Overview

 In the case that it begins unexpectedly or abruptly, it should be treated as an urgent medical emergency, most especially if the pain is focused in a specific area. 

Causes of Intense Abdominal Pain

Intense abdominal pain might be caused by many different conditions. But, the most common reasons are abnormal growths, intestinal disorders, inflammation obstruction/blockage, and infection.

Infections that occur in the blood, intestines, and throat can make a pathway for bacteria to enter the digestive tract, causing abdominal pain. Aside from this, infections of these kinds can also cause abnormalities in the digestion like constipation or diarrhea. Moreover, cramps that are associated with menstruation are also possible causes of lower abdominal pain. However, these are more popularly known as causes of pelvic pain. Other common causes of intense abdominal pain include:

• stress
• diarrhea
• vomiting
• constipation
• gastroenteritis or stomach flu
• acid reflux, when the stomach contents move backward into the esophagus, resulting in heartburn and other symptoms

Illnesses that impact the digestive system are also popular causes of intense abdominal pain. The most prevalent include the following:

• Crohn’s disease – a common inflammatory bowel disorder
• Irritable bowel syndrome or spastic colon – a common condition that causes intense abdominal pain, abnormalities in the bowel movements, and cramping
• lactose intolerance – the incapacity to break down lactose, which is the sugar found in dairy products, such as milk
• gastroesophageal reflux disease or GERD

Other causes of intense abdominal pain:

• kidney infection
• gallbladder stones 
• organ rupture or near rupture, including appendicitis or burst appendix
• kidney stones

The location of the pain in the abdomen can also indicate its cause. For instance, pain that is felt in the general area of the stomach and not just in a particular location might suggest the following:

• Crohn’s disease
• the flu
• appendicitis
• traumatic injury
• urinary tract infection
• irritable bowel syndrome

Pain that is felt in the lower abdomen might be a probable cause of:

• ectopic pregnancy
• intestinal obstruction
• appendicitis

Pain that is focused on the reproductive organs that are located in the lower abdomen of women might be a cause of:

• ectopic pregnancy
• fibroids
• pelvic inflammatory disease
• ovarian cysts
• endometriosis
• miscarriage

Pain in the upper abdominal pain might be a cause of:

• injury
• appendicitis
• uremia – the accumulation of waste particles in the blood
• gastroenteritis

Pain in the upper left abdominal pain is frequently a cause of:

• cancer
• enlarged spleen
• kidney infection
• fecal impaction – the hardened stool that is difficult to release
• heart attack
• injury

Pain in the lower left abdomen might be caused by the following:

• appendicitis
• Crohn’s disease
• kidney infection
• cancer
• ovarian cysts

Pain focused in the lower right abdomen might be caused by:

• flu
• appendicitis
• kidney infection
• hernia
• cancer

Causes of pain in the upper right abdomen might be due to:

• appendicitis
• injury
• pneumonia
• hepatitis

Diagnosis and Treatment

Cause/causes of intense abdominal pain might be diagnosed via a series of tests. But before doctors can order any proof, they need to perform physical examination first, including lightly pressing down different regions of the abdomen to look for signs of swelling and tenderness. The information acquired during the physical exam, together with the level of pain and its specific location in the abdomen, can help the doctor figure out what kinds of tests to perform. This will also guarantee the appropriate and correct diagnosis. 

Imaging tests, such as the likes of ultrasounds, MRI scans, and X-rays, are commonly performed to view tissues, organs, and many other structures within the abdomen in full detail. Moreover, these tests will make it easier for doctors to diagnose inflammation, ruptures, fractures, and tumors. Other checks carried out or ordered by doctors include the following:

• upper GI – this is a specialized X-ray test that makes use of contrast dye to monitor if there are blockages, ulcers, growths, inflammation, or other complications in the stomach.
• Endoscopy – This is performed to determine if there are abnormalities and inflammation in the stomach or esophagus.
• Colonoscopy – This is carried out to look inside the intestines or esophagus.

Aside from these tests, samples of stool, urine, and blood might also be taken to detect signs of parasitic, viral, or bacterial infections. 

