What is Emergency Abdominal Pain

Abdominal pain is a common experience. Mild abdominal pain often goes away without treatment. However, there is certain criteria coupled with abdominal pain that require immediate medical attention. It is important to be able to differentiate between emergency abdominal pain and non-emergency abdominal pain.

You may need to seek immediate medical care if the pain is severe enough that you cannot sit still comfortably and must curl up in a fetal position for any relief. Specific symptoms that require immediate medical attention for abdominal pain include:

• Bloody stools
• Fever of 101.0 F (38.33 C) or above 
• Vomiting blood (hematemesis)
• Persistent vomiting or nausea
• Yellowing of the skin or eyes
• Severe tenderness or swelling of the abdomen
• Difficulty breathing

If you have abdominal pain from a traumatic injury or are feeling pressure or pain in your chest, call 911 immediately.

Schedule an appointment with your doctor if you notice any of the following symptoms:

• Abdominal pain that lasts longer than 24 hours
• Prolonged constipation
• Recurring vomiting
• Burning sensation when urinating
• Fever
• Loss of appetite
• Unusual weight loss 

It is also important to contact your doctor if you are pregnant or breastfeeding and are experiencing abdominal pain.

Signs and Symptoms

It is important to distinguish the difference between emergency abdominal pain and non-emergency abdominal pain. There are several causes for emergency abdominal pain. Three potentially life-threatening conditions that cause abdominal pain are appendicitis, a bowel obstruction, or a bowel perforation. These conditions generally cause unbearable pain and discomfort. It is important to seek immediate medical help if you are experiencing any of the following symptoms with your abdominal pain:

• You are pregnant
• You recently had a gastrointestinal procedure (including a diagnostic endoscopy) or abdominal surgery
• If you have ever had gastric bypass, colostomy, or bowel resection
• The pain started shortly after a severe abdominal trauma
• The abdomen appears bruised or is quickly swelling in size

Additionally, your abdominal pain may be mild to start out and then gradually worsen over time. If that happens and you experience any of the following symptoms, have someone take you to the emergency room or call 911:

• Abdomen feels very hard to the touch
• Abdominal tenderness
• Coughing up or vomiting blood
• Persistent vomiting
• Bloody diarrhea
• Chest pain or pressure
• Breathing difficulties
• Fainting
• Dizziness
• Inability to have a bowel movement followed by vomiting
• Pain between your shoulder blades, or pain in neck and shoulder
• Changes in vision

Causes

Abdominal pain can be caused by several different conditions or issues. The main causes of abdominal pain are infection, inflammation, obstruction or blockage, abnormal growths, or intestinal disorders. It is important to distinguish between emergency abdominal pain and non-emergency abdominal pain. Causes for severe abdominal pain include:

• Organ rupture or near rupture (appendix burst or appendicitis)
• Kidney stones
• Kidney infection
• Gallbladder stones (gallstones)

Risk Factors

There are several risk factors associated with abdominal pain, specifically severe abdominal pain. Risk factors do not necessarily determine the underlying cause of the abdominal pain, but they do indicate a greater likelihood of experiencing abdominal pain. Sometimes it can be hard to determine whether abdominal pain is serious or not. If you have any of the following risk factors, it is always best practice to contact your primary care provider when experiencing abdominal pain:

• Diabetes
• Organ transplant
• AIDS/HIV
• Chemotherapy
• Sickle cell anemia
• Older age
• Previous abdominal surgery
• History of bowel disorder
• Exposure to stomach flu

Diagnosis

Diagnosing emergency abdominal pain will happen through a physical examination and diagnostic testing. A doctor will conduct a physical exam, checking for pain, tenderness, and swelling in the abdomen. Information gathered during the physical exam, including the location and severity of the pain, will help determine what tests to order.

Several tests may be administered to help rule out certain conditions and diagnose. MRI’s, x-rays, and ultrasounds are equipment that can provide images of organs, tissues, and other abdominal structures. They help to detect tumors, ruptures, inflammation, or fractures.

Additional tests include:

• Colonoscopy. Provides images of inside the colon and intestines
• Endoscopy. Detects inflammation or abnormalities inside the esophagus and stomach
• Upper GI. A specific x-ray test that utilizes contrast dye to assess for growths, blockages, ulcers, inflammation, or any other abnormalities in the abdomen

Your doctor may also order blood, urine, and stool samples if he or she suspects a bacterial, viral, or parasitic infection.

Treatment and Recovery

Emergency abdominal pain can feel scary and unmanageable in the moment. But the good news is that there are several treatment options that generally all have a good prognosis. The type of treatment depends on the underlying cause of the abdominal pain. For emergency abdominal pain, treatment options include:

• Surgery on the affected organ
• Medication that helps to treat pain, reduce inflammation, reduce acid reflux, and treat ulcers or infections

Please seek medical attention immediately if you are experiencing severe or chronic abdominal pain so you can begin the process of diagnosis and deciding on treatment options.

When to Call Your Healthcare Provider for Abdominal Pain

Sometimes it can be hard to determine whether your abdominal pain is serious enough to contact your doctor. It is important to understand the symptoms that warrant medical attention, and it can also be helpful to trust your instincts when in doubt. If you have any of the following symptoms, it is advised to contact your healthcare provider within a day or two:

• Burning sensation while urinating or frequent and urgent urinating
• Blood in the urine
• Pain, discomfort, and nausea when eating
• Fever above 100 degrees
• Fever lasting for 3 days or longer
• Diarrhea that lasts more than 5 days
• Significant loss of appetite
• Pain worsens or does not get better within two days
• Rectal bleeding or blood in the stool
• Excessive vaginal bleeding or clots
• Vaginal bleeding that lasts longer than normal
• Abdominal pain while being treated for cancer