Abdominal pain is one of the most common reasons people seek medical advice. It can be mild and short-lived, such as trapped wind or indigestion, or it can be severe, persistent and a sign that something needs urgent attention.
The abdomen contains many organs: the stomach, bowel, appendix, gallbladder, liver, pancreas, kidneys, bladder, major blood vessels, and reproductive organs such as the uterus, ovaries and testes. Pain in this area can also come from the muscles, ribs, spine, chest, lungs, heart or skin. That is why “stomach pain” is not always a stomach problem.
One useful way to think about abdominal pain is by location: upper right, upper middle, upper left, lower right, lower left, central, pelvic or generalised pain. Location does not give a perfect diagnosis, but it can narrow down the likely causes and help you decide how urgently to seek help.
This guide explains common causes of abdominal pain by location, what symptoms to look for, when to contact a GP or NHS 111, and when to call 999 or go to A&E.
Important: this article is for general information only and should not replace medical advice. Severe, worsening, unexplained or persistent abdominal pain should be assessed by a healthcare professional.
When abdominal pain may be an emergency
Most abdominal pain is not life-threatening, but some patterns need urgent assessment. NHS guidance advises urgent help if stomach pain gets much worse, does not go away or keeps coming back, occurs with persistent bloating, swallowing problems, pregnancy, unexplained weight loss, changes in urination, painful urination, bleeding from the bottom, abnormal vaginal bleeding or discharge, or diarrhoea that does not settle after a few days. NHS stomach ache guidance.
Call 999 or go to A&E now if abdominal pain is associated with:
- sudden, severe or rapidly worsening pain
- pain with fainting, collapse, severe dizziness or clammy skin
- chest pain, severe breathlessness or pain spreading to the jaw, arm or back
- vomiting blood or passing black, tarry stools
- heavy bleeding from the bottom
- severe pain after an injury, fall or accident
- a rigid, swollen or very tender abdomen
- severe pain with fever, shivering or looking very unwell
- yellow skin or eyes with severe pain or fever
- being unable to pass urine, poo or wind with worsening pain and bloating
- severe testicular pain
- severe pelvic pain with possible pregnancy or heavy vaginal bleeding
If you are not sure whether symptoms are urgent, use NHS 111. If someone looks seriously unwell, is confused, collapses, or the pain is sudden and severe, do not wait.
How to describe abdominal pain
Before looking at causes by location, it helps to describe the pain clearly. A clinician may ask:
- Where exactly is the pain?
- Did it start suddenly or gradually?
- Is it sharp, cramping, burning, stabbing, dull, colicky or pressure-like?
- Is it constant or does it come in waves?
- Does it move anywhere, such as to the back, shoulder, groin or chest?
- Is it worse after eating, moving, coughing, passing urine or opening your bowels?
- Is it better after eating, vomiting, passing wind or opening your bowels?
- Are there symptoms such as fever, vomiting, diarrhoea, constipation, bloating, blood in stool, painful urination, vaginal bleeding, testicular pain or weight loss?
- Could you be pregnant?
- Have you had surgery, gallstones, kidney stones, ulcers, inflammatory bowel disease or similar pain before?
The answers often matter more than the pain location alone.
Abdominal pain by location
Upper right abdominal pain
Pain in the upper right abdomen, under the ribs, often makes clinicians think about the gallbladder, liver, bile ducts, stomach, duodenum, right kidney, lung base or muscles around the ribs.
Common causes include:
- gallstones or biliary colic
- gallbladder inflammation, called cholecystitis
- acid reflux, gastritis or stomach ulcer pain
- liver inflammation or liver capsule pain
- right-sided kidney infection or kidney stone
- muscle strain or rib pain
- pneumonia or inflammation near the right lung base
Gallstone pain often starts in the upper right abdomen or upper middle abdomen and may spread to the back or right shoulder. The NHS describes gallstone pain as severe, constant, lasting longer than 30 minutes and up to several hours, often in the middle of the tummy or under the right ribs, and sometimes causing nausea or vomiting. NHS gallstones guidance.
