pain in the lower right part of the belly?
Yes
Pain in lower right part of belly
No
Pain in lower right part of belly
Do you have pain with a new bulge in your belly button or groin?
Yes
Pain with bulge at the navel or groin
No
Pain with bulge at the navel or groin
Is there any chance that you could be pregnant?
Yes
Possibility of pregnancy
No
Possibility of pregnancy
Within the past week, have you had an injury to the abdomen, like a blow to the belly or a hard fall?
Yes
Abdominal injury within past week
No
Abdominal injury within past week
Since the injury, have you had any new bleeding from the rectum, urethra, or vagina?
Yes
Bleeding from rectum, vagina, or urethra since injury
No
Bleeding from rectum, vagina, or urethra since injury
Is there a belly wound that is deeper than a scratch?
Yes
Penetrating wound
No
Penetrating wound
Have you vomited since the injury?
Yes
Has vomited since the injury
No
Has vomited since the injury
Is there pain just below the ribs?
Pain just below the ribs after an injury can be a symptom of serious damage to the liver or spleen.
Yes
Pain is below ribs
No
Pain is below ribs
Have you had any new shoulder pain since the injury?
A belly injury sometimes can cause pain in the shoulder.
Yes
Shoulder pain since injury
No
Shoulder pain since injury
Did you hurt your shoulder in the injury?
Yes
Shoulder injury
No
Shoulder injury
Do you think that the injury may have been caused by abuse?
Yes
Injury may have been caused by abuse
No
Injury may have been caused by abuse
Are your stools black or bloody?
Yes
Black or bloody stools
No
Black or bloody stools
Have you had:
At least 1 stool that is mostly black or bloody?
At least 1 stool mostly black or bloody
At least 1 stool that is partly black or bloody?
At least 1 stool partly black or bloody
Streaks of blood in your stool?
Streaks of blood in stool
Do you think you may have a fever?
Yes
Possible fever
No
Possible fever
Did you take your temperature?
Yes
Temperature taken
No
Temperature taken
How high is the fever? The answer may depend on how you took the temperature.
High: 104°F (40°C) or higher, oral
High fever: 104°F (40°C) or higher, oral
Moderate: 100.4°F (38°C) to 103.9°F (39.9°C), oral
Moderate fever: 100.4°F (38°C) to 103.9°F (39.9°C), oral
Mild: 100.3°F (37.9°C) or lower, oral
Mild fever: 100.3°F (37.9°C) or lower, oral
How high do you think the fever is?
High
Feels fever is high
Moderate
Feels fever is moderate
Mild or low
Feels fever is mild
How long have you had a fever?
Less than 2 days (48 hours)
Fever for less than 2 days
At least 2 days but less than 1 week
Fever for at least 2 days but less than 1 week
1 week or more
Fever for 1 week or more
Do you have a health problem or take medicine that weakens your immune system?
Yes
Disease or medicine that causes immune system problems
No
Disease or medicine that causes immune system problems
Do you have shaking chills or very heavy sweating?
Shaking chills are a severe, intense form of shivering. Heavy sweating means that sweat is pouring off you or soaking through your clothes.
Yes
Shaking chills or heavy sweating
No
Shaking chills or heavy sweating
Are you nauseated or vomiting?
Nauseated means you feel sick to your stomach, like you are going to vomit.
Yes
Nausea or vomiting
No
Nausea or vomiting
Have you vomited?
Yes
Vomiting
No
Vomiting
Have you vomited blood or what looks like coffee grounds?
If there is only a streak or two of blood that you are sure came from your nose or mouth, you are not vomiting blood.
Yes
Has vomited blood or what looks like coffee grounds
No
Has vomited blood or what looks like coffee grounds
How much blood have you vomited?
Two or more streaks of blood, or any amount of material that looks like coffee grounds
Has vomited material that looks like coffee grounds or at least 2 streaks of blood
One streak of blood or less
Has vomited 1 streak of blood or less
Have you felt nauseated for more than 2 full days (48 hours)?
Yes
Nausea for more than 2 days
No
Nausea for no more than 2 days
Do you have diabetes?
Yes
Diabetes
No
Diabetes
Is your diabetes getting out of control because you are sick?
Yes
Diabetes is affected by illness
No
Diabetes is affected by illness
Do you and your doctor have a plan for what to do when you're sick?
Yes
Diabetes illness plan
No
Diabetes illness plan
Is the plan helping get your blood sugar under control?
Yes
Diabetes illness plan working
No
Diabetes illness plan not working
How fast is it getting out of control?
Quickly (over several hours)
Blood sugar quickly worsening
Slowly (over days)
Blood sugar slowly worsening
Did the pain start after you took a new medicine?
Yes
Abdominal pain started after taking a medicine
No
Abdominal pain started after taking a medicine
In the past few weeks, have you been losing weight without trying?
Yes
Has been losing weight without trying
No
Has been losing weight without trying
Have your symptoms lasted longer than 1 week?
Yes
Symptoms have lasted longer than 1 week
No
Symptoms have lasted longer than 1 week

