(Acute Abdominal Pain; Severe Stomach Ache; Abdominal Cramps; Surgical Abdomen)
Acute abdomen is the medical term used for pain in the abdomen that usually comes on suddenly and is so severe that one may have to go to the hospital. Acute abdominal pain can signal a variety of more serious conditions, some of which require immediate medical care and/or surgery.
Abdominal Organs, Anterior View
There are a number of possible causes of acute abdomen. These may include:
- Viral gastroenteritis—stomach flu
- Intestinal obstruction
- Appendicitis—inflammation of the appendix
- Pancreatitis—inflammation of the pancreas
- Diverticulitis—inflammation of small pouches that form in the large intestine
- Cholecystitis—inflammation of the gallbladder, with or without gallstones
- Cholangitis—inflammation of the bile duct caused by a gallstone or a bacterial infection
- Gastritis—inflammation of the stomach lining, such as from drinking too much alcohol or prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs)
- Kidney, bladder, or urinary tract infection
- Kidney stones
- Ulcerative colitis or Crohn’s disease—inflammatory diseases of the intestines
- Sickle cell crisis
- Diabetic ketoacidosis—dangerously high levels of acids in the blood
- Ruptured or leaking abdominal aortic aneurysm—abnormally large blood vessels in the abdomen
- Ischemia—inadequate, or blocked, blood supply to one of the abdominal organs
- Infectious diarrhea /abdominal abscess
- Irritable bowel syndrome (IBS)
- Heartburn or gastroesophageal reflux disease (GERD)
- Peptic ulcer
- Heart attack
- In women:
- In infants:
Factors that increase your risk of acute abdomen will depend on the cause.
The symptoms of acute abdomen have a variety of causes. If you experience any one of them, see your physician.
- Persistent, severe pain, swelling, and/or tenderness in the upper, middle, or lower abdomen
- Guarding—involuntary contraction of the abdominal muscles
- Rigidity—when abdominal muscles are tense and board-like
You will be asked for details about your pain, such as the exact location and duration. You will also be asked about any additional symptoms you may be having such as bowel or urinary symptoms. A medical history will be taken. You will be asked about any drugs or medications you’ve taken. A physical exam will be done, including rectal and pelvic examinations.
Your bodily fluids may be tested. This can be done with:
- Blood tests
- Urine analysis
Your bodily structures may need to be viewed. This can be done with:
- CT scan
- MRI scan
- KUB (kidney, ureter, and bladder) x-rays
- Barium x-rays
Surgery may be done to visually examine the abdomen.
You may be given pain relievers. However, many doctors may delay prescribing pain relievers, since details of the pain can help find its cause. Do not take any medication such as Tylenol or ibuprofen, and do not eat or drink until you have spoken with your doctor.
Talk with your doctor about the best treatment plan for you. Depending on the underlying condition causing your acute abdomen, treatment options may include:
- Diet or lifestyle changes
- Advanced medical treatment such as surgery—may be required for the majority of severe abdominal pains that last for at least six hours in previously healthy patients
Depending on the underlying condition causing acute abdomen, prevention measures will vary. Talk with your doctor about preventing conditions that cause acute abdomen.
Family Doctor—American Academy of Family Physicians
National Digestive Diseases Information Clearinghouse (NDDIC)
Canadian Association of Gastroenterology
Canadian Digestive Health Foundation
Abdominal pain, short-term. American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/health-tools/search-by-symptom/abdominal-pain-short-term.html. Accessed June 19, 2014.
Cartwright S, Knudson M. Evaluation of Acute Abdominal Pain in Adults. Am Fam Physician. 2008 Apr 1;77(7):971-978. Available at: http://www.aafp.org/afp/2008/0401/p971.html. Accessed June 19, 2014.
Leung A, Sigalet D. Acute abdominal pain in children. Am Fam Physician. 2003 June 1;67(11):2321-2327. Available at: http://www.aafp.org/afp/20030601/2321.html. Accessed June 19, 2014.
Zeller JL. Acute abdominal pain. JAMA. 296(14):1800. Available at:
http://jama.ama-assn.org/cgi/content/full/296/14/1800. Accessed June 19, 2014.
Last reviewed May 2014 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.