Abdominal pain is a very common complaint in medicine. It’s estimated that about 75% of adolescent students and 50% of all adults experience abdominal pain.

But how do you know if your pain is serious and how do you get a clue to what’s causing it? We’ll try pointing you in the right direction here. Please note: This article was not meant to substitute a doctor, so please use it only as a helpful reference.

First things first – The location

There are 6 areas that can hurt in the abdomen, each relating to different conditions. We’ll list the possible conditions here, and whenever each of these conditions is added to A Disease A Day it will be linked here (so make sure to bookmark this page for future reference) -

1. Right upper quadrant – That’s where the liver and our bile system are located. Diseases that can cause pain here are hepatitis, cholecystitis, cholangitis, pancreatitis, Budd-Chiari syndrome, Pneumonia, or an abscess under the diaphragm.
2. Epigastric - This is the area of the abdomen under out chest. Diseases that can cause pain here are peptic ulcer disease, gastroesophageal reflux disease, Gastritis, Pancreatitis, heart attack, Pericarditis, or a ruptured aortic aneurysm.
3. Left upper quadrant – That’s where the spleen and part of the stomach are. Diseases that can cause pain here are an abscess or infarct of the spleen, gastritis, a gastric ulcer, and pancreatitis.
4. Left lower quadrant – Diseases here include diverticulitis, salpingitis, ectopic pregnancy, inguinal hernia, nephrolithiasis (kidney stones), irritable bowel syndrome, and inflammatory bowel disease (such as Crohn’s disease or ulcerative colitis).
5. Periumbilical – This is the area around our navel. Disease here could be the start of appendicitis, gastroenteritis, bowel obstruction or a ruptured aortic aneurysm.
6. Right lower quadrant – Diseases here include appendicitis, salpingitis, ectopic pregnancy, inguinal hernia, nephrolithiasis (kidney stones), inflammatory bowel disease or mesenteric adenitis.

Pain can also be all over the abdomen – in which case it can be caused by gastroenteritis, mesenteric ischemia, DKA, porphyria, malaria, familial mediterranean fever, bowel obstruction, peritonitis or irritable bowel syndrome.

Second – How can I tell if it’s serious?

Even though the final decision should be a doctor’s decision, there are some things you can do to tell if your problem is serious:

1. Refer to the appropriate article here on A Disease A Day – Each of the diseases above is marked with a color code for the Danger Level of the disease: Low, Medium and High.
2. Seek medical attention if you have any of the following -
   a. If you’ve had trauma to your abdomen, such as after an accident or injury.
   b. If you feel pressure or pain in your chest – Sometimes the pain of a heart attack can be felt as abdominal pain.
   c. If the pain is so severe that you find yourself unable to lie still
   d. If you have Bloody stools, or blood in the vomit
   e. If you have an Inability to pass stools, especially if you are have persistent nausea and vomiting
   f. If you have Fever
   g. If you have an Inability to keep food down that lasts for several days
   h. If you have Difficulty breathing
   i. If you have Painful urination, or urination that is very frequent
   j. If the pain lasts for several days and doesn’t go away

What next?

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