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

With cramping pain in the belly:

  • The pain may hurt a little or a lot.
  • The amount of pain may change from minute to minute. Cramps often get better when you pass gas or have a bowel movement.
  • The pain may feel like a tightness or pinching in your belly.
  • The pain may be in one specific area or be over a larger area. It may move around.

Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.

Symptoms of shock (most of which will be present) include:

  • Passing out (losing consciousness).
  • Feeling very dizzy or lightheaded, like you may pass out.
  • Feeling very weak or having trouble standing.
  • Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.

If you're not sure if a fever is high, moderate, or mild, think about these issues:

With a high fever:

  • You feel very hot.
  • It is likely one of the highest fevers you've ever had. High fevers are not that common, especially in adults.

With a moderate fever:

  • You feel warm or hot.
  • You know you have a fever.

With a mild fever:

  • You may feel a little warm.
  • You think you might have a fever, but you're not sure.

Temperature varies a little depending on how you measure it. For adults and children age 12 and older, these are the ranges for high, moderate, and mild, according to how you took the temperature.

Oral (by mouth) temperature

  • High: 104°F (40°C) and higher
  • Moderate: 100.4°F (38°C) to 103.9°F (39.9°C)
  • Mild: 100.3°F (37.9°C) and lower

A forehead (temporal) scanner is usually 0.5°F (0.3°C) to 1°F (0.6°C) lower than an oral temperature.

Ear or rectal temperature

  • High: 105°F (40.6°C) and higher
  • Moderate: 101.4°F (38.6°C) to 104.9°F (40.5°C)
  • Mild: 101.3°F (38.5°C) and lower

Armpit (axillary) temperature

  • High: 103°F (39.5°C) and higher
  • Moderate: 99.4°F (37.4°C) to 102.9°F (39.4°C)
  • Mild: 99.3°F (37.3°C) and lower

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

  • Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
  • Long-term alcohol and drug problems.
  • Steroid medicines, which may be used to treat a variety of conditions.
  • Chemotherapy and radiation therapy for cancer.
  • Other medicines used to treat autoimmune disease.
  • Medicines taken after organ transplant.
  • Not having a spleen.

Pain in adults and older children

  • Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
  • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

It is easy for your diabetes to become out of control when you are sick. Because of an illness:

  • Your blood sugar may be too high or too low.
  • You may not be able take your diabetes medicine (if you are vomiting or having trouble keeping food or fluids down).
  • You may not know how to adjust the timing or dose of your diabetes medicine.
  • You may not be eating enough or drinking enough fluids.

An illness plan for people with diabetes usually covers things like:

  • How often to test blood sugar and what the target range is.
  • Whether and how to adjust the dose and timing of insulin or other diabetes medicines.
  • What to do if you have trouble keeping food or fluids down.
  • When to call your doctor.

The plan is designed to help keep your diabetes in control even though you are sick. When you have diabetes, even a minor illness can cause problems.

You can get dehydrated when you lose a lot of fluids because of problems like vomiting or fever.

Symptoms of dehydration can range from mild to severe. For example:

  • You may feel tired and edgy (mild dehydration), or you may feel weak, not alert, and not able to think clearly (severe dehydration).
  • You may pass less urine than usual (mild dehydration), or you may not be passing urine at all (severe dehydration).

Severe dehydration means:

  • Your mouth and eyes may be extremely dry.
  • You may pass little or no urine for 12 or more hours.
  • You may not feel alert or be able to think clearly.
  • You may be too weak or dizzy to stand.
  • You may pass out.

Moderate dehydration means:

  • You may be a lot more thirsty than usual.
  • Your mouth and eyes may be drier than usual.
  • You may pass little or no urine for 8 or more hours.
  • You may feel dizzy when you stand or sit up.

Mild dehydration means:

  • You may be more thirsty than usual.
  • You may pass less urine than usual.

Blood in the stool can come from anywhere in the digestive tract, such as the stomach or intestines. Depending on where the blood is coming from and how fast it is moving, it may be bright red, reddish brown, or black like tar.

A little bit of bright red blood on the stool or on the toilet paper is often caused by mild irritation of the rectum. For example, this can happen if you have to strain hard to pass a stool or if you have a hemorrhoid.

