Acute Abdominal Pain in Adults: Evaluation and Diagnosis

Acute Abdominal Pain in Adults: Evaluation and Diagnosis

Abdominal pain can be a common and sometimes debilitating issue for adults. From indigestion and constipation to more serious conditions like gallstones and ulcers, the causes of abdominal pain are varied and can have a significant impact on daily life. Understanding the symptoms and treatment options for abdominal pain is essential for proper diagnosis and relief.

In this article, we will delve into the potential causes of abdominal pain in adults, explore the common symptoms that accompany it, discuss the diagnostic process, and present various treatment options. We will provide valuable insights into preventive measures that can help individuals avoid experiencing abdominal pain in the future. Whether you’re looking to understand the root of your discomfort or seeking ways to alleviate it, this comprehensive guide will equip you with the knowledge needed to address abdominal pain in adults.

Key Takeaways:

  • Abdominal pain can be caused by various factors such as indigestion, constipation, food allergies, gallstones, ulcers, and appendicitis.
  • Some common symptoms of abdominal pain in adults include nausea and vomiting, diarrhea, fever, bloating, and loss of appetite.
  • Abdominal pain in adults can be diagnosed through physical examination, imaging tests, and blood or stool tests. Treatment options include over-the-counter medications, antibiotics, and surgery depending on the cause.

What Causes Abdominal Pain?

What Causes Abdominal Pain in Adults

Abdominal pain in adults can have various causes and may indicate underlying health issues that require evaluation by a healthcare provider. The pain can originate from different structures within the abdominal cavity, including the abdominal wall, lower left quadrant, bile ducts, small intestine, large intestine, appendix, pancreas, spleen, ureters, ovaries, and uterus.

When considering the specific conditions related to abdominal pain, diverticulitis and diverticulosis are commonly associated with discomfort in the lower left quadrant. Gallstones in the bile ducts can cause severe pain, especially after a fatty meal. Gastroesophageal reflux disease (GERD) leads to a burning sensation due to stomach acid moving up into the esophagus. Meanwhile, gastroenteritis often causes crampy and sharp abdominal pain, accompanied by nausea, vomiting, and diarrhea.

Acute abdominal pain can represent a spectrum of conditions from benign and self-limited disease to surgical emergencies. Evaluating abdominal pain requires an approach that relies on the likelihood of disease, patient history, physical examination, laboratory tests, and imaging studies. The location of pain is a useful starting point and will guide further evaluation. For example, right lower quadrant pain strongly suggests appendicitis. Certain elements of the history and physical examination are helpful (e.g., constipation and abdominal distension strongly suggest bowel obstruction), whereas others are of little value (e.g., anorexia has little predictive value for appendicitis).



Indigestion, often characterized by discomfort or pain in the stomach area, can be a common cause of abdominal pain in adults.

Indigestion symptoms may include bloating, gas, nausea, and a burning sensation in the upper abdomen. Certain factors such as overeating, consuming spicy or fatty foods, stress, smoking, and certain medications can trigger indigestion.

Risk factors for developing indigestion also include obesity, pregnancy, and underlying digestive conditions. Managing indigestion involves lifestyle changes such as eating smaller, more frequent meals, avoiding trigger foods, and practicing relaxation techniques. Over-the-counter antacids may provide relief, and in severe cases, prescription medications or further medical evaluation may be necessary.


Constipation, a condition characterized by infrequent or difficult bowel movements, can lead to abdominal pain and discomfort in adults.

This discomfort can be caused by the buildup of stool in the colon, which puts pressure on the surrounding organs, leading to abdominal bloating and cramping. The straining associated with constipation can result in hard and dry stools, making them more challenging to pass. Common symptoms of constipation include:

  • infrequent bowel movements
  • hard stools
  • straining during bowel movements
  • a feeling of incomplete evacuation

These symptoms often lead to discomfort and pain in the abdomen, making it crucial to address constipation promptly to improve abdominal health.

Food Allergies

Food allergies, when triggered by specific allergens, can result in abdominal pain and digestive discomfort in adults.

This discomfort may stem from the body’s immune response to allergens such as peanuts, tree nuts, dairy, eggs, and shellfish, leading to inflammation and irritation of the digestive tract. Common symptoms of food allergies include nausea, bloating, cramps, diarrhea, and constipation.