The treatment for intense abdominal pain varies according to its cause. For instance, the doctor might prescribe IV or intravenous fluids to the patient. He/she might also order the patient to stop drinking or eating anything until such time that the primary source of pain is determined. This is important to prevent the condition from worsening – for example, eating fast food if the patient is suffering from rupture ulcer – or in case the patient needs to be prepared for surgery – it is always better to operate on patients with an empty stomach to make sure that the anesthesia will take its effect. 

Moreover, doctors might also prescribe pain medication to patients with intense abdominal pain.

• Though the pain that the patient feels might not entirely go away, they still have every right to be comfortable. With this, they could ask for medication that is intended for pain until they feel comfortable.
• In the case that the patient is not vomiting, they might receive a drink that comes with pain medication or antacid blended on it.
• For pain that is caused by bowel spasm, doctors might prescribe a shot in the leg, arm, or hip.

There are also cases of intense abdominal pain that may need surgical treatment, including:

• Bowel obstruction, at times, requires surgery. However, it still depends on the cause of the blockage, the amount of bowel obstructed, and if the obstacle is permanent or temporary.
• If the pain that the patient is experiencing is due to an infected internal organ, like gallbladder or appendix, the possible treatment required is hospitalization, monitoring, and potential surgery.
• If the intense abdominal pain is due to perforated or ruptured organs, like stomach or bowel, the doctor might order immediate surgery, and the patient will be instantly taken to the operating room.

What are the standard conditions?

Intense abdominal pain happens due to various kinds of causes and reasons. Though not all cases of severe abdominal pain can be prevented, one can still minimize the risk of acquiring such complications. Most of the time, simple lifestyle changes make a huge impact in decreasing the possibility of intense abdominal pain. These include the following:

• Eat smaller batches of food.
• Drink water more often.
• Eat a healthful diet.
• Exercise regularly.

In case you develop an intestinal disease, like Crohn’s disease, make it a point to follow the prescribed diet that your healthcare provider has given you to decrease any pain and discomfort. On the other hand, if you have GERD, avoid eating two hours before bed. This is because lying down too early right after a meal can lead to abdominal pain and heartburn. The best thing to do is to wait for at least 2 hours after a meal before sleeping or lying down. 

Risks of having Intense Abdominal Pain

Intense abdominal pain isn’t something to be ignored. If left untreated, this condition can lead to severe complications and should be consulted to a healthcare professional, such as a physician or doctor right away. Risks of intense abdominal pain include the following:

• Fever
• Fatigue
• Loss of appetite
• Bleeding from the GI tract, such as vomiting blood or bloody stools.
• Incapacity to have a bowel movement
• Bloating such as abdominal swelling and tenderness
• Vomiting
• Painful urination, problems urinating
• Unintentional weight loss
• Pain that radiates or spreads to the shoulders, neck, or chest
• Abnormalities in the bowel habits, such as diarrhea or constipation

Aside from these, intense abdominal pain after childbirth or during pregnancy should also be reported to a doctor. 

When to seek medical attention

Intense abdominal pain needs a trip to the doctor since it doesn’t just go away, unlike mild abdominal pain. Contact 911 right away if the emotional abdominal pain that you are experiencing is linked to trauma that came from an injury or accident, or pain or pressure in the chest.

You should also look for immediate health care if the intense abdominal pain makes it difficult for you to sit still or you have to curl into a ball to be comfortable, or if you experience any of the following:

• difficulty breathing
• bloody stools
• high fever that reaches more than 101°F
• swelling or extreme tenderness of the abdomen
• hematemesis or vomiting of blood
• yellowing of the eyes or skin, or otherwise known as jaundice
• continuous vomiting or swelling

Set up an appointment with your healthcare provider if you experience any of these symptoms:

• fever
• intense abdominal pain that persists more than 24 hours
• loss of appetite
• vomiting
• prolonged constipation
• burning sensation during urinating
• unintentional weight loss

Contact your doctor if you are breastfeeding or pregnant, and you suffer from intense abdominal pain.