Lower abdominal pain refers to the discomfort that occurs at or below your belly button.

Minor pain in the lower abdomen is usually no cause for concern and may clear up on its own in a day or two. However, it is still not something you should ignore.

If you experience persistent or chronic pain in the lower abdomen, you should seek medical attention. Likewise, a sudden onset of severe pain in the lower abdomen might require immediate medical care.

There are several possible causes of lower abdomen pain. To determine the cause, it is essential to decide on the location of the pain.

 

Organs in the Lower Abdominal Area

The abdomen is situated between the chest and the pelvis. The lower region of the abdomen contains vital organs involved in digestion and reproduction.

Lower left quadrant

The lower left area of the abdomen is home to the small intestine and the descending colon, sigmoid colon, and rectum. And for some women, the left ovary.

Lower right quadrant

The lower right region of the abdomen comprises of the small intestine, the cecum, and the appendix, as well as the ascending colon and transverse colon. In some women, it also houses the right ovary.

Lower middle quadrant

The bladder lies on the midline of the lower quadrant.

In men, the area also contains the male reproductive organs, including prostate and testicles.

In women, the area also contains female reproductive organs such as the uterus, cervix, ovaries, and fallopian tubes.

These anatomical differences between men and women mean that, in some cases, pain may have gender-specific causes.

 

 

Pain in the lower left abdomen

Diverticulitis

Diverticulitis is a common cause of persistent pain in the lower left side of the stomach.

Diverticulitis is the inflammation or infection of diverticula (small pouches) that develop along the intestinal wall, most commonly in the weak spots at the end of the descending and sigmoid colons. The formation of the diverticula themselves is a relatively benign condition called diverticulosis. Diverticulitis, on the other hand, may involve anything from a minor abscess to an extensive infection or perforation of the bowel.

Diverticulitis can be either acute or chronic. The acute form of diverticulitis can manifest with severe attacks of inflammation and infection. In chronic diverticulitis, the inflammation and infection may subside, but may never resolve entirely and may eventually result in bowel obstruction.

The symptoms of diverticulitis include:

  • Severe abdominal pain and cramping on the left side
  • Pain increases while eating or shortly after a meal
  • Bloating
  • Chills or fever
  • Nausea or vomiting

If untreated, diverticulitis can cause severe complications, including:

  • Peritonitis which may develop if the abscesses penetrate the infected diverticula.
  • Scarring may occur, resulting in a blockage or stricture of the intestine.
  • Fistulas may develop if an infected diverticulum connects with an adjacent organ. It may occur between the large intestine and the bladder, potentially leading to an infection of the adjacent kidneys.
  • Severe bleeding may require a blood transfusion.

Diverticulitis is more common in older people due to an increase in diverticula formation.

Mild diverticulitis may resolve with rest, diet modification, and antibiotics. Severe or persistent diverticulitis may require surgery.

 

Lower right abdominal pain

Appendicitis

Appendicitis is a common cause of pain in the lower right region of the abdomen. An early symptom of appendicitis is a dull pain in the middle of the stomach around the belly button region. Over time, the pain intensifies and travels to the lower right side of the abdomen, where the appendix is located.

Appendicitis is the inflammation of the appendix – a small, narrow tube that’s located where the large intestine and small intestines meet. Swelling may occur as a result of infection or blockage. It can affect people of all ages.

Accompanying symptoms include:

  • Nausea
  • Vomiting
  • Fever
  • Diarrhea
  • Constipation
  • Abdominal swelling
  • Poor appetite

The condition should be treated as a medical emergency. The appendix can burst if untreated; when this happens, the pain will typically spread across the whole abdominal region and may cause peritonitis. So, see your doctor immediately if you experience early symptoms of appendicitis.

 

Pain anywhere in the lower abdomen

Intestinal gas

Passing gas and bleching are normal. Intestinal gas is often trapped in the digestive tract when you swallow air while eating. Gas can also buildup if food is not digested correctly.

Other causes of intestinal gas include:

  • Swallowing more air than usual
  • Overeating
  • Eating gas-producing foods
  • Having a disruption of the colonic bacteria
  • Chewing gum
  • Smoking

As gas builds up, it can cause a painful and “knotted” feeling in your stomach.

