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Abdominal pain is a common human experience. The abdomen contains many organs, including those belonging to the digestive, the reproductive and the urinary systems. Aside from these, blood vessels, muscles, nerves and other tissues are found in the abdomen, which may become a source of pain. Usual causes of pain in the abdomen include infections, trapped wind (gas), trauma, functional disorders, or other conditions affecting the various organs and systems. Many types of mild to moderate cases of abdominal pain are relieved by resting or taking some medications or home remedies, but severe abdominal pain, which occurs suddenly and progressively worsens, may need immediate medical attention.

Possible Causes of Sudden, Severe Abdominal Pain

The most common causes of sudden, severe abdominal pain include:

  • Acute gastroenteritis - stomach cramps are accompanied by symptoms such as vomiting and diarrhea

  • Food poisoning - severe abdominal cramps are accompanied by diarrhea, fever, and chills

  • Appendicitis - severe pain in the upper abdomen or right lower abdomen, usually with vomiting, loss of appetite, and fever

  • Gallstones - pain in the right upper abdomen, sweating, vomiting, fever, chills

  • Kidney stones - accompanied by back pains, which radiate to the groin, inability to lie still, nausea, pain on urination

  • Diverticulitis - caused by inflammation of outpouchings of the intestines, which leads to lower abdominal pain, bloating, and high fever

  • Perforated Peptic Ulcer - open sores in the stomach or intestine, which cause sharp pains in the abdomen and vomiting of blood

Other possible causes include:

  • Endometriosis - severe pelvic pain associated with menstrual periods, heavy vaginal bleeding, bloating and nausea

  • Acute pancreatitis - upper abdominal pain that radiates to the back, associated with nausea, vomiting and abdominal tenderness

  • Crohn's disease - a chronic condition that can have acute episodes of severe abdominal pain, diarrhea, blood in stools and fever.

  • Twisted ovarian cyst - a large ovarian cyst may move out of position and twist, causing severe pain, vomiting and fever

  • Intestinal obstruction - may cause pain, bloating and inability to pass gas or stools

There are many other possible causes of severe abdominal pain, and it is important to recognize the accompanying signs and symptoms when one must seek immediate medical attention.

When to Seek Help

Signs and symptoms that suggest you need to see a doctor immediately include:

  • Severe pain that worsens progressively

  • Inability to move because of severe pain

  • Fainting or nearly passing out

  • Repeated vomiting

  • High fever

  • Passing out blood in vomit, stools or from vagina

  • Chest pain

  • Inability to move bowels, urinate or pass gas

  • Pain that causes you to wake up at night

  • Generalized abdominal pain that subsequently localizes to one area of the abdomen

Generally speaking, if your abdominal pain seems to be the worst pain you have experienced or alarms you in any way, your body is telling you that you need immediate treatment.


There are many possible causes of severe abdominal pain and the diagnosis will depend on the doctor's assessment of your medical history, physical examination and laboratory tests. Tests may include blood tests, urine tests, imaging exams (X-ray, CT scan, MRI, etc) and endoscopic exams. The doctor may also determine if you might need immediate surgical treatment.

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