Seek urgent medical advice if upper right pain is severe, persistent, associated with fever, vomiting, yellow skin or eyes, dark urine, pale stools, confusion or feeling very unwell. These symptoms can suggest complications such as gallbladder inflammation, bile duct blockage or infection.
Related AllHealth guides: gallstones, gallbladder pain and when surgery is needed, liver function test results explained and heartburn, acid reflux and GORD.
Upper middle abdominal pain
Upper middle pain, sometimes called epigastric pain, is felt below the breastbone and above the belly button. It may come from the stomach, oesophagus, duodenum, pancreas, gallbladder, heart or major blood vessels.
Common causes include:
- indigestion or functional dyspepsia
- acid reflux or GORD
- gastritis
- stomach or duodenal ulcer
- gallstones
- pancreatitis
- heart-related pain, especially in older adults or people with risk factors
Burning pain, sour taste, burping, bloating or symptoms worse after meals may point towards reflux or indigestion. Ulcer pain can be burning or gnawing and may be linked to meals, anti-inflammatory painkillers or H. pylori infection.
Pancreatitis often causes severe upper abdominal pain that may spread through to the back, with nausea, vomiting and feeling very unwell. It needs urgent assessment.
Upper abdominal pain is also sometimes heart-related. This is particularly important if the pain is heavy, tight, associated with sweating, breathlessness, nausea, pain in the jaw or arm, or occurs during exertion. In that situation, treat it as possible chest pain and seek urgent help. See AllHealth’s guide to chest pain and when to worry.
For persistent upper abdominal pain, NICE cancer referral guidance includes several situations where investigation may be needed, especially in people aged 55 or over with treatment-resistant dyspepsia, upper abdominal pain with abnormal blood tests, or nausea/vomiting with weight loss, reflux or dyspepsia. NICE suspected cancer recognition and referral guidance.
Related AllHealth guides: stomach ulcers, H. pylori and treatment, acid reflux and GORD, gallstones and liver blood tests.
Upper left abdominal pain
Upper left pain can come from the stomach, spleen, pancreas, left kidney, bowel, ribs, muscles or left lung base. It can also overlap with chest pain.
Common causes include:
- indigestion, reflux or gastritis
- stomach ulcer
- trapped wind or bowel spasm
- pancreatitis
- left kidney stone or kidney infection
- rib or muscle strain
- spleen problems, especially after injury
- pneumonia or pleurisy at the left lung base
Upper left abdominal pain after a blow, fall or accident should be taken seriously because of the spleen’s location. Severe upper left pain with dizziness, fainting, shoulder tip pain or feeling very unwell needs urgent assessment.
Burning upper left or central pain may still be acid reflux, gastritis or ulcer disease. Severe pain spreading to the back with vomiting can suggest pancreatitis and needs urgent care.
Central abdominal pain around the belly button
Pain around the belly button can come from the small bowel, early appendicitis, trapped wind, gastroenteritis, constipation, abdominal migraine, bowel obstruction, a hernia or, rarely, problems with major blood vessels.
Common causes include:
- gastroenteritis or food poisoning
- trapped wind
- constipation
- early appendicitis
- IBS
- umbilical hernia
- bowel obstruction
Appendicitis often begins as pain around the middle of the abdomen that later moves to the lower right side. NHS Inform describes appendicitis as typically starting with pain in the middle of the tummy that may come and go, then moving within hours to the lower right side where it becomes constant and severe. NHS Inform appendicitis guidance.
Seek urgent help if central abdominal pain becomes severe, localises to the lower right side, is associated with fever, vomiting, loss of appetite, worsening tenderness, a swollen abdomen, or inability to pass wind or stool.
Lower right abdominal pain
Lower right abdominal pain is important because appendicitis is one of the key causes to rule out. But there are many other possible causes, including bowel, urinary, gynaecological and testicular conditions.
