Pelvic pain

Pelvic pain is more common in women and common causes include:

Abdominal pain

Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.

You know that awful feeling: you’re nauseous; your stomach feels like it’s tied in a knot, and you don’t even want to move. What does your pain mean? Well, let’s talk today about abdominal pain. So, what causes abdominal pain? Almost everyone has pain in their belly at one time or another. Most of the time, a serious medical problem is not the cause, and how bad your pain is doesn’t always reflect the seriousness of the problem causing your pain. You may feel very bad pain if you are having gas or stomach cramps due to viral gastroenteritis, better known as a stomach virus. And some life-threatening conditions, such as colon cancer or a very early case of appendicitis, may cause only mild pain, or no pain at all. The important thing to know about abdominal pain is when you need immediate medical care. Less serious causes of abdominal pain include constipation, irritable bowel syndrome, food allergies, lactose intolerance, food poisoning, and a stomach virus. Other, more serious, causes include appendicitis, an abdominal aortic aneurysm, a bowel blockage, cancer, and gastroesophageal reflux. Sometimes, you may have abdominal pain from a problem that isn’t in your belly, like a heart attack, menstrual cramps, or pneumonia. So, what do you do about abdominal pain? Well, if you have mild abdominal pain, here are some helpful tips; Try sipping water or other clear fluids. Avoid solid food for the first few hours. If you’ve been vomiting, wait 6 hours and then eat small amounts of mild foods like rice, applesauce, or crackers. If your pain is high in your abdomen and occurs after meals, antacids may help, especially if you are feeling heartburn or indigestion. You should seek medical attention if you have abdominal pain and are being treated for cancer, you can’t pass any stool, you’re vomiting blood, or you have chest, neck, or shoulder pain. Call your doctor if you have abdominal pain that lasts 1 week or longer, if your pain doesn’t improve in 24 to 48 hours, if bloating lasts more than 2 days, or if you have diarrhea for more than 5 days.

There are three body views (front, back, and side) that can help you to identify a specific body area. The labels show areas of the body which are identified either by anatomical or by common names. For example, the back of the knee is called the “popliteal fossa,” while the “flank” is an area on the side of the body.

The process of digesting food is accomplished by many organs in the body. Food is pushed by the esophagus into the stomach. The stomach mixes the food and begins the breakdown of proteins. The stomach propels the food then into the small intestine. The small intestine further digests food and begins the absorption of nutrients. Secretions from the pancreas in the small intestine help neutralize the acid in the intestine to provide a proper environment for the enzymes to function. Bile from the gallbladder and liver emulsify fat and enhance the absorption of fatty acids. The large intestine temporarily stores and concentrates the remainder until it is passed out as waste from the body.

Since the abdominal area contains many different organs it is divided in smaller areas. One division method, uses one median sagittal plane and one transverse plane that passes through the umbilicus at right angles. This method divides the abdomen into four quadrants. Medical personnel can easily refer to these quadrants when describing pain or injury regarding a victim.

The appendix is a small finger-shaped tube that branches off the first part of the large intestine. The appendix can become inflamed or infected causing pain in the lower right part of the abdomen.

Blood from the aorta reaches the kidneys so it can be filtered and cleaned. Among other functions, the kidneys remove toxins, metabolic waste, and excess ions from the blood which leaves the body in the form of urine.

Considerations

Generalized pain — This means that you feel it in more than half of your belly. This type of pain is more typical for a stomach virus, indigestion, or gas. If the pain becomes more severe, it may be caused by a blockage of the intestines.
Localized pain — This is pain found in only one area of your belly. It is more likely to be a sign of a problem in an organ, such as the appendix, gallbladder, or stomach.
Cramp-like pain — This type of pain is not serious most of the time. It is likely to be due to gas and bloating, and is often followed by diarrhea. More worrisome signs include pain that occurs more often, lasts more than 24 hours, or occurs with a fever or rectal bleeding.
Colicky pain — This type of pain comes in waves. It very often starts and ends suddenly, and is often severe. Kidney stones and gallstones are common causes of this type of belly pain.

