Abdominal Pain

Abdominal Pain: Classification and Possible Causes

Abdominal pain — an extremely diverse symptom that can indicate a vast number of conditions, from mild indigestion to life‑threatening surgical pathologies. Accurate interpretation of abdominal pain requires the physician to analyze its character, location, duration, and accompanying symptoms in detail. For the patient, it is important to know the "red flags" that require immediate medical attention.

How is abdominal pain classified?

Based on the mechanism of onset, three main types of pain are distinguished:

• Visceral pain: Occurs when nerve endings in the walls of internal organs are irritated. It is usually dull, aching, poorly localized (the person cannot point precisely where it hurts) and often felt along the midline of the abdomen. An example is pain caused by intestinal gas distension.
• Parietal (somatic) pain: Results from irritation of the peritoneum — the membrane lining the abdominal cavity. This pain is sharp, cutting, intense and clearly localized. It worsens with any movement, coughing. A classic example is pain in appendicitis.
• Referred (radiating) pain: Pain perceived in an area distant from the affected organ. For example, gallbladder problems can cause pain that radiates to the right shoulder.

Causes of pain depending on location

The location of pain can provide important clues about its cause, although this is not an absolute rule.

• Upper abdomen: May be related to the stomach (gastritis, ulcer), pancreas (pancreatitis), gallbladder.
• Periumbilical area: Early appendicitis, small‑bowel problems.
• Lower abdomen: Appendicitis (in the right iliac region), large‑bowel issues, in women — gynecological problems, in everyone — bladder problems.

The causes of abdominal pain in children and pregnant women have their own specifics, which can be read in the articles "Abdominal Pain in Children" and "Abdominal Pain After Childbirth".