Common causes include:
- appendicitis
- constipation or trapped wind
- IBS
- Crohn’s disease affecting the end of the small bowel
- kidney stone or UTI
- ovarian cyst, ovarian torsion or pelvic inflammatory disease
- ectopic pregnancy
- testicular torsion or referred testicular pain
- inguinal hernia
Appendicitis pain may be worse with walking, coughing, pressing the area or releasing pressure. It may come with nausea, vomiting, loss of appetite, fever, constipation, diarrhoea or urinary symptoms. The NHS notes that appendicitis can be atypical, especially in pregnancy, young children and older adults. NHS appendicitis guidance.
Seek urgent medical help for lower right pain that is worsening, constant, severe, associated with fever or vomiting, or if pregnancy is possible. Ectopic pregnancy and ovarian torsion can be emergencies. Sudden severe testicular pain is also an emergency.
Lower left abdominal pain
Lower left abdominal pain is often linked with bowel causes, especially constipation, IBS or diverticular disease, but urinary, gynaecological and hernia causes are also possible.
Common causes include:
- constipation
- trapped wind
- IBS
- diverticular disease or diverticulitis
- ulcerative colitis or Crohn’s disease
- kidney stone or UTI
- ovarian cyst, ovarian torsion or pelvic inflammatory disease
- ectopic pregnancy
- inguinal hernia
Diverticular disease often causes lower left abdominal pain, bloating and changes in bowel habit. The NHS lists symptoms including lower left tummy pain, pain that may get worse after eating and improve after passing stool or wind, constipation, diarrhoea, blood in stool and bloating. NHS diverticular disease and diverticulitis guidance.
Diverticulitis means the diverticula have become inflamed or infected. It may cause more severe pain, fever, diarrhoea or frequent bowel movements, and feeling unwell. Seek medical advice if lower left pain is persistent, worsening, associated with fever, blood in stool, vomiting or significant tenderness.
Related AllHealth guides: diverticular disease and diverticulitis, constipation in adults, IBS and blood in stool.
Lower central abdominal pain
Lower central pain is felt above the pubic bone. It may come from the bladder, uterus, prostate, bowel, pelvic floor muscles or reproductive organs.
Common causes include:
- urinary tract infection
- bladder irritation
- painful periods
- endometriosis
- fibroids
- pelvic inflammatory disease
- pregnancy-related pain
- prostatitis
- constipation or IBS
Pain with burning when urinating, needing to pee often, urgency or cloudy urine may suggest UTI. Pain with fever and back pain could suggest kidney infection. See AllHealth’s guide to pain when urinating: UTI, kidney stones, STIs or something else.
Pelvic pain with abnormal vaginal bleeding, unusual discharge, pain during sex, fever or possible pregnancy needs medical advice. Severe pelvic pain, fainting, shoulder tip pain or heavy bleeding with possible pregnancy needs urgent help.
Generalised abdominal pain
Generalised pain means pain felt across much of the abdomen rather than one exact spot. It can be caused by many conditions, from minor to serious.
Common causes include:
- gastroenteritis or food poisoning
- IBS
- constipation
- trapped wind
- coeliac disease
- inflammatory bowel disease
- bowel obstruction
- peritonitis or severe abdominal infection
- diabetic ketoacidosis in people with diabetes
- abdominal migraine, more common in children
Crampy pain with diarrhoea and vomiting is often gastroenteritis, but dehydration can become a problem, especially in children, older adults and people with long-term conditions. Pain with a rigid abdomen, worsening tenderness, fever, confusion, collapse or inability to pass wind or stool needs urgent assessment.
Related AllHealth guides: digestive health symptoms and common conditions, coeliac disease, IBD, Crohn’s disease and ulcerative colitis, and dehydration symptoms.
Common causes of abdominal pain by body system
Digestive causes
Digestive causes are among the most common reasons for abdominal pain. They include indigestion, reflux, gastritis, ulcers, gallstones, constipation, IBS, gastroenteritis, food poisoning, coeliac disease, IBD, diverticular disease, haemorrhoids, anal fissures and bowel obstruction.
Digestive pain may be linked to meals, bowel movements, bloating, wind, diarrhoea, constipation, nausea, vomiting, weight loss or blood in stool.
