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The abdomen is a large cavity in the trunk, below the chest cavity and diaphragm, that contains various organs and tissues. These include parts of the digestive system, the genitourinary system, blood vessels, nerves, muscles, and spinal bones. The abdomen can be anatomically divided into four quadrants, with left and right halves and upper and lower halves. Some parts of the organ systems extend to the pelvic cavity, just below the lower abdomen, and into the external genitalia (sex organs).

Pain is a common symptom when any of these organs or tissues is diseased, traumatized, stretched or blocked, causing inflammation. Pain in the lower abdomen and pelvic areas may be due to inflammation in any of these organs:

  • the appendix, parts of the large intestine and rectum

  • the urinary bladder and the ureters (tubes that connect to the kidneys)

  • the ovaries, fallopian tubes and uterus

  • spermatic cords

  • skin, nerves, blood vessels and muscles

  • bones of the lower spine

  • lower portion of the aorta (a large artery)

Common Causes of Lower Abdominal Pain

The most common causes of pain in the lower abdomen due to gastrointestinal problems include appendicitis, constipation, irritable bowel syndrome, and diverticulitis. When the digestive system is involved, common accompanying symptoms may include fever, changes in bowel habits, gas and bloating, blood in the stool, nausea and vomiting, changes in appetite, and loss of weight.

Lower abdominal and pelvic pain may also be due to disorders in the genitourinary system, and common causes include infection in the urinary bladder and urinary tract and urinary stones. Common accompanying symptoms include fever, burning sensation when urinating, inability to urinate, urinating in small amounts, and presence of blood in the urine.

In women, pain may also be caused by pelvic inflammatory disease, ectopic pregnancy, menstrual pain, ovulation pain, and other disorders in the uterus and ovaries. Accompanying symptoms may include changes in menstrual cycles, abnormal vaginal discharge and abnormal vaginal bleeding.

In men, pain may be related to disorders in the prostate and inguinal hernia. Accompanying symptoms may include changes in urinary habits (enlarged prostate) and bulging groin (inguinal hernia).

Tumors developing in any of these organs may also cause abdominal or pelvic pain, and accompanying symptoms may include fever, weight loss, and others, depending on the organ involved.

When to See a Doctor

It is best to see a doctor if your symptoms persist or do not improve after a few days of home treatment.

Immediate treatment is needed if you have high fever, severe abdominal pain, or if abdominal pain is due to trauma to the abdomen or pelvis.

Other symptoms that signal immediate treatment include:

  • vomiting for more than a few days

  • inability to pass stools for more than a few days

  • blood in the stools or vomit

  • blood in the urine

  • abdomen is painful to touch

  • difficulty breathing

  • pain is getting worse

  • painful urination

  • inability to pass urine

The diagnosis of your abdominal pain may be made after a thorough clinical evaluation, which may be supported by laboratory tests. These may include blood tests, urine analysis, stool exams, and radiological or imaging exams (x-ray, MRI, ultrasound, CT scan, etc). Endoscopic examination to view the internal organs may also be requested when appropriate.

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