Causes

Many different conditions can cause abdominal pain. The key is to know when you need to get medical care right away. Sometimes, you may only need to contact a health care provider if your symptoms continue.

Less serious causes of abdominal pain include:

Constipation
Irritable bowel syndrome
Food allergies or intolerance (such as lactose intolerance)
Food poisoning
Stomach flu

Other possible causes include:

Appendicitis
Abdominal aortic aneurysm (bulging and weakening of the major artery in the body)
Bowel blockage or obstruction
Cancer of the stomach, colon (large bowel), and other organs
Cholecystitis (inflammation of the gallbladder) with or without gallstones
Decreased blood supply to the intestines (ischemic bowel)
Diverticulitis (inflammation and infection of the colon)
Endometriosis
Heartburn, indigestion, or gastroesophageal reflux (GERD)
Hernia in which the intestine is stuck or twisted
Inflammatory bowel disease (Crohn disease or ulcerative colitis)
Kidney stones
Muscle strain
Pancreatitis (swelling or infection of the pancreas)
Pelvic inflammatory disease (PID)
Ruptured ovarian cyst
Severe menstrual cramps
Tubal (ectopic) pregnancy
Ulcers
Urinary tract infections (UTI)

Home Care

You can try the following home care steps to ease mild abdominal pain:

Sip water or other clear fluids. You may have sports drinks in small amounts. People with diabetes must check their blood sugar often and adjust their medicines as needed.
Avoid solid food for the first few hours.
If you have been vomiting, wait 6 hours, and then eat small amounts of mild foods such as rice, applesauce, or crackers. Avoid dairy products.
If the pain is high up in your abdomen and occurs after meals, antacids may help, especially if you feel heartburn or indigestion. Avoid citrus, high-fat foods, fried or greasy foods, tomato products, caffeine, alcohol, and carbonated beverages.
DO NOT take any medicine without talking to your provider.

These additional steps may help prevent some types of abdominal pain:

Drink plenty of water each day.
Eat small meals more frequently.
Exercise regularly.
Limit foods that produce gas.
Make sure that your meals are well-balanced and high in fiber. Eat plenty of fruits and vegetables.

When to Contact a Medical Professional

Get medical help right away or call 911 or the local emergency number if you:

Are currently being treated for cancer
Are unable to pass stool, especially if you are also vomiting
Are vomiting blood or have blood in your stool (especially if bright red, maroon or dark, tarry black)
Have chest, neck, or shoulder pain
Have sudden, sharp abdominal pain
Have pain in, or between, your shoulder blades with nausea
Have tenderness in your belly, or your belly is rigid and hard to the touch
Are pregnant or could be pregnant
Had a recent injury to your abdomen
Have difficulty breathing

Contact your provider if you have:

Abdominal discomfort that lasts 1 week or longer
Abdominal pain that does not improve in 24 to 48 hours, or becomes more severe and frequent and occurs with nausea and vomiting
Bloating that persists for more than 2 days
Burning sensation when you urinate or frequent urination
Diarrhea for more than 5 days
Fever, over 100°F (37.7°C) for adults or 100.4°F (38°C) for children, with pain
Prolonged poor appetite
Prolonged vaginal bleeding
Unexplained weight loss
Unable to keep down any foods or liquids

What to Expect at Your Office Visit

Your provider will perform a physical exam and ask about your symptoms and medical history. Your specific symptoms, the location of pain and when it occurs will help your provider detect the cause.

LOCATION OF YOUR PAIN

Where do you feel the pain?
Is it all over or in one spot?
Does the pain move into your back, groin, or down your legs?

TYPE AND INTENSITY OF YOUR PAIN

Is the pain severe, sharp, or cramping?
Do you have it all the time, or does it come and go?
Does the pain wake you up at night?

