Abdominal Pain

“When I got to school, my stomach did a lot of back flips because of all of the new foods. I miss my mom’s cooking.”

John L., Notre Dame University

The abdomen is the body region between the lower ribs and the pelvis that contains many vital organs:

Abdominal pain can range from mild to severe: be dull or sharp; acute or chronic. Acute pain is sudden pain. Chronic pain can be constant or pain that recurs over time. The type of pain, its location, and other symptoms that come with it help suggest the cause.

Signs, Symptoms & Causes

There are many causes of abdominal pain. Common ones in students and the symptoms that accompany them are listed below.

Constipation
Constipation results from not drinking enough fluids, not eating enough dietary fiber, not being active enough, and from misusing laxatives.

Symptoms of constipation are:

	A hard time passing stool, not being able to pass stool, and/or having very hard stools
	Straining to have a bowel movement
	Abdominal swelling or feeling of continued fullness after passing stool

Gastroenteritis
Gastroenteritis is inflammation of the lining of the stomach and intestines. Causes include having an intestinal virus, food poisoning, and drinking contaminated water or too much alcohol. Symptoms of gastroenteritis include:

	Abdominal pain or cramping
	Nausea and/or vomiting
	Diarrhea
	Fever and/or chills

It may be hard to tell from symptoms if you have an intestinal virus or food poisoning. Suspect food poisoning if others who have eaten the same foods you did also have symptoms.

Lactose Intolerance
Lactose intolerance results from a lack of an enzyme (lactase) needed to digest the sugar (lactose) in dairy products.

Symptoms of lactose intolerance are:

	Abdominal cramping, pain, and bloating after drinking milk or eating other dairy products
	Gas and diarrhea

Menstrual Cramps in Females
Hormones cause the uterus to go into spasms. Premenstrual bloating increases the abdominal pain.

Symptoms of menstrual cramps are:

	Mild to severe abdominal pain
	Back pain, fatigue, and/or diarrhea

Peptic Ulcer
A peptic ulcer is an ulcer in the stomach or first section of the small intestine.

Symptoms include:

	A gnawing or burning pain between the breast-bone and navel. This is the most common symptom. The pain often occurs between meals and in the morning. It may last from a few minutes to a few hours and may be relieved with eating or antacids.
	Loss of appetite and weight loss
	Nausea or vomiting dark, red blood or material that looks like coffee grounds
	Bloody, black, or tarry stools

The causes of peptic ulcers are known to be 2 things:

	An infection with Helicobacter pylori (H. pylori) bacteria. This causes about 80% of peptic ulcers.
	The repeated use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), such as over-the-counter and prescribed ibuprofen. This causes about 20% of peptic ulcers.
	Peptic ulcers are not caused by stress, but stress can aggravate them. (See “Stress”.)

Treatment

Treatment depends on the cause. The key is knowing when it’s just a minor problem like a mild stomach ache or when it’s something worse. Pain that persists can be a sign of a medical condition or illness. Very severe abdominal pain usually requires immediate medical care.

Questions to Ask

Is the abdominal pain very severe? Is the pain so bad that you can’t move or gets a lot worse when you move?

Are all of these symptoms of appendicitis present? You have not had your appendix removed. Pain that usually starts in the upper part of the stomach or around the belly button and that moves to the lower right part of the abdomen. The pain can be sharp and severe. Tenderness when the right lower area of the abdomen is pressed Nausea, vomiting, or no appetite Mild fever

For females, do you have the following signs and symptoms of an ectopic pregnancy or pelvic inflammatory disease (PID)? You are sexually active and have missed one or more periods or have vaginal bleeding you can’t explain. Cramping or pain that can be severe in your lower abdomen Sudden fainting or dizziness

Do you have signs and symptoms of an acute kidney infection?

Do you have the following signs and symptoms of kidney stones? Pain that started in your mid back and then moved to your abdomen or groin Frequent urination (but you only pass small amounts of urine) Inability to urinate except in certain positions Bloody urine Chills and/or fever Nausea and vomiting

With abdominal pain, do you have any of these problems? The whites of your eyes or your skin looks yellow. A recent injury or blow to the abdomen Severe diarrhea Lightheadedness or dizziness Constipation for more than a week Sensitive skin on the abdomen Fever

With abdominal pain, do you have signs and symptoms of a bladder infection?

With abdominal pain, are any of these conditions present? Constant belching, nausea, gas, or gurgling noises Worsening pain when bending over or lying down Possible pregnancy

Self-Care/Prevention

To Help Ease Pain in General:

	Place a hot water bottle or a heating pad, set on low, over the area of pain.
	Find a comfortable position. Relax.
	Take an over-the-counter medicine for pain that does not cause stomach upset. (See “OTC Medications”)
	Don’t wear tight-fitting clothes.
	Don’t do strenuous exercise.
	Eat foods as tolerated.

For Constipation:
Eat foods high in fiber: Bran; whole-grain breads and cereals; and fresh fruits and vegetables.

	Drink at least 11/2 to 2 quarts of water and other liquids every day. Hot water, tea, or coffee may help stimulate the bowel.
	Get plenty of exercise.
	Don’t resist the urge to have a bowel movement.
	Antacids and iron supplements can be binding.
	If you get constipated easily, discuss the use of these with your provider.
	Don’t use “stimulant” laxatives, such as Ex-Lax, or enemas without your provider’s okay.
	Long-term use of them can make you even more constipated and lead to a mineral imbalance and reduced nutrient absorption. If needed, take an over-the-counter bulk-forming laxative, such as Metamucil.

For Food Poisoning:
To prevent food poisoning:

	Wash your hands and food preparation surfaces and utensils, especially after handling raw meat and eggs.
	Cook foods to a safe temperature. Follow product and/or recipe directions.
	Refrigerate perishable foods promptly. These include milk, cheese, meat, poultry, eggs, and fish. Refrigerate leftovers, and use them within 3 to 4 days.
	Hot foods should be kept at or above 140 degrees Fahrenheit.
	Cold foods should be kept at or below 40 degrees Fahrenheit.
	Carry items in a thermos or with a cold pack, if necessary.
	When in doubt, throw it out.

When you have food poisoning, follow self-care measures in “Vomiting & Nausea”.

For Lactose Intolerance:
See “Self-Care for Lactose Intolerance”.

For Menstrual Cramps: Take an over-the-counter medicine for menstrual cramps. (See “OTC Medications”)

	Drink hot tea, (regular, chamomile, or mint).
	Hold a heating pad or hot water bottle on your abdomen or lower back.
	Take a warm bath.
	Gently massage your abdomen.
	Do mild exercises, such as yoga and walking.
	When you can, lie on your back and support your knees with a pillow.
	Rest. Avoid stress as your period approaches.

{Note: If you get stomach aches due to stress, see “Stress” for information on how to deal with it.}

Table of Contents

October 24, 2001