Urinary causes
Urinary causes include UTI, kidney infection, kidney stones, bladder pain syndrome and urinary retention. Clues include painful urination, urgency, frequency, blood in urine, back or side pain, fever, cloudy urine, reduced urination or inability to pass urine.
See AllHealth’s guides to urine test results explained and kidney blood test results.
Gynaecological causes
In women, trans men and non-binary people with female reproductive organs, abdominal or pelvic pain may come from periods, ovulation, endometriosis, fibroids, ovarian cysts, pelvic inflammatory disease, miscarriage, ectopic pregnancy or ovarian torsion.
Persistent or frequent abdominal or pelvic pain, especially in people aged 50 or over, may need assessment for ovarian cancer according to NICE suspected cancer guidance. NICE suspected cancer symptom guidance.
Related AllHealth guides: endometriosis, fibroids, ovarian cysts, heavy periods and vaginal discharge.
Male reproductive and prostate causes
Lower abdominal, pelvic, groin or testicular pain may be linked to prostatitis, epididymitis, testicular torsion, hernia, kidney stones or urinary infection. Sudden severe testicular pain is an emergency because testicular torsion needs urgent treatment.
Related AllHealth guides: prostatitis, enlarged prostate and testicular cancer symptoms and self-check.
Heart and lung causes
Not all abdominal pain comes from the abdomen. Heart attack can sometimes feel like upper abdominal discomfort, indigestion, nausea or pressure, especially in older adults, women and people with diabetes. Pneumonia or pleurisy can also cause upper abdominal pain because the lower lungs sit close to the diaphragm.
Upper abdominal pain with chest tightness, breathlessness, sweating, faintness, pain spreading to the arm, neck or jaw, or symptoms during exertion should be treated as possible heart-related pain. See chest pain: when to worry.
Abdominal pain after eating
Pain after eating can suggest indigestion, reflux, gastritis, gallstones, IBS, food intolerance, coeliac disease or, less commonly, problems with blood supply to the bowel.
Gallstone pain may come after fatty meals and can be severe, constant and located in the upper right or upper middle abdomen. IBS pain may worsen after eating and improve after opening the bowels or passing wind. Coeliac disease may cause bloating, diarrhoea, fatigue, weight loss or nutrient deficiencies.
If pain after eating is persistent, severe, associated with vomiting, weight loss, swallowing problems, black stools or anaemia, seek medical advice.
Abdominal pain with diarrhoea
Crampy abdominal pain with diarrhoea is often caused by gastroenteritis, food poisoning, IBS, IBD, diverticulitis, medication side effects or food intolerance.
Seek medical advice if diarrhoea lasts more than a few days, there is blood or mucus, fever, severe pain, dehydration, recent antibiotics, recent travel, pregnancy, older age, a weakened immune system or known inflammatory bowel disease.
Abdominal pain with constipation
Constipation can cause cramping, bloating, lower abdominal pain, nausea and reduced appetite. Pain may improve after passing stool or wind. Common triggers include low fibre intake, dehydration, inactivity, medicines, pregnancy, IBS, thyroid disease and ignoring the urge to go.
Seek medical advice if constipation is new and persistent, associated with weight loss, blood in stool, vomiting, severe bloating, anaemia, or inability to pass wind or stool.
Abdominal pain with blood in stool
Blood in stool should not be ignored. Bright red blood may come from piles or an anal fissure, but it can also be caused by inflammation, infection, diverticular disease, polyps or bowel cancer. Dark or black stools can suggest bleeding higher in the digestive tract and need urgent advice.
See AllHealth’s guides to blood in stool and piles and haemorrhoids.
Abdominal pain in children
Children often get tummy pain from constipation, viral infections, food poisoning, anxiety, trapped wind, urinary infections or mesenteric adenitis after a viral illness. But appendicitis, bowel obstruction, testicular torsion, kidney infection and other serious causes can occur.
