Abdominal rigidity
Rigidity of the abdomen
Abdominal rigidity is stiffness of the muscles in the belly area, which can be felt when touched or pressed.
You know that awful feeling: you're nauseous; your stomach feels like it's tied in a knot, and you don't even want to move. What does your pain mean? Well, let's talk today about abdominal pain. So, what causes abdominal pain? Almost everyone has pain in their belly at one time or another. Most of the time, a serious medical problem is not the cause, and how bad your pain is doesn't always reflect the seriousness of the problem causing your pain. You may feel very bad pain if you are having gas or stomach cramps due to viral gastroenteritis, better known as a stomach virus. And some life-threatening conditions, such as colon cancer or a very early case of appendicitis, may cause only mild pain, or no pain at all. The important thing to know about abdominal pain is when you need immediate medical care. Less serious causes of abdominal pain include constipation, irritable bowel syndrome, food allergies, lactose intolerance, food poisoning, and a stomach virus. Other, more serious, causes include appendicitis, an abdominal aortic aneurysm, a bowel blockage, cancer, and gastroesophageal reflux. Sometimes, you may have abdominal pain from a problem that isn't in your belly, like a heart attack, menstrual cramps, or pneumonia. So, what do you do about abdominal pain? Well, if you have mild abdominal pain, here are some helpful tips; Try sipping water or other clear fluids. Avoid solid food for the first few hours. If you've been vomiting, wait 6 hours and then eat small amounts of mild foods like rice, applesauce, or crackers. If your pain is high in your abdomen and occurs after meals, antacids may help, especially if you are feeling heartburn or indigestion. You should seek medical attention if you have abdominal pain and are being treated for cancer, you can't pass any stool, you're vomiting blood, or you have chest, neck, or shoulder pain. Call your doctor if you have abdominal pain that lasts 1 week or longer, if your pain doesn't improve in 24 to 48 hours, if bloating lasts more than 2 days, or if you have diarrhea for more than 5 days.
The gallbladder is an organ that normally functions to store bile excreted from the liver. Bile is a solution composed of water, bile salts, lecithin, cholesterol and some other small solutes. Changes in the relative concentration of these components may cause precipitation from solution and formation of a nidus, or nest, around which gallstones are formed. Gallstones can become large and block the opening from the gallbladder or cystic duct. This produces pain in the right upper quadrant or midepigastrum (above the belly button) in the abdomen that feels like cramping.
The appendix is a small finger-shaped tube that branches off the first part of the large intestine. The appendix can become inflamed or infected causing pain in the lower right part of the abdomen.
Considerations
When there is a sore area inside the belly or abdomen, the pain will often get worse when a hand presses against your belly area.
Your fear or nervousness about being touched (palpated) may cause your abdominal muscles to stiffen, but there should be no pain.
If you have pain when you are touched and you tighten the muscles to guard against more pain, it is more likely caused by a physical condition inside your abdomen. The condition may affect one or both sides of your body.
Abdominal rigidity may occur with:
Causes
Causes can include:
- Abscess inside the abdomen
- Appendicitis
- Cholecystitis caused by gallstones
- Hole that develops through the entire wall of the stomach, small intestine, large bowel, or gallbladder (gastrointestinal perforation)
- Injury to the abdomen
- Peritonitis
When to Contact a Medical Professional
Get medical care right away if you have pain when the belly is gently pressed and then released.
What to Expect at Your Office Visit
You will probably be seen in an emergency room.
The health care provider will examine you. This may include a pelvic exam, and possibly a rectal exam.
The provider will ask questions about your symptoms, such as:
- When did they first start?
- What other symptoms do you have at the same time? For example, do you have abdominal pain?
You may have the following tests:
- Abdominal and pelvic CT scan
- Abdominal and pelvic ultrasound
- Blood tests
- Colonoscopy
- Esophagogastroduodenoscopy (EGD)
- Paracentesis
- Sigmoidoscopy
- Stool analysis
- Urine tests
- X-rays of the chest or abdomen
You will probably not be given any pain relievers until a diagnosis is made. Pain relievers can hide your symptoms.
References
Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW. Abdomen. In: Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW, eds. Seidel's Guide to Physical Examination. 10th ed. St Louis, MO: Elsevier; 2023:chap 18.
Landmann A, Bonds M, Postier R. Acute abdomen. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 46.
McQuaid KR. Approach to the patient with gastrointestinal disease. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 118.
Version Info
Last reviewed on: 10/9/2024
Reviewed by: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
