Abdominal pain

and Martina Feichter, medical editor and biologist

Hanna Rutkowski is a freelance writer for the medical team.

More about the experts

Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.

More about the experts All content is checked by medical journalists.

Abdominal pain is not just a typical women's ailment during menstruation. Men can also complain of pain or stinging in the lower abdomen with prostate and testicular diseases. In both sexes, indigestion and urinary tract infections can also trigger abdominal pain. You have to act immediately if the entire abdominal wall hardens and severe pain occurs when touched. Then there may be a potentially life-threatening "acute abdomen" (acute abdomen)! Read everything you need to know about the symptom of abdominal pain.

Brief overview

Description: acute or chronic abdominal pain in different positions (right, left, both sides) and characteristics (stabbing, pulling, colic-like etc.)
Causes: Causes in the area of the genital organs (e.g. menstruation, endometriosis, fallopian tube inflammation, ectopic pregnancy, ovarian cyst, fibroids, prostate inflammation, inflammation of the prostate or epididymis, twisting of the testicles, malignant tumors such as cervical cancer, urinary tract cancer or cancer of the urinary tract), Renal colic etc.), constipation, appendicitis, inflamed intestinal diverticula, intestinal obstruction. Inguinal hernia etc.)
Examinations: doctor-patient conversation, physical examination, blood test, stool examination, urine examination, gynecological examination, smear, ultrasound, colonoscopy, laparoscopy
Treatment: depending on the cause, for example with medication (pain relievers, antispasmodics, antibiotics, etc.) or surgery (for testicular torsion, ectopic pregnancy, etc.)

Abdominal pain: description

Abdominal pain refers primarily to complaints in the lower abdomen. The region between the easily palpable hip bones, which is bordered on the side by the groin and on the top by the navel, is called the lower abdomen or abdomen. The pubic area is one of them.

The term "abdomen" is often used colloquially. Doctors tend to speak of the lower abdomen.

Which organs are in the abdomen?

The organs of the pelvis are located in the abdomen: the female or most of the male genital organs, the urinary bladder including the urethra and the ureters coming from the kidneys, as well as the lower intestinal section.

Characteristic of pain

The character of abdominal pain can be very different. Sometimes the symptoms are unilateral; in other cases they extend over the entire lower abdomen. They can express themselves as a dull pressure, as a pulling or as a stinging in the abdomen. It is also important to differentiate between acute and chronic abdominal pain. All of these factors help the doctor to narrow down the possible causes of the symptoms.

Abdominal pain: causes

Abdominal pain can have different causes in both sexes: Often the symptoms originate from the female or male genital organs. In other cases, the digestive organs or urinary tract are the source of abdominal pain.

Female reproductive organs

Abdominal pain in women is very often related to gynecological problems such as:

Menstrual pain (dysmenorrhea): Almost every woman suffers from severe cramp-like pain in the abdomen and back during menstruation at least once in her life. In addition, particularly severe period pains are often a sign of endometriosis. Ovulation can also be felt as an abdominal pull.
Endometriosis: In this benign disease, the lining of the uterus is also located outside the uterus, particularly often in the abdomen, in the peritoneum and in the small pelvis. Like the normal lining of the uterus, these endometriosis centers follow the monthly cycle - as a result, bleeding outside the uterus occurs. Severe menstrual pain and stinging in the abdomen are typical.
Ovarian Cyst (Ovarian Cyst): A small cyst on the ovary is not unusual and often does not cause any problems. However, a pedunculated cyst can twist and constrict blood vessels. The possible consequence is severe abdominal pain.
Ectopic pregnancy: In this case, the fertilized egg nests in the mucous membrane of the fallopian tube instead of in the uterus. This cannot follow the growing embryo for long - the fallopian tubes burst, which can lead to severe pain in the abdomen, bleeding and infections.
Inflammation of the ovaries and fallopian tubes (adnexitis): Inflammation of the fallopian tubes (salpingitis) and ovarian inflammation (oophoritis) often occur in combination as adnexitis. The cause are usually germs that have risen from the vagina via the uterus to the fallopian tubes and ovaries (e.g. chlamydia, mycobacteria, gonococci). Symptoms of acute adnexitis are severe abdominal pain (one or both sides), discharge, spotting, and sometimes vomiting.
Inflammation of the lining of the uterus (endometritis): Infections of the vagina (colpitis) can rise and spread to the uterus. Signs of this include burning abdominal pain, vaginal discharge, itching and intermenstrual bleeding. If the triggering germs rise even further, there is a risk of fallopian tube inflammation and ovarian inflammation (adnexitis).
Sinking of the uterus: When the uterus subsides, the uterus has sunk down in the pelvis. In extreme cases, it may even come out of the vagina in whole or in part (uterine prolapse). Typical symptoms of uterine subsidence are abdominal pain or a feeling of pressure and fullness in the lower abdomen. In addition, back pain, the urge to urinate, constipation and pain when urinating or defecating may occur.
Benign or malignant tumors: Pain in the lower abdomen can also result from tumors of the genital organs, such as a myoma. Fibroids are benign tumors of the uterus that occur in a large number of women. Sometimes they remain asymptomatic; however, depending on their location and size, they can also trigger pelvic pain, bleeding disorders and / or constipation. Occasionally, pelvic discomfort is caused by malignant tumors, such as ovarian cancer or cervical cancer.

