Abdominal pain is one of the most common symptom which compels the patient to visit the doctor. Abdomen is a complicated body cavity which houses important organs. The bulk of 6 feet long intestine resides in abdomen along with liver, gall bladder, pancreas, spleen, kidneys to name a few. The lower part of abdominal cavity called pelvis houses organs involved in reproduction like uterus, fallopian tubes and ovaries in females. Along with it there are multiple small lymphnodes which are integral part of immune system and mesentery and omentum which supports intraabdominal organs. So clearly abdomen is a Pandora’s box and myriad problems with these organs can cause abdominal pain. The cause can be as benign as renal stone and as serious as intraabdominal cancer. Let us have a look on common such causes.

Fig-1- Common causes of abdominal pain

Acute Appendicitis – It is inflammation of appendix, a part of small intestine seen frequently in young adults. The pain of appendicitis first appears in mid abdomen and later moves to right lower part of abdomen. Along with pain patient has fever and vomiting. Not all acute appendicitis require surgery, many are managed conservatively with medications. Acute appendicitis developing in elderly should invite a suspicion of underlying malignancy.

Gall Stones – Gall stones can cause pain mainly in upper central and right upper abdomen. This is seen overweight, middle aged females. A gall stone getting stuck in gall bladder will cause inflammation of gall bladder while if stone get stuck in bile duct then it can cause jaundice and fever. Such stuck stone needs to be removed endoscopically followed by removal of gall bladder with surgery.

Intestinal Obstruction – This causes pain in central part of abdomen along with vomiting, abdominal distention, and cessation of flatus and stools. It can occur in children and in adults. The common causes in India are worms, adhesions, abdominal tuberculosis and cancer of intestine.

Acute Diverticulitis – This problem is seen in elderly who are chronically constipated. The large intestine of such patient develops and outpouching which can get inflamed. This pain is located in lower abdomen and such patients are easily managed with short bowel rest and antibiotics.

Acute Pancreatitis – It is swelling of pancreas and if not diagnosed early can have serious consequences. It is mostly seen in alcoholics but gall stones can also cause it. The pain is excruciating located in upper abdomen and radiates to the back. It can be managed very well if diagnosed early. However, it can be life threatening as it can lead to multi organ failure and in long term can produce a swelling is abdomen known as pseudocyst.

Peptic Ulcer – Ulcer can occur in any part of intestine. Duodenal ulcer produce pain located in central part of abdomen which is relieved by meals. When ulcer perforates (Burst) the pain becomes severe and unbearable.

Acute Mesenteric Ischemia – This is again a serious condition which if not treated promptly can lead to gangrene of intestine. This occurs due to blockage of blood supply of intestines. It produces pain all over the abdomen.

Any abdominal cancer when it grows cause pain like colon cancer.

Extra Abdominal Causes – Certain conditions not directly involving abdominal organs can also cause abdominal pain, sickle cell anemia crisis, acute adrenal insufficiency, hyper parathyroidism, porphyria, lead poisoning to name a few. So a meticulous and timely workup is required for diagnosis and management of abdominal pain. And abdominal pain even of small duration should be taken seriously.