Lower Abdominal Pain: Symptoms, Causes And Diagnosis

Lower abdominal pain can range from mild to severe, and it can occur anywhere from the belly button to the pelvis. Sometimes it’s just a dull, aching sensation that’s easy to dismiss. Other times, it manifests as sharp, stabbing pain that can knock you off your feet. And it’s common—abdominal pain accounts for 10% to 12% of emergency room visits worldwide, according to a study published in Clinical Pathways in Emergency Medicine[1].

Gas, indigestion, and constipation are less serious causes of abdominal pain. While these conditions do not usually necessitate immediate medical attention, determining the exact cause of abdominal pain can be difficult. Furthermore, the severity of your stomach pain does not always correspond to the severity of the underlying condition. A viral stomach bug, for example, can cause excruciating pain, whereas more serious conditions, such as colon cancer, may cause little or no pain.

What Exactly Is Lower Abdominal Pain?

 

Consider drawing a horizontal line at the level of your belly button. Lower abdominal pain is defined as any significant discomfort located below that line, according to Carl V. Crawford, M.D., a gastroenterologist at Weill Cornell Medicine in New York City. According to Dr. Crawford, the pain can sometimes be confined to a very specific area that can be pointed to with one finger. However, it can be more difficult to pinpoint its origin at times.

According to Vanessa Méndez, M.D., a triple board-certified gastroenterologist, internist, and lifestyle medicine physician and founder of the telemedicine practice Planted Forward, this is because the region is home to many internal organs, including the stomach, liver, gallbladder, pancreas, small intestine, and large intestine. “Each of these organs plays a different role in digestion and will generally express distress in a different way,” Dr. Méndez explains.

Lower abdominal pain can also be acute or chronic. According to Dr. Mendez, acute pain is defined as a new problem with a sudden onset, whereas chronic pain is defined as pain that has been present for an extended period of time—either continuously or intermittently. Acute pain is usually caused by illness or injury and resolves on its own. Chronic pain can last months, if not years.

According to Dr. Méndez, determining whether the source of your lower abdominal pain is acute or chronic can help your health care provider narrow down the cause and determine the best treatment.

The location is also important. According to Elena Ivanina, D.O., director of neuro-integrative gastroenterology at Lenox Hill Hospital in New York City, doctors frequently view the abdomen in four quadrants plus the epigastrium, or midline between the sternum and belly button. “The small intestines are usually in the middle around the belly button, and the large intestine is in an upside-down “U” on the abdomen’s edges and across the top,” she continues. According to Dr. Ivanina, the quadrants and their associated symptoms are as follows:

• The pain in the right upper quadrant is caused by the liver and gallbladder.
• Left upper quadrant symptoms are non-specific and can be caused by pain in a variety of locations.
• Symptoms in the right lower quadrant are typically caused by pain in the small to large bowel.
• Left lower quadrant symptoms are typically indicative of colon pain.
• Epigastrium symptoms indicate stomach or pancreatic pain.
• What Are the Causes of Lower Abdominal Pain?
• When it comes to lower abdominal pain, there are numerous potential causes. The following are some of the more common causes.

Gas Locked Up

 

According to Dr. Crawford, trapped gas is common during the digestion process. We swallow air when we eat, and bacteria work to break down carbohydrates as food travels through the digestive tract, producing gas as a byproduct. This process produces gasses, which can cause unpleasant symptoms.

Symptoms: Acute pain from trapped gas can occur anywhere in the abdomen, resulting in belching, bloating, a distended stomach, and flatulence. According to Dr. Crawford, people usually feel better after passing gas. Dr. Méndez recommends gentle movements such as walking, yoga stretches, light abdominal massaging, plenty of water, and calming teas to help relieve gas-related abdominal pain.

IBS is an abbreviation for Irritable Bowel Syndrome (IBS)

 

According to the American College of Gastroenterology, 10% to 15% of adults in the United States may have Irritable Bowel Syndrome (IBS)[2]. According to Aniruddh Setya, M.D., a board-certified pediatric gastroenterologist at Joe DiMaggio Children’s Hospital and Kidz Medical Services in Hollywood, Florida, IBS is a GI tract disorder characterized by chronic abdominal pain and altered bowel habits.

