The abdominal cavity houses many organs. Various diseases of each of these organs can cause pain. When evaluating the diseases of these organs, pain usually serves as a more urgent signal compared to headaches and backaches. Abdominal pain is a symptom that should be addressed promptly.

 While painkillers are prescribed for other chronic pain, it is extremely risky to give painkillers for abdominal pain without determining the cause. This is because alleviating the pain could hide the underlying disease, leading to delays in treatment and potentially causing more significant harm.

Inside the abdominal cavity, there are the stomach, intestines, liver, pancreas, gallbladder, bile ducts, spleen, appendix, kidneys and urinary tracts, bladder, uterus and ovaries in women, and the prostate in men. There are many acute and chronic pain arising from all these organs and from the abdominal wall. Evaluating all these types of pain is quite challenging. A thorough examination of the patient is essential.

Among abdominal pain, the most common are pain due to appendicitis, pain resulting from inflammation and stones of the gallbladder, pain arising from stomach and duodenal ulcers, and pain from inflammation of the pancreas. Additionally, severe pain  emerge in cancers of the abdominal organs.

Abdominal pain is usually classified according to the area where the pain is located to more easily reach a diagnosis. For this purpose, the abdominal region is divided into various parts.

Around the Navel

Pain around the navel may be associated with diseases of the small intestine and appendix inflammation (appendicitis).

Upper Middle Area

This area is also called the epigastric region. It's located above the navel in the middle. Pain in this area is usually related to stomach diseases. These could be acid reflux, gastritis, or ulcers. Additionally, diseases of the upper part of the small intestine (duodenum), pancreas, and gallbladder can also cause continuous and severe pain in this area.

Another condition causing pain in this area is a diaphragmatic hernia. Moreover, cancers of the organs located in this area (stomach, pancreas) also result in severe pain in the upper middle of the abdomen.

Upper Left Area

Pain in this area is not very common. Occasionally, it may appear due to diseases related to the stomach, spleen, pancreas, and colon.

Upper Right Area

The most important cause of severe pain in the upper right area is inflammation of the gallbladder. The pain that arises from this condition can spread to the navel and the back. Sometimes diseases stemming from the pancreas or duodenum can cause pain in the upper right area of the abdomen.

Lower Middle Area

Pain in this area may be due to colon inflammations, urinary tract infections in women, or diseases related to reproductive organs. A commonly seen painful condition in this area is spastic colon.

Lower Left Area

Pain in this area are often due to problems originating from the end of the intestine. Diverticulitis, a specific colon inflammation, and Crohn's disease can be cited as examples.

Lower Right Area

In colon diseases, pain can also be felt in this area. Pain from appendicitis, after its initial period, spreads to the lower right part of the abdomen.

Referred Pain

Pain originating from organs outside the abdominal area, like the lower parts of the lungs, kidneys, uterus, and ovaries, sometimes spread to the abdominal region. This type of pain is called referred pain. Additionally, it's common for pain arising from abdominal organs to spread to other areas. For example, gallbladder pain can spread to the chest and right shoulder, and pancreatic pain can spread to the back and between the shoulder blades. These are also examples of referred pain.

Diagnosis in Abdominal Pain

For patients consulting a physician due to abdominal pain, to determine the cause of the pain, the patient's complaints are first thoroughly inquired about, followed by a physical examination, various laboratory tests, imaging methods, and, if necessary, endoscopic examinations.

The way the pain starts is important. For instance, sudden onset pain can be a sign of a dietary disorder in the intestines, a blockage in the gallbladder ducts, or a blockage in the intestines.

The nature of the pain also provides valuable diagnostic information. For instance, in bowel obstructions, pain emerges in the form of cramps due to intestinal contractions. A blockage in the bile ducts leads to severe and constant pain in the upper abdominal area. Acute pancreatitis typically results in very severe, unbearable, constant pain in the upper abdomen and back. Acute appendicitis starts as pain around the navel and, as the condition progresses, moves to the lower right part of the abdomen.

Another important diagnostic criterion is the duration of the pain. For example, spastic colitis pain can last for months or even years with fluctuations. Gallbladder pain usually doesn't last more than a few hours. Pain due to pancreatic inflammation continues for several days.

Imaging methods are very important in diagnosing abdominal pain. Direct radiography (x-ray) can identify bowel obstructions or perforations. Contrast-enhanced radiography provides valuable information about the stomach-intestine system. Ultrasound is also a very valuable diagnostic method. Diseases of the gallbladder, appendix, liver, kidneys, and urinary tract can be detected with ultrasound. Computed tomography (CT) and magnetic resonance imaging (MRI) show the anatomy of the abdominal region perfectly, allowing for definitive diagnoses in many diseases.