Usually, gas is nothing to worry about. It should pass through the esophagus or rectum when you burp or fart, respectively. Symptoms will often dissipate within hours, but persistence for several weeks could indicate a more serious underlying condition, such as diabetes or lactose intolerance.

Consult your doctor if you persistently pass gas or if you have other symptoms, such as:

  • Unintentional weight loss
  • Constipation
  • Blood in the stool
  • Vomiting or diarrhea
  • Heartburn

Celiac disease

Celiac disease is a chronic condition that results from an inability to digest gluten. When you have celiac disease, your immune system attacks parts of the intestine, causing a range of digestive problems and vitamin deficiencies.

Symptoms may include:

  • Pressure and gas
  • Pain in the abdomen
  • Bloating
  • Diarrhea
  • Weight loss
  • Fatigue

Children with untreated celiac disease may also suffer from growth stunts and malnourishment as a result of the condition.

Lactose intolerance

Lactose intolerance refers to the inability to digest milk and milk-based products, such as yogurt and cheese. This is due to the lack of an enzyme called lactase, which breaks down the lactose in milk.

Common symptoms include:

  • Pain in the lower abdominal area
  • Diarrhea or constipation
  • Bloating
  • Nausea
  • A growling stomach

Irritable bowel syndrome (IBS)

Irritable bowel syndrome (IBS) is a chronic disorder that affects the large intestine. A doctor may only diagnose IBS once they have ruled out other probable causes of your symptoms.

IBS symptoms include:

  • Abdominal pain
  • Pressure
  • Constipation or diarrhea
  • Gas
  • Bloating
  • Stomach cramp
  • A change in bowel movements
  • Mucus in the stool

The symptoms of IBS may flare up and dissipate over time, especially after a bowel movement.

There is currently no cure for IBS. Treatment focuses on managing symptoms through diet modification, stress management, and medications.

Inflammatory bowel disease

Inflammatory bowel disease (IBD) is an umbrella term used to describe a group of debilitating disorders that cause chronic inflammation in the digestive tract. IBD may also increase your risk of colorectal cancer.

The most common causes of IBD are ulcerative colitis and Crohn’s disease.

  • Ulcerative colitis causes chronic inflammation and ulcers in the innermost lining of your large intestine (colon) and rectum.
  • Crohn’s disease causes inflammation of the digestive tract lining, which often spreads deep into affected tissues.

Crohn’s disease is common in the small intestine, whereas ulcerative colitis is common in the colon. Both chronic disorders cause inflammation in the digestive tract, which may lead to abdominal pain.

The pain will be different based on what kind of IBD is present and where any inflammation in the small or large intestine is located. Pain from ulcerative colitis tends to be found in the lower-left quadrant of the abdomen, and patients often describe it as being crampy. Pain from Crohn’s disease could be located in almost any area of the abdomen, depending on what section of the intestine (either the large intestine or the small intestine) is affected; in the two most common form of Crohn’s disease – ileocolitis and ileitis – the pain might be found in the middle of the lower right abdomen.

IBD may also cause:

  • Severe diarrhea
  • Fatigue
  • Rapid weight loss
  • Fever
  • Blood in your stool
  • Reduced appetite
  • Insomnia
  • Bloating
  • Persistent diarrhea, often with blood

The goal of IBD treatment is to reduce the inflammation that triggers your signs and symptoms. IBD treatment usually involves either medication or surgery.

Shingles

If you ever had the chickenpox, the varicella-zoster virus stays dormant in your body for your entire life. Sometimes, the virus reappears, causing a painful rash on one side of the abdomen – this is shingles. Your risk of getting shingles increases after age 50.

Symptoms of shingles include:

  • Pain when touched
  • Burning, numbness, or tingling
  • Itching
  • Tenderness on the skin
  • Rash
  • Blisters that may break open and form scabs

You may feel itchiness and tenderness on an area of the skin before the rash appears. When the rash appears, the pain can be severe.

Hernia

A hernia is where an internal organ or other body part pushes through the tissue or muscle that holds it in place (e.g., abdominal wall), causing a small lump. Several types of hernias exist, most of which occur in the abdomen. Sometimes, a lump or bulge may appear in the midsection or near the groin.

Hernias are often harmless and occur with a few other symptoms. However, some hernia can cause pain or discomfort in the affected area, which may intensify when strained, such as when coughing or lifting a heavy object.