Seek urgent help if a child has severe or worsening pain, persistent vomiting, green vomit, blood in stool, a swollen abdomen, fever with drowsiness, dehydration, pain in the testicle, pain that moves to the lower right abdomen, or if they look very unwell.
Abdominal pain in pregnancy
Some abdominal discomfort can happen in pregnancy because of stretching ligaments, constipation, indigestion or Braxton Hicks contractions later on. But pregnancy also changes the urgency of abdominal pain because ectopic pregnancy, miscarriage, pre-eclampsia, placental problems, UTI, kidney infection and appendicitis need prompt assessment.
Seek urgent maternity or medical advice for abdominal pain in pregnancy if there is vaginal bleeding, shoulder tip pain, fainting, severe one-sided pain, fever, pain when urinating, reduced baby movements later in pregnancy, severe headache, visual symptoms, swelling, or feeling very unwell.
What tests might be needed?
Tests depend on the likely cause. Many mild cases do not need tests, but persistent, severe or unclear pain may require investigation.
Possible tests include:
- temperature, pulse, blood pressure and oxygen levels
- abdominal examination
- urine dipstick and urine culture
- pregnancy test where relevant
- blood tests for infection, anaemia, kidney function, liver function, pancreas enzymes or inflammation
- stool tests if infection or inflammation is suspected
- ECG if heart-related pain is possible
- ultrasound scan, often for gallbladder, liver, kidneys, pelvis or pregnancy-related questions
- CT scan if appendicitis, diverticulitis, obstruction, stones or other acute problems are suspected
- endoscopy or colonoscopy for persistent upper gut or bowel symptoms
Related AllHealth guides: how to understand blood test results, urine test results, liver function tests, CRP and inflammation blood tests and scan results explained.
What can help mild abdominal pain at home?
If pain is mild, short-lived and there are no red flags, simple self-care may help:
- rest and avoid heavy meals for a short time
- sip fluids, especially if there has been vomiting or diarrhoea
- try gentle movement if pain feels like trapped wind or constipation
- use a warm compress or hot water bottle wrapped in a towel
- avoid alcohol and very fatty or spicy meals while symptoms settle
- ask a pharmacist about suitable medicines for indigestion, constipation, diarrhoea or pain relief
Be careful with anti-inflammatory painkillers such as ibuprofen or naproxen if you have indigestion, stomach ulcer symptoms, kidney disease, are on blood thinners, are pregnant, or have been told to avoid them. These medicines can irritate the stomach and are not suitable for everyone.
Do not mask severe or worsening pain with repeated painkillers instead of seeking help. If the pain is getting worse, becoming localised, or associated with fever, vomiting, bleeding, fainting or a rigid abdomen, get medical advice.
When to see a GP
Arrange a GP appointment if abdominal pain:
- does not go away or keeps coming back
- is affecting eating, sleep, work or daily life
- is associated with unexplained weight loss
- comes with persistent bloating
- comes with a change in bowel habit lasting several weeks
- comes with blood in stool or black stools
- is linked with swallowing problems, persistent reflux or vomiting
- is associated with painful urination or changes in urine
- is associated with abnormal vaginal bleeding or discharge
- occurs in pregnancy
- is new and persistent in someone over 50
- is associated with anaemia or abnormal blood tests
Use NHS 111 for urgent advice if pain is getting worse quickly, you are unsure what to do, or you need help deciding whether urgent care or A&E is appropriate.
The bottom line
Abdominal pain can come from many places: stomach, bowel, gallbladder, appendix, kidneys, bladder, reproductive organs, muscles, chest or heart. Location helps, but the full pattern matters more.
Upper right pain may suggest gallbladder or liver problems. Upper middle pain may be reflux, ulcer, gallstones, pancreas or sometimes heart-related. Lower right pain raises concern for appendicitis, but urinary, bowel and pelvic causes are also possible. Lower left pain is often bowel-related, especially constipation, IBS or diverticular disease. Pelvic pain may be urinary, bowel, gynaecological or prostate-related.
