Lower Abdominal Pain
What is lower abdominal pain?
Pain in the lower abdomen is often related to the digestive tract, but can also be related to conditions of the body wall, skin, blood vessels, urinary tract, or reproductive organs. The area may be tender to the touch or the pain may be severe and the whole abdomen might be rigid.
Lower abdominal pain can be extremely uncomfortable and with that comes severe anxiety. Patients and parents become worried with the onset of lower abdominal pain.
Severe pain can be a symptom of inflammation, appendicitis, bowel obstruction, or bowel perforation. Severe pain in women may result from twisting of an ovary (ovarian torsion), rupture of an ovarian cyst, ectopic pregnancy, or pelvic inflammatory disease. Men may experience severe lower abdominal pain from testicular torsion or injury. Crampy pain may be due to gas, indigestion, inflammation or infection, or, in women, from menstrual cramps or endometriosis.
Severe pain that comes in waves may be caused by kidney stones. Trauma to the body wall, hernias, and shingles can also cause lower abdominal pain. A hernia is a weakening of muscle or tissue that allows organs or other tissues to protrude through it. Shingles is a reactivation of the chickenpox (varicella-zoster) virus involving a painful, blistering rash that often forms a stripe across the affected area of skin.
Pain that is sudden in onset, severe, persistent, recurring, or worsening, or that is accompanied by other serious symptoms is often the most worrisome.
Lower abdominal pain can be caused by serious medical conditions. Seek immediate medical care (call 911) if you stop having bowel movements, have bloody stools, are vomiting blood, have severe pain or a rigid abdomen, have been injured, had a sudden onset of sharp pain, have cancer, or might be pregnant and have abdominal pain or vaginal bleeding.
If your lower abdominal pain is persistent or causes you concern, seek prompt medical care, particularly if it is worsening instead of improving. If you have bladder symptoms, a fever, decreased appetite, or unexplained weight loss, you should also seek prompt medical care.
What other symptoms might occur with lower abdominal pain?
Lower abdominal pain may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Symptoms are frequently associated with the digestive tract, but they may also involve other body systems.
Digestive tract symptoms that may occur along with lower abdominal pain
Lower abdominal pain may accompany other symptoms affecting the digestive tract including:
- Abdominal cramping
- Abdominal swelling, distension or bloating
- Bloody stool (blood may be red, black, or tarry in texture)
- Nausea with or without vomiting
- Urgent need to pass stool
Other symptoms that may occur along with lower abdominal pain
Lower abdominal pain may accompany symptoms related to other body systems including:
- Body aches
- General ill feeling
- Muscle spasms
- Pain during sexual intercourse
- Pain or burning with urination
- Pain, numbness or tingling
- Palpable mass in the abdomen or pelvic area
- Unexplained weight loss
Serious symptoms that might indicate a life-threatening condition
In some cases, lower abdominal pain may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:
- Bleeding while pregnant
- Change in level of consciousness or alertness, such as passing out or unresponsiveness
- High fever (higher than 101 degrees Fahrenheit)
- Inability to have bowel movements, especially if accompanied by vomiting
- Rapid heart rate (tachycardia)
- Rigidity of the abdomen
- Severe abdominal or pelvic pain or sharp abdominal pain that comes on suddenly
- Trauma to the abdomen
- Vomiting blood, rectal bleeding, or bloody stool
What causes lower abdominal pain?
Often, lower abdominal pain is related to conditions of the digestive tract, but can also be related to conditions of the body wall, skin, blood vessels, urinary tract, or reproductive organs.
Digestive tract causes of lower abdominal pain
Lower abdominal pain may be caused by digestive tract conditions including:
- Bacterial, parasitic or viral infection of the gastrointestinal tract
- Celiac disease (severe sensitivity to gluten from wheat and other grains that causes intestinal damage)
- Chronic constipation
- Diverticulitis (inflammation of an abnormal pocket in the colon)
- Food intolerance such as lactose intolerance (inability to digest lactose, the sugar in dairy products)
- Inflammatory bowel disease (includes Crohn’s disease and ulcerative colitis)
- Irritable bowel syndrome (IBS; digestive discomfort that does not cause intestinal damage or serious disease)
- Meckel’s diverticulum (congenital, abnormal pouch near the lower end of the small intestine)
Other causes of lower abdominal pain
Lower abdominal pain can also be caused by conditions of other body systems including:
- Abdominal hernia (weakened area of the abdominal wall, through which internal organs can pass)
- Cancer of an abdominal or pelvic organ
- Endometriosis (condition where tissues resembling the uterine lining grow in other areas of the body)
- Kidney stones
- Menstrual cramps
- Ovarian cysts (benign sacs in an ovary that contain fluid, air, or other materials)
- Pelvic inflammatory disease (PID; infection of a woman’s reproductive organs)
- Shingles (painful, blistering rash, often forming a stripe, resulting from a reactivation of the varicella-zoster, or chickenpox, virus)
- Urinary tract infection
- Uterine fibroids (abnormal growths of uterine muscle tissue that can cause uterine enlargement or discomfort)
Serious or life-threatening causes of lower abdominal pain
In some cases, lower abdominal pain may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:
- Abdominal abscess
- Bowel obstruction or perforation
- Colonic volvulus (twisting of the colon)
- Ectopic pregnancy (life-threatening pregnancy growing outside the uterus)
- Intestinal ischemia (loss of blood supply to the intestines leading to death of intestinal tissue)
- Intussusception (telescoping of the intestines into themselves, which can cause intestinal ischemia)
- Occlusion, embolism, or thrombosis of the mesenteric artery
- Ovarian torsion (twisting of the ovary)
- Peritonitis (infection of the lining that surrounds the abdomen)
- Ruptured appendix
- Significant abdominal trauma
- Testicular injury
- Testicular torsion (twisting of the spermatic cord)
Questions for diagnosing the cause of lower abdominal pain
To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your lower abdominal pain including:
- When did you first notice pain in your lower abdomen?
- Have you had pain like this before?
- Do you have any other symptoms?
- Does anything make your symptoms go away or make them worse?
- What medications are you taking?
- Have you been injured?
- Is there any possibility you might be pregnant?
What are the potential complications of lower abdominal pain?
Because lower abdominal pain can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:
- Abdominal abscess
- Adverse effects of treatment of lower abdominal pain
- Bowel obstruction, perforation or infarction (severe injury to an area of the bowel due to decreased blood supply)
- Fistula (abnormal hole or tube between organs or tissues)
- Internal hemorrhage
- Intestinal obstruction and rupture of the intestinal wall
- Ruptured appendix
- Spread of cancer
- Spread of infection
- Surgery to remove parts of the digestive tract due to inflammation, rupture, obstruction, serious infection, or a malignant condition