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When Should I Worry About Lower Abdominal Pain?

Reviewed on 6/8/2022
Senior woman with abdominal pain being checked by a doctor
See a doctor when you have abdominal pain and symptoms such as pain that is severe and lasts more than an hour or comes and goes for more than 24 hours, pain starts suddenly, fever greater than 102°f (39°c), black and tarry stool, bloody bowel movements, vomiting, inability to eat or drink for several hours, diarrhea, weight loss without trying, loss of appetite, and feeling a lump in the abdomen.

Pain in the lower abdomen is usually related to gastrointestinal diseases or female reproductive conditions. 

Lower abdominal pain may be dull or sharp, intermittent or constant, mild or severe. Pain may also radiate to other parts of the abdomen, or parts of the body such as the back, flank, or shoulder.

Symptoms of lower abdominal pain depend on the cause.

Symptoms that may accompany lower abdominal pain may include: 

If you experience any of the following symptoms with lower abdominal pain, see a doctor because these may be a sign of a more serious condition:

  • Pain is severe and lasts more than an hour or comes and goes for more than 24 hours
  • Pain starts suddenly
  • Fever greater than 102°f (39°c)
  • Black, tarry stool
  • Bloody bowel movements
  • Vomiting
  • Inability to eat or drink for several hours
  • Diarrhea
  • Weight loss without trying 
  • Loss of appetite
  • Feeling a lump in the abdomen

What Causes Lower Abdominal Pain?

There are many possible causes of lower abdominal pain. 

Causes of lower abdominal pain that are localized to one side include:

Causes of lower abdominal pain that may not always be localized to one side include:

Causes of lower abdominal pain that are considered diffuse, meaning they have nonspecific or variable patterns of pain include:

Causes of lower abdominal pain in women include: 

Causes of lower abdominal pain in postoperative patients include: 

  • Postoperative ileus 
  • Surgical site infections 
  • Hematoma/seroma formation and nerve injury 

How Is Lower Abdominal Pain Diagnosed?

The diagnosis of the cause of lower abdominal pain begins with a history and physical exam. Depending on the patient’s symptoms and the specific location of the lower abdominal pain, the physical exam may involve a rectal examination and/or a pelvic examination. 

Blood tests to help diagnose the cause of lower abdominal pain include:

  • Complete blood count (CBC) with differential
  • Electrolytes, blood urea nitrogen (BUN), creatinine, and glucose
  • Aminotransferases, alkaline phosphatase, and bilirubin
  • Calcium
  • Lipase and/or amylase
  • Serum iron, total iron binding capacity, and ferritin
  • Anti-tissue transglutaminase
  • Pregnancy testing for women

Imaging tests to help diagnose the cause of lower abdominal pain include:

Other tests to help diagnose the cause of lower abdominal pain may include:

  • Urine tests
  • Stool tests
  • Electrocardiography (ECG or EKG)

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Reviewed on 6/8/2022
References
Image Source: iStock Images

https://www.uptodate.com/contents/causes-of-abdominal-pain-in-adults?search=Stomach%20Pain&source=search_result&selectedTitle=4~150&usage_type=default&display_rank=4

https://www.uptodate.com/contents/evaluation-of-the-adult-with-abdominal-pain?search=Stomach%20Pain&source=search_result&selectedTitle=5~150&usage_type=default&display_rank=5