HISTORY OF YOUR PAIN

Have you had similar pain in the past? How long has each episode lasted?
When does the pain occur? For example, after meals or during menstruation?
What makes the pain worse? For example, eating, stress, or lying down?
What makes the pain better? For example, drinking milk, having a bowel movement, or taking an antacid?
What medicines are you taking?

OTHER MEDICAL HISTORY

Have you had a recent injury?
Are you pregnant?
What other symptoms do you have?

References

Landmann A, Bonds M, Postier R. Acute abdomen. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 46.

Martinez JP. Abdominal pain. In: Walls RM, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2018:chap 23.

McQuaid KR. Approach to the patient with gastrointestinal disease. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 118.

Weber F. Gastrointestinal and hepatic manifestations of systemic diseases. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 37.

Version Info

Last reviewed on: 3/31/2024

Reviewed by: Jenifer K. Lehrer, MD, Department of Gastroenterology, Aria – Jefferson Health Torresdale, Jefferson Digestive Diseases Network, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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Pelvic pain

Pelvic pain varies. It may affect a small area around your pelvis (your lower tummy) or the whole area.

Types of pelvic pain include:

a sharp, stabbing or burning pain that happens suddenly
a pain that comes on slowly but does not go away
a dull or heavy ache, or feeling of pressure
a twisted or knotted feeling
a cramping or throbbing pain, which may come and go
pain only when you’re doing something, like exercising, having sex, or peeing

Common causes of pelvic pain

There are lots of causes of pelvic pain. It might be caused by an infection or a condition affecting one of the organs in the pelvic area, such as the bowel or bladder.

Common causes include:

constipation or irritable bowel syndrome
urinary tract infections (UTIs)
sexually transmitted infections (STIs)

Most causes of pelvic pain are not serious. But there a few conditions that cause pelvic pain and need emergency treatment, such as appendicitis and peritonitis.

But do not self-diagnose – see a GP if you’re worried.

Pelvic pain in women

Pelvic pain is more common in women and common causes include:

period pain
conditions affecting female reproductive organs, such as an ovarian cyst or endometriosis
pelvic pain in pregnancy

Rarely it could be something more serious, like an ectopic pregnancy, womb cancer or ovarian cancer.

Pelvic pain in men

Pelvic pain can sometimes be caused by conditions affecting the prostate, such as prostatitis.

Non-urgent advice: See a GP if:

pelvic pain does not go away
you have been feeling bloated for a while (about 3 weeks)
you’re losing weight without trying to
there’s blood in your pee or poo, or an unusual discharge or bleeding from your vagina
you have constipation or diarrhoea that does not go away

Urgent advice: Ask for an urgent GP appointment or get help from NHS 111 if:

You have pelvic pain and:

it’s severe, getting worse or hurts when you move or touch the area
you find it difficult to pee or poo
you have pain when peeing or need to pee more than usual
you have a very high temperature (you feel hot and shivery)
you are pregnant or may be pregnant

Treatments for pelvic pain

Any treatment for pelvic pain will depend on the cause.

A GP might suggest treatments such as:

antibiotics
painkillers
physiotherapy, such as exercises for the pelvic floor muscles
hormone treatments

They may refer you for tests or to a specialist if they do not know what is causing your pain.

Information:

Self-refer for treatment

If you have pelvic pain, you might be able to refer yourself directly to services for help with your condition without seeing a GP.

To find out if there are any services in your area:

ask the receptionist staff at your GP surgery
check your GP surgery’s website
contact your local integrated care board (ICB) – find your local ICB
search online for NHS treatment for pelvic pain near you

Page last reviewed: 17 March 2022
Next review due: 17 March 2025

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Heavy Feeling In Lower Abdomen

Pelvic pain

Abdominal pain

Considerations

Causes

Home Care

When to Contact a Medical Professional

What to Expect at Your Office Visit

References

Version Info

Pelvic pain