Some additional symptoms of hernia complications include:

  • Pain when laughing or crying
  • Pressure
  • Increased pain
  • A dull ache
  • Swelling or bulging at the site
  • A feeling of fullness

Hernias may cause serious problems, so consult your doctor if you suspect that you may have one.

Constipation

Constipation occurs when you are unable to pass a stool. It is often due to poor diet or lack of exercise.

Some symptoms of constipation include:

  • Needing to exert pressure to the abdomen to expel stool
  • Straining when passing stool
  • A lumpy or hard stool
  • Feeling like the stool has not passed completely
  • Feeling like the rectum is blocked
  • Having fewer than three bowel movements per week

Kidney Stones

Kidney stones are formed from the buildup of crystals, minerals, and salts that form inside your kidneys. The size of the kidney stones may vary considerably. Larger kidney stones may get stuck and cause severe pain around the lower abdomen, back, side, and the groin.

Pain may occur when the kidney stones begin to move around inside the kidney or pass through the ureter. The intensity of the pain may come in waves. Kidney stone pain – also known as renal colic – is one of the most severe types of pain imaginable.

Typical symptoms of kidney stones include:

  • Abdominal pain
  • Pain when urinating
  • Nausea or vomiting
  • Blood in the urine
  • Cloudy or smelly urine
  • Fever or chills
  • Painful or frequent urination

Kidney infection

A kidney infection is triggered by bacteria that usually comes from your ureters, urethra, or bladder.

Although kidney infection may cause pain in your lower abdomen, you are more likely to feel pain in your lower back, sides, or groin. The pain is typically milder than from kidney stones.

Some symptoms include:

  • Pain or burning when urinating
  • Fever
  • Diarrhea
  • Frequent urination
  • Pus or blood in the urine (hematuria)
  • Cloudy or smelly urine
  • Chills
  • Nausea and vomiting
  • Loss of appetite

A kidney infection requires prompt medical attention. When untreated, kidney infections can permanently damage your kidneys, or the bacteria can spread to your bloodstream and cause a life-threatening infection.

Cystitis or urinary tract infections

A urinary tract infection (UTI) can affect any part of the urinary tract, including the bladder, kidneys, and urethra. However, it is most common in the bladder (cystitis).

UTIs is more common in females than in males. Females often experience pain in the pelvis, whereas males typically experience pain in the rectum.

Interstitial Cystitis

Interstitial cystitis refers to chronic bladder inflammation that has no known cause. The inflammation stiffens the bladder wall and makes it difficult for the bladder to expand fully when filling with urine. It causes pelvic pain, which eases following urination.

Other symptoms include:

  • Painful urination
  • Frequent need to urinate
  • Pain during sex
  • Pain or tenderness in the bladder, lower abdomen, and pelvic area.

Symptoms vary from person to person, may be mild or severe, and can even change in each person as time goes on. It’s more common in females over the age of 40.

Intestinal obstruction

When a blockage occurs in the intestine, food is unable to pass through. This results in a painful back-up.

Intestinal obstructions are more common in older adults. It is typically caused by other conditions, such as colon cancer or diverticulitis.

Common symptoms of intestinal obstruction include:

  • Abdominal pain
  • Inability to pass stool
  • Distention
  • Vomiting
  • Constipation

Cancer

In rare cases, cancerous growth in the gastrointestinal system, reproductive system, or urinary tract may be the reason for lower abdominal pain. Cancer may also cause other symptoms, depending on where it appears.

 

Causes of lower abdominal pain in MEN only

Inguinal hernia

An inguinal hernia occurs when fat or a portion of the small intestine pushes through a weak part of the lower abdomen. If this happens, you’ll notice a slight bulge in your groin area between your thigh and lower abdomen. This is the most common type of abdominal hernia and is predominantly found in men.

Symptoms include:

  • Pain in the groin that worsens when lifting, straining, coughing, or during physical activity
  • A bulge on the side of the groin that may become larger over time and usually disappear when you lay down
  • Heaviness, weakness, aching or burning in the groin
  • An enlarged or swollen scrotum

An inguinal hernia isn’t necessarily dangerous. It doesn’t improve on its own, however, and can lead to life-threatening complications. Your doctor is likely to recommend surgery to fix an inguinal hernia that’s painful or enlarging.

