Abdominal Pain: When It’s an Emergency and What to Do
Abdominal pain is the single most common reason that adults visit the emergency department in the United States, and Dr. David Kim is involved in many of the cases that present urgently or emergently. As a general surgeon at Wood County Hospital, his job is to determine whether your acute abdominal pain can be treated medically or requires surgical intervention. For most of us, when stomach pain strikes, trying to wait it out with a glass of ginger ale, an antacid and a little rest can be the right call. Other times it isn't. The goal is to know which situation applies to you.
Defining Abdominal Pain
Abdominal pain refers to any discomfort felt between the chest and the pelvis. It can be acute, meaning it comes on suddenly and intensely, or chronic, meaning it persists or recurs over a longer period. Pain may be generalized, spreading across a large portion of the abdomen, or concentrated in one specific area. The character of the pain matters, too. Cramping, sharp, stabbing or dull aching sensations can each point to different underlying causes.
Location is especially telling. "The left side of the belly is different from the right side. It's different from the top, different from the bottom, different from the center," said Dr. Kim. The abdomen houses many organs, including the stomach, intestines, liver, gallbladder, appendix, kidneys and, in women, the reproductive organs. Pain in different quadrants of the abdomen can indicate problems with specific organs or systems. Paying attention to where the pain is and how it feels is valuable information for any medical provider trying to identify what's causing it.
Common Causes of Abdominal Pain
Most abdominal pain falls into the category of digestive or non-emergency issues. Those conditions can be uncomfortable and disruptive but may not require emergency care. Some examples include:
Digestive Issues
• Gas and bloating: Excess gas builds up in the digestive tract and can cause pressure, cramping or a feeling of fullness. It often resolves on its own or with over-the-counter remedies.
• Constipation: When stool moves too slowly through the colon, it can cause aching or pressure in the lower abdomen. Increased fluid intake and fiber may help. Others may require the use of a stool softener or laxative to find some relief.
• Indigestion: Also known as dyspepsia, indigestion causes discomfort or a burning sensation in the upper abdomen, often after eating. Antacids and dietary adjustments are typically effective.
• Irritable bowel syndrome (IBS): IBS is a chronic condition that causes cramping, bloating, gas and changes in bowel habits. Symptoms fluctuate and are often tied to stress or diet.
Other Non-Emergent Issues
• Muscle strain: Straining the abdominal muscles through exercise, heavy lifting or sudden movement can cause pain that feels worse with activity or touch. This can certainly mimic other abdominal problems.
• Menstrual cramps: Cramping during menstruation is common and familiar for many women. It typically occurs in the lower abdomen and follows a predictable pattern tied to the menstrual cycle. It’s important for female patients to know whether their abdominal pain is their “expected” menstrual pain or different from the norm.
• Food intolerance vs. poisoning: Difficulty digesting certain foods, such as lactose or gluten, can cause bloating, cramping and diarrhea after eating. It is helpful to remember what you ate during the day before your abdominal symptoms started.
• Urinary tract infection (UTI): UTIs can cause discomfort in the lower abdomen or pelvic area, along with a frequent or burning sensation when urinating.
For mild discomfort, over-the-counter options are often enough to bring relief. "If it's a minor upset, those kinds of medications will usually take care of it," Dr. Kim said. "And if these are symptoms that you've had before and these are medications that have worked for you, perfect. These would be situations that are safely observable at home." Common go-to remedies include over-the-counter antacids, acid reducers (famotidine), stomach-soothing medications and, for some, ginger ale or a heating pad.
Signs Your Abdominal Pain is an Emergency
When pain goes beyond the ordinary or comes with additional warning signs, getting evaluated quickly can make a significant difference in outcomes. "No matter what, if you think that something requires evaluation, you should trust your instincts and go get it checked out," Dr. Kim said.
Seek immediate medical attention if stomach pain is accompanied by any of the following:
• Sudden, severe pain that comes on intensely or without warning
• Pain that is getting progressively worse rather than improving
• Pain that doesn't go away and doesn't respond to the usual remedies
• Fever alongside abdominal pain
• Persistent or worsening nausea and vomiting
• A rigid, hard or unusually tender abdomen
• Significant bloating that develops alongside pain
• Chest pain or shortness of breath accompanying abdominal discomfort
• Pain in one specific, focused area rather than generalized discomfort
• Rapid heart rate or sweating
Two conditions that frequently bring people to the emergency room are gallbladder problems and appendicitis. Both produce highly localized pain, and both can lead to serious illness and hospitalization. The gallbladder sits beneath the right rib cage, just below the liver, and when it flares up, the pain is concentrated enough to point to with one finger. The appendix sits in the lower right portion of the abdomen in an equally specific spot. Dr. Kim describes this kind of pain plainly: it is "not like anything you've ever experienced before in terms of location and intensity." If that type of focused, unfamiliar pain has been present for an hour or more and isn't improving, it's time to be evaluated.
When Extra Caution is Necessary
While abdominal pain can affect anyone, certain groups face a higher risk of serious complications and may need to seek care sooner rather than later. In children, abdominal pain can be harder to assess because young patients may struggle to describe what they're feeling or where the pain is located. Pain that causes a child to stop normal activity, comes on suddenly or persists beyond a short period warrants a call to a pediatrician or a visit to the emergency room, especially if fever, vomiting or changes in behavior accompany it.
Women should pay particular attention when abdominal pain feels different from what's familiar. Dr. Kim notes that women generally know the difference between typical menstrual cramping and something outside the norm, since they’ve experienced that type of discomfort from a young age. When lower abdominal pain doesn't match that familiar pattern, it's worth taking seriously.
Pregnant women should treat any sharp, severe or persistent pain with extra caution, especially when paired with bleeding, dizziness or contractions, and seek medical evaluation promptly. Older adults also need to be cautious. Conditions like appendicitis or bowel obstruction can present with less dramatic symptoms in older patients, making it easier to underestimate the severity. Any new or unusual abdominal pain in an older adult is worth discussing with a doctor sooner rather than later.
Emergency Care at Wood County Hospital
When abdominal pain escalates to an emergency, having access to high-quality care matters. Wood County Hospital's emergency department is equipped to evaluate and treat a wide range of urgent conditions, including those causing severe or sudden abdominal pain.
If you or a loved one is experiencing abdominal pain that concerns you, don't wait. Trust your instincts and contact Wood County Hospital or visit the emergency department. For non-emergency questions or to connect with a general surgery provider like Dr. Kim, call 419-354-8900.