All infection-related inflammations of the upper female genital tract (such as fallopian tube and ovarian inflammation, uterine inflammation) are summarized under the term "pelvic inflammatory disease (PID)". All of these forms of pelvic inflammation can be accompanied by abdominal pain.

Male reproductive organs

Abdominal pain in men is often due to diseases of the prostate, testes, or epididymis:

Prostate inflammation: Acute inflammation of the prostate gland (prostatitis) in particular causes pain when urinating and in the abdomen, as well as during and after ejaculation.
Inflammation of the epididymis: In case of epididymitis (epididymitis), the scrotum shows painful swelling, reddening and overheating in the affected area. The pain can radiate into the groin and lower abdomen. The inflammation can also extend to the testicles themselves. The combination of inflammation of the epididymis and inflammation of the testicles (orchitis) is called epididymoorchitis.
Testicular twist: A testicle can twist on its cord, especially in childhood. This testicular torsion manifests itself in sudden pain in the affected side of the scrotum. This pain can radiate to the groin and even the lower abdomen. Testicular torsion must be treated as soon as possible! The twisted testicle can die within a few hours.
Prostate cancer: A malignant tumor of the prostate is the most common type of cancer in men. It only becomes noticeable late in symptoms such as abdominal pain (in the prostate area), pain and problems with urination and ejaculation, and blood in the urine.

Digestive tract

In both sexes, abdominal pain can also originate from the digestive tract:

Constipation: When hard feces build up in the lower intestines, abdominal pain can result.
Appendicitis (appendicitis): The symptoms often begin in the upper abdomen or the navel and then move to the right lower abdomen. Sometimes the pain extends to the left side of the lower abdomen or the entire abdomen. In addition, acute appendicitis can cause fever, loss of appetite, nausea and vomiting.
inflamed intestinal protuberances: Inflamed mucous membrane protuberances in the large intestine (diverticulitis) cause dull abdominal pain, usually on the left side. This is because diverticula usually form in the descending lower part of the large intestine, i.e. in the lower left half of the abdomen. Other symptoms of diverticulitis can include fever, diarrhea, and constipation.
Inflammatory bowel disease: Crohn's disease typically causes colicky pain in the right lower abdomen (similar to appendicitis). Diarrhea often accompanies it. Ulcerative colitis is also associated with cramping pelvic pain and diarrhea.
Inguinal hernia: In the case of an inguinal hernia, abdominal viscera emerge through a gap in the abdominal wall in the groin area. This can be recognized by a visible and / or palpable swelling in the groin. Some patients also report a feeling of pressure, pulling or pain in the groin (possibly up to the testicles / labia). If you suddenly experience severe pain, reddening of the groin, nausea and vomiting, parts of the intestines (like a loop of intestines) have become trapped in the gap. Then you have to alert a doctor immediately!
Colon cancer: Colon cancer in the lowest section of the intestine (rectum) can cause changes in bowel movements (constipation, diarrhea) and blood in the stool, as well as cramp-like pain in the lower abdomen.
Ileus: A deep-seated intestinal obstruction makes itself felt with symptoms such as pelvic pain, stool retention, nausea and vomiting. The person concerned must be treated by a doctor as soon as possible!
Mesenteric infarction: This is the occlusion of an intestinal artery. Signs of this are sudden violent abdominal pain (depending on the location of the infarction, possibly in the lower abdomen), accompanied by nausea, vomiting, diarrhea, restlessness, racing heart and sweating. Because the section of the intestine that is actually supplied by the affected vessel can die off, a mesenteric infarction must be treated as quickly as possible!