Managing food allergies and their related abdominal pain involves identifying and avoiding trigger foods, seeking medical diagnosis and guidance, and potentially incorporating anti-inflammatory and digestive support through dietary changes and supplements.


Gallstones, often found in the gallbladder or bile ducts, are a potential source of abdominal pain and discomfort in adults.

The formation of gallstones can result from an imbalance in the chemicals stored in the gallbladder. This imbalance can lead to the formation of hardened deposits, causing a range of symptoms, including intense pain in the upper abdomen and back, nausea, vomiting, and bloating. When these symptoms occur, seeking medical attention is crucial. Diagnostic methods such as ultrasound and CT scans are commonly used to identify gallstones, while treatment options may include medication, extracorporeal shock wave lithotripsy (ESWL), or surgical removal of the gallbladder, known as cholecystectomy.


Ulcers, which can develop in the stomach lining or gastrointestinal tract, may contribute to abdominal pain and discomfort in adults.

When ulcers form on the lining of the stomach (gastric ulcers) or the upper part of the small intestine (duodenal ulcers), they can result in a variety of symptoms. These may include burning pain in the abdomen, bloating, nausea, and vomiting.

In severe cases, ulcers can lead to bleeding, which may manifest as black, tarry stools or vomiting of blood. This bleeding can also result in anemia due to the loss of red blood cells.


Appendicitis, characterized by inflammation of the appendix, is a serious condition that commonly presents with severe abdominal pain in adults.

It’s important to recognize the signs and symptoms of appendicitis, as a delay in seeking medical attention can lead to complications such as a ruptured appendix and infections.

The onset of appendicitis is often marked by sudden and intensifying abdominal pain, typically starting around the navel and then moving to the lower right side of the abdomen. Other common symptoms include loss of appetite, nausea, vomiting, and a low-grade fever.

Due to the potential severity of this condition, prompt medical evaluation and potential surgical intervention are necessary to prevent further complications and ensure a speedy recovery.

What Are the Symptoms?

What Are the Symptoms of Abdominal Pain in Adults

Adults experiencing abdominal pain may exhibit various associated symptoms, and it’s crucial for healthcare providers to ask targeted questions to identify potential related factors.

Common symptoms often associated with abdominal pain in adults include:

  • nausea
  • vomiting
  • diarrhea

which may indicate underlying gastrointestinal issues. The presence of fever, bloating, and loss of appetite can provide valuable clues for evaluation and assessment. Integrated symptom assessment is crucial in determining the severity and potential causes of abdominal pain, allowing for targeted treatment and management.

Nausea and Vomiting

Abdominal pain in adults can be accompanied by symptoms such as nausea and vomiting, indicating potential involvement of the digestive system.

Experiencing nausea and vomiting along with abdominal pain can be distressing, often signaling an underlying issue with the gastrointestinal tract or other abdominal organs. These symptoms may be caused by a range of conditions, including:

  • gastroenteritis
  • peptic ulcers
  • gallstones
  • appendicitis

or more serious conditions such as:

  • pancreatitis
  • intestinal obstruction
  • abdominal aortic aneurysm

Understanding the specific cause is crucial for effective treatment. Treatment approaches may include:

  • medications to reduce inflammation or manage infection
  • surgical intervention for conditions like appendicitis or obstructive issues
  • dietary modifications to alleviate digestive discomfort


Adults experiencing abdominal pain may also present with symptoms of diarrhea, reflecting potential gastrointestinal disturbances.

This combination of symptoms can indicate various underlying causes such as infections, food intolerances, inflammatory bowel disease, or irritable bowel syndrome. It’s important to consider the management strategies for abdominal pain and diarrhea, including diet modification, medications, and stress reduction techniques.

The significance of these symptoms lies in their potential to indicate serious conditions, making it crucial to seek medical evaluation and proper diagnosis for proper treatment.


The presence of fever alongside abdominal pain in adults may signal an underlying infection or inflammatory process that requires prompt evaluation.

When fever and abdominal pain occur together, it can indicate various potential causes, such as appendicitis, urinary tract infection, gastroenteritis, or even more severe conditions like diverticulitis or pancreatitis. An elevated temperature with abdominal discomfort can also point towards peritonitis or pelvic inflammatory disease. Swift medical assessment is vital to determine the source of the symptoms and prevent potential complications.


Bloating, often accompanied by abdominal pain, can be indicative of underlying digestive system disturbances that warrant investigation in adults.