Because other GI conditions must be ruled out by a gastroenterologist before a true diagnosis of IBS can be made, Dr. Méndez refers to IBS as a diagnosis of exclusion. While the exact cause is unknown, IBS is thought to be caused by a disruption in gut-brain communication, which causes hypersensitivity in the intestinal organs and altered muscle contraction in the GI tract, she adds.

Symptoms: IBS causes chronic pain in the lower abdomen. IBS symptoms include abdominal pain, gas, bloating, and bowel changes such as constipation, diarrhea, and loose stool. According to Dr. Setya, common triggers include stress and certain foods such as dairy and fermentable sugars. Dr. Crawford adds that treatments range from dietary changes to medications designed to control the altered bowel pattern or pain.

IBD is an abbreviation for Inflammatory Bowel Disease (IBD)

 

According to Dr. Méndez, inflammatory bowel disease (IBD) refers to two disorders that involve chronic inflammation of the intestinal tract. According to the Centers for Disease Control and Prevention, these two conditions—disease Crohn’s and ulcerative colitis—may affect up to 3 million people in the United States. [3]

According to Dr. Crawford, Crohn’s disease can cause inflammation and irritation anywhere along the intestinal tract, from the mouth to the anus, but it is most commonly found in the last part of the small intestine and the colon. If the condition is not treated, it can lead to deep ulcers and scarring in the intestinal lining, as well as abscesses, fistulas (abnormal connections between two organs), and anal fissures.
According to Dr. Méndez, ulcerative colitis causes inflammation and ulcers along the lining of the large intestine and rectum. Unlike Crohn’s disease, inflammation occurs only in the innermost layer of the colon and rectum lining, but if left untreated, it can result in a small hole in the lining, according to Dr. Crawford.

Symptoms: According to Dr. Méndez, common symptoms of ulcerative colitis and Crohn’s disease, both chronic conditions, include frequent diarrhea, lower abdominal cramping and pain, bloody stools, fever, weight loss, fatigue, and night sweats. Medication, bowel rest, or surgery may be used to treat these chronic conditions.

Constipation

 

Constipation is likely if you have infrequent bowel movements that are difficult or painful to pass, according to Dr. Setya. He goes on to say that the condition, which is usually caused by dietary triggers, dehydration, and stress, frequently occurs in people who have no identifiable underlying cause. Dr. Méndez says constipation is the most common digestive complaint among her patients.

Constipation can be acute or chronic, and it usually causes pain and discomfort in the lower abdomen. Acute constipation symptoms include having three or fewer bowel movements in a week, having hard, lumpy stools that are difficult to pass, and feeling as if not all of your stool has passed. According to Dr. Setya, bleeding can occur if the delicate anal tissue tears. Drinking more water, eating more fiber, and getting more exercise can often help relieve constipation, but if constipation persists or becomes chronic, it’s important to see a doctor.

Diverticulitis

 

Diverticula, or small, sac-like structures, are thought to form inside the colon as a result of chronic constipation caused by a low-fiber diet. Diverticulosis is the medical term for this condition. Diverticulitis occurs when these pouches become inflamed or infected, and it is most common in adults over the age of 60, according to Dr. Méndez.
Symptoms: According to Dr. Méndez, acute diverticulitis is commonly felt on the left lower abdomen and can last for several days, and it can be accompanied by nausea, vomiting, fever, and constipation.

Infection of the Urinary Tract

 

When bacteria enters the urethra by accident, it can cause a urinary tract infection, or UTI.

Dr. Méndez describes urinary tract infection symptoms as a strong need to urinate, pain or burning in the lower pelvis, and burning while passing only small amounts of urine. “The urine may also smell bad and look old (cloudy or reddish-pink if blood is present),” she adds. Antibiotics are used to treat these acute infections.