Urinary tract

Urinary tract disorders are other possible causes of abdominal pain in men and women:

Urinary tract infection: Ascending bacterial infections up to the urinary bladder or even kidneys typically manifest themselves with pain when urinating, blood in the urine and dull abdominal pain.
Urinary stones: Urinary stones can be located in different parts of the urinary tract, for example in the bladder (bladder stones), in the ureter (ureteral stones) or in the kidney (kidney stones). If they damage the mucous membrane in the urinary tract or block the passage of urine, abdominal pain may occur, and possibly other symptoms such as blood in the urine. In the case of very strong, wave-like pain as a result of stone loss, one speaks of ureter colic or renal colic.
Bladder cancer: abdominal pain in the area of the flanks may indicate a malignant tumor of the bladder. Such pain only occurs at an advanced stage of the tumor. Blood in the urine and problems with emptying the bladder are often early signs of bladder cancer.

Abdominal pain: when do you need to see a doctor?

Several of the above causes of abdominal pain (intestinal obstruction, rupture of the fallopian tube during pregnancy, mesenteric infarction, etc.) can lead to an "acute abdomen" - a potentially life-threatening condition. Therefore, see a doctor immediately if:

the pain does not subside, but increases over time
symptoms such as fever, vomiting, nausea or stool retention occur
the abdominal wall feels hard and tight
You notice blood in your stool or urine
low blood pressure is accompanied by a rapid pulse (a possible sign of shock such as high blood loss)

You should also consult a doctor to clarify the cause of all other abnormally long-lasting or unclassifiable abdominal pain.

Abdominal Pain: What Does the Doctor Do?

Various methods and examination steps help to find the reason for the abdominal pain:

Doctor-patient discussion: In order to collect the medical history (anamnesis), the doctor will ask the patient, among other things, how long the pain has existed, where exactly it hurts, how severe the pain is and how it can be described (stabbing, pulling, etc. ). This information provides initial clues as to the cause of the symptoms.
Physical examination: the doctor palpates the abdomen. In this way, he can feel tender spots, swellings or indurations. If the abdominal wall is hard and sensitive to pressure, this so-called defensive tension can indicate an acute abdomen.
Gynecological examination: In women, gynecological diseases are often the cause of abdominal pain. A gynecologist can diagnose such diseases. A pregnancy test is also done for women of childbearing potential.
Ultrasound: Many causes of abdominal pain can be identified in the ultrasound examination of the abdominal organs, for example endometriosis, myomas or urinary stones.
Blood, urine and stool tests: The analysis of blood, urine and stool samples can indicate, among other things, inflammations and infections (fallopian tube inflammation, inflamed intestinal diverticula, etc.) as the cause of the abdominal pain.
Smears: Smears (e.g. from the vagina or the male urethra) can be used to detect various infections (e.g. with chlamydia).
Colonoscopy: It also helps to identify diseases and disorders in the digestive tract that cause abdominal pain.
Laparoscopy: A laparoscopy is necessary if other examinations cannot clarify the cause of the pain. Fine medical devices (including a small camera) are inserted into the abdomen through small incisions in the abdomen in order to examine the inside more closely. Pathological changes that are discovered in the process can sometimes be eliminated immediately (such as cysts).

Abdominal pain: treatment

For acute pain, the doctor may prescribe pain relievers or anticonvulsant medication. In addition, treatment is done depending on the cause. If, for example, urinary stones cause pain in the abdomen and do not go away on their own, the stones are often shattered using shock waves or removed as part of a cystoscopy. Inflammation of the fallopian tubes and ovaries (adnexitis) is treated with antibiotics. Surgery is necessary for testicular torsion, ruptured appendix and ectopic pregnancy.

Abdominal Pain: You Can Do It Yourself

For abdominal pain of harmless cause (menstrual pain, constipation, painful flatulence, etc.) you can help yourself with these tips:

Warmth: A hot water bottle or a cherry stone pillow heated in the microwave on the stomach often relieves pain and cramps.
Relaxation bath: A warm bath can also help against abdominal pulling.
Herbal tea: For mild urinary tract infections, bladder and kidney teas (birch leaves, bearberry leaves and more) are recommended for flushing the urinary tract. For example, a tea made from fennel, anise, caraway or peppermint can help with abdominal pain as a result of an upset bowel.
Light food: If you have digestive problems, you should switch to light food (rusks, rice, plenty of fluids, etc.) that do not put additional strain on the intestines.
Abdominal massage: Gently stroking the stomach sometimes brings relief from stinging in the abdomen.
Painkillers: If the period pain is severe, women can take a painkiller such as ibuprofen for a short period of time. Magnesium can help prevent cramp-like abdominal pain during menstruation (e.g. foods rich in magnesium such as nuts or a magnesium supplement).

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