What’s Causing Your Lower Abdominal Pain?

Lower abdominal pain has a way of stopping you in your tracks. But trying to figure out the source of stomach pain can be tricky especially when so many things may be to blame. (Was it the shrimp?) Gastroenterologist Michael Kirsch, MD, shares some of the most common causes.

Irritable bowel syndrome (IBS)

What is it? A colon or lower bowel disorder.

Where’s the pain? Lower abdomen, but sometimes all over the belly.

Other symptoms?

• Bowel sensitivity with constipation.
• Diarrhea.
• Bloating.
• Cramps.

What else you should know: IBS is one of the most common causes of abdominal pain, and it occurs more often in women. It’s also known as nervous stomach, irritable colon or spastic colon.

Constipation

What is it? When bowel movements happen less often than usual or stools become hard to pass.

Where’s the pain? Lower left side of the abdomen, sometimes mid-abdomen.

Other symptoms:

• Bloating.
• Cramps.

Appendicitis

What is it? Inflammation in your appendix, a thin tube located on the lower right side of your abdomen.

Where’s the pain? Starts in the belly button area and moves down to the lower right.

Other symptoms:

• Nausea.
• Vomiting.
• Fever.
• Diarrhea or constipation.

Diverticulitis

What is it? Inflammation of pouches in the colon, which are called diverticula.

Where’s the pain? Lower left side of the abdomen, but it can be anywhere in the belly.

Other symptoms:

• Nausea.
• Vomiting.
• Fever

Urinary tract infection (UTI)

What is it? Infection in the urinary tract, which includes the urethra, kidneys and bladder.

Where’s the pain? Pelvis or abdomen bladder.

Other symptoms:

• Pain when you urinate.
• Pelvic pressure.
• Need to urinate often or urgently.
• Changes in the color and smell of your urine.

Other causes of stomach pain

• Certain vascular diseases: Conditions where the intestines don’t get enough blood can cause pain and cramps. “A common one is a lack of blood supply to the large bowel, or colon, called ischemic colitis,” Dr. Kirsch says. This typically causes left-sided cramping and bleeding.
• Gynecological issues: “That whole organ system is in the pelvis, so ruptured ovarian cysts, a twisted ovary or ectopic pregnancies can all cause lower abdominal pain,” he notes.
• Groin hernias: Hernias happen when an organ pushes through the enclosed area that holds it. A hernia in the groin can cause lower abdominal pain and discomfort.
• Tumors: People who have tumors in the large intestine may experience stomach pain and a change in their bowel pattern, especially if it’s blocking something.

When to see a doctor

Since some of these conditions are chronic and vary from person to person, the answer can be more subtle than you might think, says Dr. Kirsch. “If you asked a dozen different doctors on the best approach to evaluating abdominal pain, you wouldn’t have agreement.”

But here’s a good rule to live by: If there has been a significant change or worsening of your chronic abdominal symptoms or brand new stomach symptoms, then seek out a doctor’s advice.