Certain medicines and foods can affect the color of stool. Diarrhea medicines (such as Pepto-Bismol) and iron tablets can make the stool black. Eating lots of beets may turn the stool red. Eating foods with black or dark blue food coloring can turn the stool black.

If you take aspirin or some other medicine (called a blood thinner) that prevents blood clots, it can cause some blood in your stools. If you take a blood thinner and have ongoing blood in your stools, call your doctor to discuss your symptoms.

Symptoms of a heart attack may include:

  • Chest pain or pressure, or a strange feeling in the chest.
  • Sweating.
  • Shortness of breath.
  • Nausea or vomiting.
  • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
  • Lightheadedness or sudden weakness.
  • A fast or irregular heartbeat.

The more of these symptoms you have, the more likely it is that you're having a heart attack. Chest pain or pressure is the most common symptom, but some people, especially women, may not notice it as much as other symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, or a strange feeling in your chest or other areas.

Many prescription and nonprescription medicines can cause belly pain or cramping. A few examples are:

  • Aspirin, ibuprofen (such as Advil or Motrin), and naproxen (such as Aleve).
  • Antibiotics.
  • Antidiarrheals.
  • Laxatives.
  • Iron supplements.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

After you call 911 , the operator may tell you to chew 1 adult-strength (325 mg) or 2 to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.

Postoperative Problems
Pregnancy-Related Problems
Abdominal Pain, Age 11 and Younger
Problems After Delivery of Your Baby

Home Treatment

Most of the time, abdominal pain improves with home treatment and you do not need a visit to a doctor. Specific home treatment for abdominal pain often depends on the symptoms you have along with the pain, such as diarrhea or nausea and vomiting.

If you have mild abdominal pain without other symptoms, try the following:

  • Rest until you are feeling better.
  • Drink plenty of fluids to prevent dehydration. You may find that taking small, frequent sips of a beverage is easier on your stomach than trying to drink a whole glass at once. Do not drink carbonated or caffeinated drinks, such as soda pop, tea, or coffee.
  • Try eating several small meals instead of 2 or 3 large ones. Eat mild foods, such as rice, dry toast or crackers, bananas, and applesauce. Do not eat spicy foods, other fruits, alcohol, and drinks that have caffeine until 48 hours after all symptoms have gone away.
  • Do not eat foods that are high in fat. Foods high in fat may increase your abdominal pain.
  • Do not use aspirin or other nonsteroidal anti-inflammatory medicines, such as ibuprofen and naproxen. These medicines may irritate your stomach and increase your pain.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

  • Pain increases, does not improve, or localizes to one specific area of the abdomen.
  • Other symptoms develop, such as diarrhea, nausea, vomiting, or a fever.
  • Symptoms become more severe or frequent.

Prevention

Abdominal pain can often be prevented.

  • Develop regular bowel habits to prevent abdominal pain caused by constipation. For more information, see the topic Constipation, Age 12 and Older.
  • Develop regular eating habits. Overeating is a common cause of abdominal discomfort. Eat slowly and stop when you feel full.
  • To prevent abdominal pain caused by swallowing air (aerophagia), do not chew gum or drink carbonated beverages.
  • Prevent abdominal injuries by wearing your seat belt safely and correctly every time you drive or are a passenger in a car.
    • Wear both your lap and shoulder belts. The shoulder strap should cross the collarbone, and the lap belt should fit low and tight.
    • Do not wear your shoulder strap slipped behind the back or under the arm. This dangerous habit can cause severe injury, especially in cars with air bags.

Preparing For Your Appointment

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

  • How long have you had the pain?
  • What were you doing when the pain started?
  • Did the pain start suddenly or develop gradually?
  • How severe is your pain? Rate your pain on a scale of 1 to 10.
  • Is your pain generalized or localized? If you have localized pain, where is it located?
  • Is your pain cramping, a steady ache, burning, or a tearing sensation?
  • Is your pain changing? If so, how?
  • Is the pain constant, or does it come and go?
  • Have you had other symptoms, such as nausea, vomiting, constipation, diarrhea, a change in urination, or fever?
  • Have you had this type of pain before? If so, did you see a doctor? How was the pain treated?
  • What makes the pain better? What makes the pain worse?
  • Have you recently traveled outside of the country?
  • Have you drunk any untreated well, stream, or lake water?
  • Do you have any health risks?

Credits

ByHealthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Adam Husney, MD - Family Medicine
Kathleen Romito, MD - Family Medicine

Current as ofNovember 20, 2017