Infection of the Kidneys

 

According to Dr. Ivanina, a kidney infection, also known as pyelonephritis, is a type of UTI that can be severe and necessitate IV antibiotics. It begins in the bladder and spreads upward, infecting one or both kidneys.

Symptoms: According to Dr. Ivanina, symptoms of this acute infection may include flank (side) pain, back pain, fever with chills (bad enough to cause shaking), nausea, and vomiting.

Stones in the kidney

 

Kidney stones are concentrated deposits of salts and minerals that form in your kidneys and pass through your urinary system, according to Dr. Ivanina. These stones can become lodged in the urinary tract, causing a backup of urine in the kidney, bladder, or urethra, causing infection and pain.

Symptoms: According to Dr. Ivanina, symptoms of this acute condition include sharp, severe pain in the back, side, abdomen, and groin that comes in waves, as well as discolored, foul-smelling urine and a change in urinary frequency. She adds that nausea, vomiting, fever, and chills are possible side effects.

Appendicitis

 

According to Dr. Crawford, the appendix is a small, tubular-like structure that extends into the cecum of the colon. Mucus, cells, and bacteria normally travel freely from the appendix into the cecum, but when there is a blockage, inflammation of the appendix can occur. Appendicitis is a serious condition. According to Dr. Setya, it is critical to get to the ER if you believe you are experiencing symptoms because surgery is frequently required.

According to Dr. Setya, acute appendicitis symptoms include right lower abdominal pain, nausea, vomiting, loss of appetite, and fever. The pain may be centered near the belly button at first, but as the inflammation progresses, he says, it will migrate to the right lower quadrant of the abdomen. Severe pain can strike without warning.

Lower Abdominal Pain vs. Pelvic Pain

 

Pelvic pain is also known as lower abdominal pain, but it refers to problems with the genitourinary tract, uterus, fallopian tubes, and ovaries, according to Dr. Carpenter. Pelvic pain can be caused by a variety of factors, including:

• Sexually transmitted infections
• UTIs (urinary tract infections)
• Polycystic ovarian syndrome is characterized by ovarian cysts (PCOS)
• Torsion of the ovaries
• Endometriosis
• Pelvic floor dysfunction
• Diagnosis of Lower Abdominal Pain

According to Dr. Méndez, the underlying cause of lower abdominal pain varies from person to person. Most of the time, it’s something minor, like trapped gas or indigestion, but lower abdominal pain can be a sign of something more serious, she adds.

A thorough history and physical exam are required to make a diagnosis. Your doctor may perform urine, blood, and stool tests, enemas, a colonoscopy (a procedure in which a scope is used to view different organs in the body—for example, an upper endoscopy looks at the esophagus and stomach), or an endoscopy (a procedure in which a scope is used to view different organs in the body—for example, an upper endoscopy looks at the esophagus and stomach). “A gastroenterologist will perform a thorough workup to determine the root cause, including a review of dietary and lifestyle habits,” Dr. Méndezs continues. Dr. Carpenter adds that you may be referred to other specialists such as a urologist, gynecologist, or even a surgeon.

According to Dr. Ivanina, a multidisciplinary approach is essential for correctly diagnosing lower abdominal pain. The tests will differ depending on the specialist to whom you are referred. “A gastroenterologist may order a CT scan of the abdomen/pelvis as well as a colonoscopy. An internal examination and a pelvic ultrasound may be ordered by a gynecologist. “A urologist may perform urine tests and use imaging to evaluate the bladder,” she explains.

When Should You See a Doctor for Lower Abdominal Pain?

 

It’s normal to have a mild upset stomach or indigestion from time to time, but if your abdominal pain is persistent, worsening, or associated with other symptoms, Dr. Ivanina recommends seeing a doctor. Among the more concerning symptoms are:

• Fever\sChills
• Nausea
• Vomiting
• Significant stomach distension Constipation
• Diarrhea
• You have blood in your stool.
• As innocuous as many cases of lower abdominal pain may be, it’s always a good idea to consult your doctor if you begin to experience symptoms that concern you.