When Lower Abdominal Pain Could Be Serious

Medically Reviewed By William C. Lloyd III, MD, FACS
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Many people experience pain in the lower belly (abdomen) from time to time. It could be pain from stomach flu, gas, or constipation that will go away without treatment. But, pain in the lower abdomen is never normal and can be due to a serious condition. Sometimes, it's a medical emergency.

Organs in your lower abdomen that may cause pain include your:

  • Appendix

  • Part of the colon known as the descending colon

  • Bladder

  • Abdominal aorta

  • Uterus, ovaries, and fallopian tubes in women

Causes of Lower Abdominal Pain

Call your doctor about any pain in your lower abdomen that is severe or long-lasting or keeps coming back. The type of pain you experience is key to helping your doctor figure out what's causing it. Acute pain is pain that starts suddenly. Chronic pain is pain you've had for a long time. This type is less likely than acute pain to be an emergency.

Pain in your abdomen might be sharp, dull, burning or crampy. It may start in one place and move (radiate) to another area, such as your groin. It's also important to pay attention to the other symptoms you experience with the pain. Always tell your doctor if you experience any of these "red flag" symptoms with your abdominal pain:

Common causes of lower abdominal pain include:

  • Gastroenteritis. The common name for this is stomach flu. It can cause crampy pain in your lower abdomen. Other stomach flu symptoms may include watery diarrhea, nausea, vomiting, fever, and body aches.

  • Bladder infection or inflammation. These bladder conditions can cause acute or chronic lower abdominal pain. You also may feel pressure, have a frequent urge to pass urine, feel a burning pain when passing urine, and have a fever.

  • Cancer, infection, or inflammatory bowel disease of the descending colon. The descending colon is the part of the large intestine that holds stool just before it moves into the rectum. Problems with the descending colon can cause crampy pain in the lower abdomen. Other symptoms may include changes in bowel habits, weight loss, fever, blood or mucus in the stool, and tenderness when pressing on the right lower abdomen. A blocked bowel, also called a bowel obstruction, can cause pain along with constipation and swelling.

  • Diverticulitis. This is inflammation of the colon. It can cause acute and sharp pain in the lower abdomen. The pain may come and go. Other symptoms include bloody stools, nausea or vomiting, chills or fever, and constipation or diarrhea.

  • Ovarian cyst, menstruation, and infection in women. Lower abdominal pain in women originating from female organs can be acute or chronic. Other symptoms may include vaginal bleeding and changes in bowel habits. An ovarian cyst can cause pelvic pain in women. The pain may come and go, be dull and radiate to the back. Menstrual pain is a dull pain that starts before a period. A pelvic infection also may cause lower abdominal pain, fever, vaginal discharge, or bleeding.

When to Seek Emergency Care

Anyone experiencing acute or severe abdominal pain lasting more than 30 minutes, with constant vomiting, should go to an emergency room (ER) or call 911.

Other causes of lower abdominal pain that require immediate medical attention in an ER include:

  • Appendicitis. This causes acute pain that starts in the middle or right side of the abdomen and radiates down to the lower right side. The lower right side may be tender and swollen. Other symptoms of appendicitis include chills, fever, nausea or vomiting, and constipation or diarrhea.

  • Renal colic. This is caused by a stone passing down into the bladder. This causes acute and severe pain that radiates from the side to the groin area. Other symptoms of a kidney stone include nausea and vomiting, blood in the urine, or inability to pass urine.

  • Ruptured aortic aneurysm. Rupture of the large artery that passes through the center of the abdomen causes acute and severe abdominal pain and back pain. Other symptoms include sweaty and clammy skin, nausea and vomiting, dizziness, inability to pass stool and urine, and passing out (loss of consciousness). Call 911 for the fastest emergency response.

  • Ectopic pregnancy. This is a pregnancy that occurs outside the womb, usually in a fallopian tube. It causes acute abdominal pain that is sharp and stabbing. Pain from an ectopic pregnancy may come and go. Other symptoms may include vaginal bleeding, nausea and vomiting, weakness, dizziness, and passing out.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 21
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