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Abdominal discomfort: 13 regions might need a doctor

Abdominal discomfort is pain in the abdominal area accompanied by symptoms such as an upset stomach, a fluttering sensation, distension, bloating, or a feeling of fullness. Abdominal discomfort


Abdominal Discomfort

Abdominal discomfort is pain in the abdominal area accompanied by symptoms such as an upset stomach, a fluttering sensation, distension, bloating, or a feeling of fullness. Abdominal discomfort can occur anywhere in the abdomen, from the upper to the middle to the lower regions. Abdominal discomfort can range from common illnesses such as indigestion, gas, or constipation to gastrointestinal tract and liver diseases such as appendicitis, irritable bowel syndrome (IBS), or gallstones, which can vary in severity and require specific treatment. Those who experience persistent abdominal discomfort lasting more than 48 hours without relief should seek medical attention for a proper diagnosis of their symptoms.

What causes abdominal discomfort?

There are numerous causes of abdominal discomfort; the severity, symptoms, and co-morbidities vary depending on the location of the pain. Abdominal discomfort is caused by the following causes and factors:

Upper abdominal discomfort

1. Indigestion

Abdominal discomfort from indigestion is caused by overeating, eating too quickly, eating high-fat foods, hard-to-digest foods, spicy foods, caffeine, alcohol, soft drinks, certain antibiotics, or even anxiety, resulting in abdominal discomfort, bloating, flatulence, abdominal fullness, and an upset stomach.

2. Gas and gas pains

Abdominal discomfort from gas and gas pains is caused by swallowing air while eating or drinking quickly, chewing gum, or smoking, which causes accumulated gas in the upper digestive tract as well as accumulated gas in the large intestine, which is caused by bacterial digestion of carbohydrates such as starch, short-chain carbohydrates (sugars), or dietary fibers (in those who do not have digestive enzymes in the stomach to help digest carbohydrates), resulting in abdominal discomfort, bloating, flatulence, gas, stomach fullness, and frequent burps and passing gases.

3. Peptic ulcers

Abdominal discomfort from peptic ulcers is caused by erosion of the stomach lining by gastric acid and digestive enzymes due to irregular meals, spicy foods, acid-inducing medications, certain anti-inflammatory drugs, stress, smoking, and infection with Helicobacter pylori (H. Pylori), resulting in abdominal pain, upper abdominal pain, abdominal discomfort, a burning sensation beneath the breastbone when the stomach is empty or full, gastric outlet obstruction (GOO), gas in the stomach, a tight stomach, and bloating after eating.

4. Gastritis 

Abdominal discomfort from gastritis has many causes, such as eating irregularly, fasting, taking painkillers or anti-inflammatory drugs such as aspirin, ibuprofen, and caffeine, inflammation of the stomach lining, or H. pylori bacterial infection, resulting in abdominal pain, abdominal discomfort, cramps, distension, bloating, flatulence, and frequent belching. If gastritis symptoms are present, there will be cramping pain, heartburn, burning pain, dull pain, or pain under the epigastric right upper abdomen, as well as abdominal pain when the stomach is empty or full and feeling hungry, which may be accompanied by nausea and vomiting.

Abdominal Discomfort 3

5. Food poisoning

Abdominal discomfort from food poisoning is caused by eating food or water contaminated with bacteria, viruses, parasites, overnight food, undercooked food, unclean food, or food contaminated with heavy metals, resulting in abdominal pain, nausea, vomiting, and diarrhea. There may be abdominal pain along with dysentery-like symptoms such as cramping pain, diarrhea, loose stools, fatigue, and possibly fever.

6. Gastroesophageal reflux disease (GERD) 

Abdominal discomfort from gastroesophageal reflux disease is caused by the lower esophageal sphincter relaxing more frequently than usual, resulting in acid reflux with gastric juice backing up into the esophagus, causing acid reflux, heartburn, a burning sensation under the epigastrium, acute abdominal pain, abdominal cramps, dull pain, distension, bloating, sour eructation, and frequent gastric juice reflux after eating food, particularly spicy, high-fat foods, or alcohol. Some may experience vomiting and black stools.

7. Gallstones 

Abdominal pain from gallstones in the gallbladder is caused by the crystallization of fat, cholesterol, or bilirubin within the gallbladder. Gallstones in the gallbladder may cause abdominal pain, abdominal discomfort, stomach cramps, heartburn, and colicky pain in the right ribcage under the epigastric that could last for 4-6 hours continuously, does not go away, and may radiate to the right shoulder blade associated with bloating, flatulence, severe abdominal pain, nausea, and vomiting. It is imperative to seek prompt medical attention to evaluate the symptoms thoroughly.

