Acute Abdominal Pain refers to pain going on 1-2 weeks, oftentimes just a few days. In contrast, Chronic Abdominal Pain, which continues on & off for weeks to years, is caused by completely different conditions.
Areas of the Abdomen

xxxxxxxxxxxxAcute Upper Abdominal Pain xxxxxxxxx Acute Lower Abdominal Pain
xxxxxxxxxxxxAcute Flank Pain xxxxxxxxxxxxxxxxxxx Acute Generalized Abdominal Pain
xxxxxxxxxxxxChronic Abdominal Pain
The term โAcute Abdominal Painโ can also mean very serious and needing surgery, like appendicitis, but thatโs not how weโre using the word here. Also, various conditions may cause some pain, but primarily cause other more prominent symptoms like vomiting or diarrhea that lead a patient to seek care. Those arenโt addressed here; weโre now dealing with the patient whose main concern is new-onset belly pain.
Having identified the primary area of pain, we think of the diseases localized there (realizing that there may be some overlap). See our diagrams and discussion of The Gastro-Intestinal System.
Acute Abdominal Pain — Causes
Before we even start to think about the cause of abdominal pain, we form a rapid idea as to whether a patient will need surgery. We say โyesโ when the person struggles to walk, doubled over, holding their belly.
If the disease is just as serious, but a little less advanced, the belly still tenses up every time we touch it, even if we tap on it or gently rock it. On the other hand, the child who leaps off the exam table, landing with a happy thud, doesnโt need surgery!
Abdominal pain plus fever is also concerning. Not just โfeeling hot,โ but a measured temperature over 100.6ยฐ F (38.0ยฐ C). Maybe itโs an infection we can treat (like the bladder or kidney), but if we canโt make a sure diagnosis then & there, theyโll need a variety of same-day tests best obtained in an E.R.
Weโre also overly cautious when an immunocompromised person (with weak immune system) has a new, never-before abdominal pain. They can have serious conditions with hardly any symptoms. Such people include:
โข Elderly โข Debilitated โข Malnourished โข Alcoholics | โข Kidney Failure โข Liver Failure โข Cancer โข Immunosuppressive Meds | โข AIDS โข Various Chronic Diseases xxxx(Lupus, severe diabetes, xxxxxxxetc.)xxx |
And we beware the Severely Mentally Ill (with psychosis), who tolerate high degrees of pain. So if they come to us with a new type of abdominal pain, something bad may be going on.
Onward now, to Diagnosis: Choose the location of pain which most interests you:
- Acute Upper Abdominal Pain:xxxxxxxxxSummary ApproachxxxxxxxFull Discussion
- Acute Lower Abdominal Pain:xxxxxxxxxSummary ApproachxxxxxxxFull Discussion
- Acute Flank Pain:xxxxxxxxxxxxxxxxxxxSummary ApproachxxxxxxxFull Discussion
- Acute Generalized Abdominal Pain:xxxxSummary ApproachxxxxxxxFull Discussion
- Chronic Abdominal PainxxxxxxxxxxxxxxSummary ApproachxxxxxxxFull Discussion