This type of hernia can cause serious issues. Get help immediately if you have:

  • Sudden pain that quickly intensifies
  • Extreme redness or tenderness at the bulge site
  • Inability to have a bowel movement or pass gas
  • Nausea and vomiting

Testicular torsion

In testicular torsion, the testicle turns and twists the spermatic cord. This twisting restricts blood flow to the testicles and cause severe pain and swelling in the scrotum. It is most common in boys aged 12 to 16.

The condition causes abdominal pain and other symptoms, including:

  • Sudden, severe scrotum pain and swelling
  • Pain that radiates to the groin or lower abdomen
  • Pain in one testicle
  • Abdominal pain
  • Nausea and vomiting
  • Painful urination
  • Uneven testicle position
  • Fever

Testicular torsion is severe. Get immediate medical attention if you have sudden or severe pain in your testicles. You still need to see a doctor if the pain goes away on its own. Emergency surgery may prevent testicular damage and preserve your ability to have children.

Prostatitis

Prostatitis is the inflammation in the prostate. It may cause painful urination and pain in the lower abdomen. The swelling may spread to areas around the prostate and cause other symptoms, such as:

  • Lower back pain
  • A fever
  • Difficulty urinating

Epididymitis

Epididymitis is the inflammation of the epididymis, which is the tube behind the testicles that carries sperm to the urethra. It can result from issues such as injury or infection.

Symptoms may include:

  • Pain in the pelvis or testicles
  • Pain during sexual activity
  • Abnormal discharge from the penis
  • Tenderness of the penis

Treatment usually involves antibiotics to eliminate the underlying infection.

 

Causes of lower abdominal pain in WOMEN only

Menstrual cramps (dysmenorrhea)

Menstrual cramps (dysmenorrhea) usually happen before your period, as the uterus contracts and shed its lining. More than half of women who menstruate will experience cramps for at least 1-2 days per cycle. The cramp may feel like a muscle spasm or a jabbing pain on either or both sides of the pelvis.

Other common symptoms include:

  • Dull, constant ache
  • Pain throughout your lower back and thighs
  • Nausea
  • Loose stools
  • Headaches
  • Dizziness

Endometriosis

Endometriosis occurs when the uterus lining grows outside of the uterus. It most commonly involves your ovaries, fallopian tubes, and the tissue lining your pelvis. Rarely, endometrial tissue may spread beyond pelvic organs.

It is a chronic condition that can cause pain in the pelvis or lower back during menstruation.

In addition to severe cramps and pelvic pain, endometriosis can cause:

  • Pain during or after sex
  • Pain with bowel movements or urination during menstruation
  • Heavy menstrual periods
  • Spotting or bleeding during periods
  • Painful menstrual cramps that worsen with time (dysmenorrhea)
  • Heavy menstrual periods
  • Spotting between periods
  • Subfertility

The symptoms are often “cyclical” meaning that the pain is worse right before or during the period, and then improves.

Ovarian cyst

An ovarian cyst refers to a fluid-filled sac inside or on the ovary. Most ovarian cysts develop as a consequence of your menstrual cycle; they are known as functional cysts.

Most cysts usually don’t cause pain or discomfort, and may eventually dissipate on their own in a few months. However, a large ovarian cyst, especially if it’s ruptured, can lead to severe symptoms, including severe pain or internal bleeding.

Symptoms include:

  • Dull or sharp lower abdominal pain
  • Bloating
  • Full or heavy feeling in your abdomen
  • Pain during sex
  • Persistent urination
  • Abnormally heavy or light periods

See your doctor immediately if these symptoms are accompanied by:

  • Sudden and severe abdominal pain
  • Fever and vomiting
  • Cold and clammy skin
  • Rapid breathing
  • Weakness
  • Lightheadedness

Ovarian torsion

Ovarian torsion happens when your ovary, or possibly fallopian tube, becomes twisted, restricting the organ’s blood flow. If the blood restriction persists for too long, it can lead to tissue death. It is more likely to happen with pregnancy or the use of fertility drugs.

Also known as adnexal torsion, the condition can cause severe lower abdominal pain.

Other symptoms include:

  • Irregular periods
  • Pain during sex
  • Nausea and vomiting
  • Feeling full even though you’ve barely eaten

See your doctor if you experience sudden severe pain in your abdomen that is accompanied by vomiting. Surgery is often required to untwist the ovary or remove it. Your doctor may also prescribe medications to minimize pain and nausea before surgery.