These symptoms may be linked to various gastrointestinal factors, such as irritable bowel syndrome (IBS), lactose intolerance, or celiac disease. Digestive issues like constipation and gas can also contribute to abdominal bloating and discomfort. Understanding the potential triggers behind these symptoms is crucial in addressing them effectively. Healthcare professionals might recommend dietary adjustments, stress management techniques, or medications to alleviate bloating and abdominal pain.

Maintaining a healthy and balanced diet, staying hydrated, and regular physical activity can positively impact digestive health and reduce these distressing symptoms.

Loss of Appetite

Adults experiencing abdominal pain may also report a loss of appetite, which can be indicative of potential disruptions in their nutritional and dietary habits.

This loss of appetite may lead to inadequate intake of essential nutrients, including proteins, vitamins, and minerals, potentially exacerbating the overall health condition. In cases of persistent abdominal discomfort, the association between appetite changes and digestive disorders highlights the need for medical evaluation to address underlying problems and promote appropriate dietary modifications.

How is Abdominal Pain Diagnosed?

How is Abdominal Pain Diagnosed In Adults

Abdominal pain in adults is typically diagnosed through a comprehensive evaluation by a healthcare provider, often involving physical examinations and targeted assessments.

Medical history review plays a crucial role in understanding the possible causes of the abdominal pain. The healthcare provider gathers information about the onset of pain, its location, intensity, duration, aggravating or alleviating factors, and associated symptoms. This helps in ruling out potential underlying conditions such as gastrointestinal issues, urinary tract problems, or reproductive system disorders.

Physical examinations, including palpation, percussion, and auscultation, are performed to identify possible tender areas, masses, or abnormal sounds. Depending on the initial assessment, the healthcare provider may recommend further diagnostic tests such as imaging studies (ultrasound, CT scan, MRI) or laboratory tests (blood work, urine analysis) to pinpoint the cause of the abdominal pain.

Acute abdominal pain is a common presentation in the outpatient setting and can represent conditions ranging from benign to life-threatening. If the patient history, physical examination, and laboratory testing do not identify an underlying cause of pain and if serious pathology remains a clinical concern, diagnostic imaging is indicated.

The American College of Radiology has developed clinical guidelines, the Appropriateness Criteria, based on the location of abdominal pain to help physicians choose the most appropriate imaging study. Ultrasonography is the initial imaging test of choice for patients presenting with right upper quadrant pain.

Computed tomography (CT) is recommended for evaluating right or left lower quadrant pain. Conventional radiography has limited diagnostic value in the assessment of most patients with abdominal pain. The widespread use of CT raises concerns about patient exposure to ionizing radiation. Strategies to reduce exposure are currently being studied, such as using ultrasonography as an initial study for suspected appendicitis before obtaining CT and using low-dose CT rather than standard-dose CT. Magnetic resonance imaging is another emerging technique for the evaluation of abdominal pain that avoids ionizing radiation.


What Are the Treatment Options?

The treatment of abdominal pain in adults depends on the underlying cause and may involve various approaches, including over-the-counter medications, antibiotic therapy, or surgical interventions.

Over-the-counter medications, such as ibuprofen or acetaminophen, are commonly used to alleviate mild to moderate abdominal pain caused by conditions like menstrual cramps or indigestion. Antibiotic therapy becomes necessary when the pain is due to bacterial infections, such as appendicitis or diverticulitis. Surgical interventions are typically recommended for severe cases of abdominal pain resulting from conditions like gallstones, hernias, or pancreatitis. Each treatment option is tailored to address the specific underlying cause of the pain and requires a thorough evaluation by a healthcare professional.

Over-the-counter Medications

For certain cases of abdominal pain, adults may find relief through the use of over-the-counter medications, such as non-steroidal anti-inflammatories, to alleviate discomfort.

These medications work by reducing inflammation in the body and can help in managing mild to moderate abdominal pain. Antacids are also commonly used to neutralize stomach acid, providing relief from indigestion and heartburn, which are common causes of abdominal discomfort.

Pain relief medications like acetaminophen can be effective in managing pain associated with conditions such as menstrual cramps or muscle strains. Anti-diarrheal medications like loperamide can help with abdominal pain caused by diarrhea.


In cases where abdominal pain is associated with bacterial infections, healthcare providers may prescribe antibiotics to address the underlying infectious process in adults.