8. Hangovers 

Abdominal discomfort from a hangover is caused by drinking too much alcohol until the body contains high cellular and blood alcohol levels, which stimulate the kidney to excrete a large amount of water and urine, resulting in a deficit of body water and plasma electrolytes and essential nutrients such as magnesium, potassium, and vitamin B excreted with urine. Excessive alcohol consumption causes headaches, dizziness, fatigue, dry throat, and thirst and may be accompanied by abdominal discomfort, nausea, vomiting, and diarrhea. It is recommended to drink water frequently, 1-2 glasses at a time, to replenish the loss. If symptoms do not improve within 24 hours, seek medical attention right away.

Middle abdominal discomfort

9. Irritable bowel syndrome (IBS) 

Abdominal discomfort caused by irritable bowel syndrome is secondary to dysmotility of the distal intestines with excessive, uncoordinated contractions. The intestines are sensitive to stimulants such as spicy food, caffeine, or mental stress, resulting in generalized or left-side abdominal discomfort, cramps, distension, stomach fullness, and abnormal bowel habits such as constipation, diarrhea, or alternating constipation and diarrhea. Symptoms of IBS often come and go for a prolonged period of time. Some women may experience more pain during their menstrual cycle.

Lower abdominal discomfort

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10. Constipation 

Abdominal pain from constipation is caused by slow intestinal contractions, or peristalsis, making it impossible to maintain healthy excretory habits. As a result, stools stagnate in the intestines for an extended time, allowing the large intestine to reabsorb water from the feces, causing stool hardening and gases in the intestines, resulting in abdominal discomfort, inability to pass stools, difficulty passing stools, abdominal distension, stomach fullness, and cramps. Constipation can be relieved by eating high-fiber foods like vegetables and fruits, drinking plenty of water, taking laxatives, and exercising regularly.

11. Appendicitis 

Abdominal discomfort from appendicitis is caused by an inflamed, obstructed appendiceal lumen, resulting in accumulated bacteria and pressure in the appendix, causing inflammation, swelling in the epigastric area, periumbilical pain, or pain in the middle of the stomach around the navel, abdominal pain similar to gastritis, dull pain, squeezing, and releasing pain alternately similar to diarrhea but unable to excrete. Consequently, pains will gradually shift and localize to the lower right abdomen and become more severe. If left untreated, it will result in appendicitis, which can cause rupture within the abdominal cavity and could be life-threatening. It is critical to seek medical attention as soon as possible for an urgent appendectomy.

12. Diverticulitis 

Abdominal pain caused by diverticulitis is common in the colon, where small pouches or sacs (diverticula) in the digestive tract's walls become inflamed or infected, causing abdominal pain in the left lower abdomen, fever, and changes in bowel habits. In cases of mild diverticulitis symptoms, the doctor may prescribe antibiotics and suggest dietary changes. Severe symptoms of diverticulitis may require hospitalization or surgery. Abdominal pain caused by the formation of diverticula and diverticulitis can be prevented by eating more fiber, reducing red meat consumption, and adopting a healthier lifestyle.

13. Endometriosis 

Abdominal discomfort from endometriosis is caused by the endometrium growing outside the uterine cavity, such as the uterine wall, uterine muscle, peritoneum, ovaries, intestinal wall, or other organs that cause pain in the lower abdomen around the pelvic area, particularly before and during menstruation. Endometriosis can cause pelvic pain during or after sex, abdominal discomfort with an urge to defecate, abdominal discomfort with dysentery, severe menstrual cramps, pain sensation in the abdomen cavity, irritable bowel syndrome, bloating, diarrhea, and rectal bleeding. It is critical to seek medical attention for a thorough examination.

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Abdominal discomfort shouldn’t be ignored, Seek a doctor for an Exam

Abdominal discomfort can be caused by a variety of factors, ranging from simple causes such as eating spicy foods, certain medications, or anxiety to medical emergencies that necessitate a thorough abdomen examination to diagnose disease and symptoms. Those who have frequent abdominal discomfort, chronic abdominal discomfort that does not go away, abdominal discomfort or pain throughout the abdomen or in a specific area, and/or have associated symptoms such as rectal bleeding, nausea, vomiting, or severe abdominal pain should see a doctor at the hospital as soon as possible to diagnose the symptoms and receive appropriate treatment. Abdominal discomfort can be curable with drugs, gastrointestinal endoscopy or surgery, and behavior modification.

Article by

  • Asst.Prof.Dr Pongphob Intaraprasong
    Asst.Prof.Dr Pongphob Intaraprasong A Doctor Specializing in Gastroenterology and Hepatology

Published: 05 Feb 2024