Ectopic pregnancy

An ectopic pregnancy may ensue when a fertilized egg implants itself before it reaches the uterus, such as in one of the fallopian tubes.

In addition to abdominal pain, other symptoms can include:

  • A missed period and other pregnancy signs
  • Pain on one side late in the period cycle
  • Vaginal bleeding or discharge
  • Painful urination or bowel movements
  • Pain where your shoulder ends and your arm begins
  • Diarrhea or nausea
  • Pallor

These symptoms can intensify as the egg grows.

An ectopic pregnancy cannot proceed normally. The fertilized egg can’t survive, and the growing tissue may cause life-threatening bleeding if left untreated. An ectopic pregnancy that ruptures is severe and needs surgery to repair the fallopian tube. Get medical help right away if you’re:

  • Feeling sick or dizzy
  • Feeling faint
  • Looking pale

Pelvic inflammatory disease (PID)

Pelvic inflammatory disease (PID) is an infection of the female upper genital tract. It’s usually caused by sexually transmitted diseases (STDs), including chlamydia and gonorrhea.

PID can cause pain in your lower abdomen and pelvis, as well as:

  • Unusual vaginal discharge with an unpleasant odor
  • Pain and bleeding during sex
  • Pain or burning sensation during urination
  • Bleeding between periods
  • Fever

See your doctor if you think you or your partner have been exposed to an STD or if you have any genital symptoms, such as an unusual sore or discharge.

Painful Ovulation

If you feel an unpleasant sensation on one side of your pelvis in the middle of your menstrual cycle, you may be experiencing mittelschmerz (derived from German terms for “middle” and “pain”).

Painful ovulation occurs when the fluid released by your ovary during ovulation spread within the pelvic area, causing irritation and pain in the pelvis. The pain is generally felt on one side of the pelvis or abdomen. The discomfort may persist for minutes to hours, and it may switch sides of the body, depending on which ovary released the egg.

Pelvic adhesions

A pelvic adhesion is a scar tissue that may cause nearby organs to stick together. This may result in chronic pelvic pain.

Pelvic adhesions could form due to endometriosis, an old infection, or other issues in the area.

Your doctor may recommend minimally invasive surgeries to help reduce adhesions and relieve symptoms.

Uterine fibroids

Uterine fibroids are lumps of fibrous tissue and muscle within the uterus. They may be inside the uterus, or on its surface, or attached to it by a cord-like structure. While they are benign, these growths may be a source of pain and discomfort in the pelvis or lower back. Fibroids may also cause cramping or excessive bleeding during menstruation.

Miscarriage

Miscarriage refers to the sudden loss of a pregnancy, usually within the first 20 weeks. Symptoms may include pain and cramps on either side of the pelvic region. It is often accompanied by vaginal bleeding as well as the loss of tissue or fluid from the vagina.

 

When to see a doctor

See a doctor if your lower abdominal pain is unexplainable or persists for more than a few days.

If you have pain in the lower abdomen that is related to an injury or accident, call emergency services immediately. You should also seek immediate medical help if you experience pain or pressure in your chest.

Ask someone to help you get to the emergency room if you have:

  • Fever
  • Severe tenderness in the affected area
  • Swelling of the abdomen
  • Bloody stools
  • Persistent nausea and vomiting
  • Unexplained weight loss
  • Skin that looks yellow (jaundice)
  • Pain or pressure in your chest

Immediate care can help prevent these symptoms from becoming life-threatening.

 

Diagnosis

Your doctor can use various techniques to explore the possible causes of your lower abdominal pain.

These include:

  • CT scans
  • MRI scans
  • Ultrasound imaging
  • Endoscopy
  • Physical examination

Once your doctor identifies a particular diagnosis, they will be able to provide more personalized care.

 

Treatment

The type of treatment modality will depend on the specific condition.

Lower abdominal pain that results from an infection, such as diverticulitis, may only require antibiotics. On the other hand, structural abnormalities, such as intestinal obstruction or hernia, may require surgery.

Hence, it is essential to identify the exact cause of your lower abdominal pain.

 

The Bottom Line

In most cases, a pain in the lower abdomen is not a cause for concern. However, medical attention should be sought if the pain is persistent or severe.