Antibiotics are powerful medications that can effectively combat bacterial infections by either killing the bacteria or inhibiting their growth. When treating abdominal pain related to bacterial infections, healthcare professionals consider various factors such as the patient’s medical history, the specific type of bacteria involved, and the severity of the infection. The choice of antibiotics is influenced by the known sensitivity of the infecting bacteria, and factors such as the patient’s age, allergies, and other existing medical conditions.

Some common classes of antibiotics used in the management of abdominal pain related to bacterial infections include penicillins, cephalosporins, macrolides, and fluoroquinolones. These antibiotics have different mechanisms of action and target a wide range of bacterial pathogens that may cause abdominal discomfort.


In certain severe cases of abdominal pain, adults may require surgical interventions to address underlying conditions such as appendicitis or complications related to gallstones.

These conditions often necessitate prompt surgical intervention to prevent further complications and alleviate the intense pain and discomfort experienced by the patients. For instance, appendicitis requires immediate surgical removal of the inflamed appendix to prevent rupture, which can lead to life-threatening infections.

Similarly, complications caused by gallstones such as cholecystitis may require gallbladder removal surgery, known as cholecystectomy, to resolve the pain and prevent recurrent attacks.

How Can Abdominal Pain Be Prevented?

How Can Abdominal Pain Be Prevented In Adults

Preventing abdominal pain in adults often involves adopting a healthy lifestyle, maintaining balanced dietary habits, and seeking prompt medical attention for any concerning symptoms.

Regular physical activity, such as walking, swimming, or yoga, can contribute to gut health and help prevent abdominal pain. Incorporating fiber-rich foods like fruits, vegetables, and whole grains into one’s diet can aid in preventing digestive issues that may lead to discomfort. Mindful eating practices, like chewing food slowly and avoiding overeating, can promote proper digestion, reducing the risk of experiencing abdominal pain. Annual check-ups with a healthcare provider can also play a crucial role in early detection and management of any underlying conditions causing abdominal pain.

One important study said:

The purpose of this prospective study was to elucidate the characteristics of adult patients with acute abdomen admitted to a Finnish university hospital. A total of 639 patients entered the study. The most common cause of acute abdomen was non-specific abdominal pain (NSAP) (33.0%) followed by acute appendicitis (23.3%) and acute biliary disease (8.8%). The male:female ratio was 47:53 in the whole study population, but there were differences in the age and sex distributions when studied by diagnosis. NSAP was mainly presented in young women, but also in patients over 75 years of age.

Acute appendicitis was most frequently found in young men, and biliary disease was most common in elderly women. A male predominance was noted in cases of alcoholic pancreatitis and gastritis, renal stones and peptic ulcer. Young women and elderly patients were slightly over-represented in the study population when compared with the whole population residing within the study area. 43% of the patients were operated on, and surgery was most common in patients aged 55-64 years and 15-24 years. Altogether 15% of the patients were discharged without hospitalisation.

Twelve patients (1.9%) died of various causes, the most common of which was malignancy (four patients). In conclusion, a considerably large proportion (one third) of cases with acute abdomen remained without any specific explanation. Further, age and gender seem to be important factors when the most probable cause of acute abdomen is to be considered. Operative treatment is necessary in almost half of cases, and mortality for acute abdomen is low.


What are the common causes of abdominal pain in adults?

Some of the most common causes of abdominal pain in adults are indigestion, constipation, gas, acid reflux, and menstrual cramps.

How is abdominal pain in adults diagnosed?

The diagnosis of abdominal pain in adults can involve a physical examination, medical history, and possibly imaging tests such as x-rays or ultrasounds.

When should I seek medical help?

You should seek medical help if your abdominal pain is severe, persistent, or accompanied by other symptoms like fever, vomiting, or difficulty breathing.

What are some lifestyle changes that can help with abdominal pain?

Some lifestyle changes that can help alleviate abdominal pain in adults include eating a healthy diet, exercising regularly, managing stress levels, and avoiding trigger foods.

Is abdominal pain always a sign of a serious medical condition?

No, abdominal pain in adults can be caused by minor issues such as gas or indigestion, but it can also be a symptom of a more serious medical condition. It is important to consult a healthcare professional for a proper diagnosis.

How can I prevent abdominal Pain?

To prevent abdominal pain in adults, you can make simple changes to your diet and lifestyle such as eating smaller meals, avoiding trigger foods, staying hydrated, and managing stress levels. It is also important to seek medical treatment for any underlying conditions that may be causing the pain.

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