Mild, short-lived pain often settles. But severe, worsening, persistent, recurrent or unexplained pain — especially with fever, vomiting, blood, black stools, weight loss, pregnancy, fainting, chest symptoms, painful urination or a rigid abdomen — should be assessed.
FAQ: abdominal pain by location and when to get help
What is the most common cause of abdominal pain?
Common causes include indigestion, trapped wind, constipation, gastroenteritis, IBS, period pain, urinary infections and muscle strain. However, the cause depends on location, severity, duration and associated symptoms.
When should I worry about abdominal pain?
Worrying signs include sudden severe pain, worsening pain, fever, vomiting blood, black stools, blood in stool, fainting, chest pain, breathlessness, pregnancy, a rigid abdomen, inability to pass urine or stool, or unexplained weight loss.
What causes upper right abdominal pain?
Upper right pain may be caused by gallstones, gallbladder inflammation, liver problems, reflux, gastritis, stomach ulcer, kidney infection, kidney stone, rib pain or pneumonia near the right lung base.
What causes lower right abdominal pain?
Lower right pain may be caused by appendicitis, constipation, IBS, Crohn’s disease, kidney stones, UTI, ovarian cysts, ectopic pregnancy, pelvic infection, hernia or testicular problems.
What causes lower left abdominal pain?
Lower left pain is often caused by constipation, trapped wind, IBS or diverticular disease. Other causes include diverticulitis, inflammatory bowel disease, kidney stones, UTI, ovarian problems, ectopic pregnancy or hernia.
Can abdominal pain be a heart attack?
Sometimes. Heart attack can feel like upper abdominal discomfort, indigestion, nausea or pressure, especially in older adults, women and people with diabetes. Pain with sweating, breathlessness, chest pressure or pain spreading to the arm, jaw or back needs urgent help.
How does appendicitis pain usually start?
Appendicitis often starts as pain around the middle of the abdomen that later moves to the lower right side and becomes more constant and severe. It may come with nausea, vomiting, fever or loss of appetite.
What does gallbladder pain feel like?
Gallbladder pain often feels severe and constant in the upper right or upper middle abdomen. It may last longer than 30 minutes, come after eating, spread to the back or right shoulder, and cause nausea or vomiting.
Can constipation cause severe abdominal pain?
Constipation can cause cramping, bloating and significant discomfort. However, severe pain with vomiting, a swollen abdomen or inability to pass wind or stool needs urgent assessment to rule out obstruction or other causes.
Can stress cause abdominal pain?
Stress can worsen IBS, indigestion, reflux, gut sensitivity and muscle tension. But persistent, severe, new or red-flag abdominal pain should not be assumed to be stress without assessment.
What tests are done for abdominal pain?
Tests may include urine tests, pregnancy test, blood tests, stool tests, ECG, ultrasound, CT scan, endoscopy or colonoscopy, depending on symptoms and examination findings.
Should I eat if I have abdominal pain?
If pain is mild, small bland meals may be tolerated. Avoid alcohol and heavy, fatty or spicy meals. If pain is severe, worsening, associated with vomiting or you may need urgent assessment, avoid forcing food and seek advice.
Can a UTI cause abdominal pain?
Yes. A UTI can cause lower abdominal pain, burning when peeing, urgency and frequency. Kidney infection may cause back or side pain, fever, chills, vomiting and feeling very unwell.
Can abdominal pain be cancer?
Most abdominal pain is not cancer. However, persistent pain with unexplained weight loss, blood in stool, black stools, difficulty swallowing, persistent bloating, anaemia or a lasting change in bowel habit should be assessed.
When should I call NHS 111 for abdominal pain?
Call NHS 111 if pain is worsening, persistent, recurrent, associated with vomiting, fever, painful urination, abnormal bleeding, diarrhoea that does not settle, or if you are unsure whether urgent care is needed.
When should I call 999 for abdominal pain?
Call 999 if pain is sudden and severe, associated with collapse, chest pain, severe breathlessness, vomiting blood, black stools, heavy bleeding, a rigid abdomen, severe injury, or if someone looks seriously unwell.
