When Is Abdominal Pain An Emergency?
- David S. Klein, MD FACA FACPM
- Sep 22
- 5 min read
Updated: Sep 25
Abdominal pain can be unsettling at any stage of life. Many causes are harmless, but some need urgent care.
This post explains when to worry about abdominal pain and when to see a doctor. It follows an evidence-based approach and uses insights from reputable medical sources.
Understanding Abdominal Pain
Abdominal pain is any discomfort felt anywhere between the chest and groin. Because the abdomen contains many organs, pain can come from the digestive system, muscles or even organs outside the belly. The severity does not always match the seriousness of a chronic condition and may pass or persist depending upon the cause.
Acute abdominal pain starts suddenly and lasts hours or days. Causes range from infections to injuries.
Chronic pain that persists for weeks or longer and is often due to underlying conditions such as irritable bowel syndrome or ulcers. Persistent abdominal pain always warrants medical evaluation.
Common Causes of Abdominal Pain
Digestive issues:
Gas, indigestion, constipation and diarrhea often cause temporary pain. Eating too quickly, food poisoning, or food intolerances may also lead to discomfort.
Inflammation:
Infections like viral gastroenteritis, peptic ulcers, or urinary tract infections can cause inflammatory pain.
Female reproductive cycle:
Menstrual cramps and ovulation pain are common sources of lower abdominal discomfort.
Other organs:
Problems in the chest (heart attack), pelvis, or back can mimic stomach pain.
When to Worry About Abdominal Pain
Most bellyaches resolve with time, but certain features suggest a more serious issue. Pay attention to the duration and severity of pain and any accompanying symptoms.
Pain That Persists or Worsens
Unexplained abdominal pain that is persistent or severe requires medical attention. If the pain follows trauma, occurs during pregnancy or in young children, seek prompt evaluation.
Persistent pain after surgery or in older adults may indicate bowel obstruction or another complication.
Seek a doctor’s assistance immediately if abdominal pain is accompanied by:
Fever: Persistent fever can signal infection or inflammation.
Nausea or vomiting: Continuous nausea or vomiting, especially with inability to keep liquids down, is a red flag.
Blood in stool, urine or vomit: Blood can indicate bleeding in the gastrointestinal tract.
Jaundice: Yellowing of the skin and eyes may suggest liver or gallbladder disease.
Swelling and tenderness: A swollen or tender abdomen requires evaluation.
Shortness of breath or chest pressure: Pain associated with difficulty breathing or chest pain could reflect heart or lung problems.
Inability to pass gas or stool: Bloating, constipation, and an inability to pass gas can signal bowel obstruction
Some situations demand immediate emergency care. Recognizing these signs can be lifesaving.
Signs You Should Go to the ER Immediately
According to the Mayo Clinic, you should call emergency services if your abdominal pain is severe and accompanied by trauma, chest pressure, or pain.
Go to the emergency department if you experience:
Severe, sudden pain: A sudden onset of intense pain that makes movement difficult is concerning.
Pain with fever or chills: Fever may point to infection or inflammation.
Persistent pain in the lower right abdomen: This may indicate appendicitis.
Chest pressure or shortness of breath: Pain radiating to the chest, shoulder, or back can mimic heart attack.
Pain with bloody vomiting or black stools: These signs suggest internal bleeding.
Bloating with inability to pass gas or stool: Could be a bowel obstruction.
Conditions That Require Urgent Care
Several conditions necessitate urgent evaluation.
Appendicitis
Pain often begins near the belly button and migrates to the lower right abdomen. It may start slowly and worsen over 12-24 hours.
Appendicitis is more common in teenagers and young adults.
Bowel Obstruction
Bloating, constipation and inability to pass gas, especially in people with previous abdominal surgery, suggest obstruction.
Acute Pancreatitis
Pain starts in the upper abdomen and worsens after eating. Symptoms may include fever and rapid pulse.
Kidney Stones
Sharp, cramping pain in the lower abdomen or back that peaks rapidly, often early in the morning, could signal kidney stones.
Gallbladder Infection
Severe right upper quadrant pain with fever and jaundice may indicate cholecystitis.
Not All Abdominal Pain Requires An Emergency Room Visit.
Your primary care doctor can evaluate many conditions and decide if specialist care is needed. Schedule a doctor's visit if your pain lasts more than a few days or if it worries you.
Seek care sooner if you have underlying medical problems or are older, pregnant, or immunocompromised.
What Your Primary Care Provider Can Help With
Your doctor can diagnose and treat conditions like indigestion, constipation, food intolerance, or mild infections.
They may prescribe medication, recommend lifestyle changes, or order basic tests. If you have chronic conditions such as irritable bowel syndrome, your doctor can help manage symptoms and refer you to a specialist if needed.
When to Ask for a Specialist Referral
You might need a gastroenterologist or surgeon if your symptoms are persistent, unexplained, or linked to structural issues.
Conditions like inflammatory bowel disease, gallstones, or hernias often require specialist evaluation. Recurrent pain in older adults may call for imaging studies to rule out cancer or vascular problems.
What to Expect During a Medical Evaluation
Questions You'll Be Asked
Health professionals will ask about the location, intensity, and duration of your pain. They may inquire about your diet, bowel habits, and any triggers or relieving factors.
Possible Tests or Imaging
Your doctor may perform blood tests, urine tests or stool studies.
Imaging like ultrasound or CT scans can reveal gallstones, appendicitis or other structural problems. Endoscopy may be used to examine the stomach or intestines.
The tests ordered depend on your symptoms, age and medical history.
How to Track Your Symptoms at Home
A symptom diary can provide valuable insight. Be sure to include:
Time: Record when the pain occurs and how long it lasts.
Location: Note where you feel pain and whether it spreads.
Severity: Use a scale from 0 to 10 to rate intensity.
Triggers or relief: Track foods, activities, or bowel habits that affect pain and any medications that help.
Final Thoughts On When Should You Worry About Abdominal Pain
Abdominal pain is a common complaint across all ages.
Most cases are minor, but persistent or severe pain or pain with concerning symptoms should prompt a medical evaluation.
Understanding when abdominal pain is an emergency helps you act quickly and reduces the risk of complications. Listen to your body and seek care when something feels wrong.
At Longwood, Florida-based Stages of Life Medical Institute, our pain specialists diagnose all forms of abdominal pain and help guide appropriate treatment. To become a new patient, simply click here.
David S. Klein, MD, FACA, FACPM
1917 Boothe Circle, Suite 171
Longwood, Florida 32750
Tel: 407-679-3337
Fax: 407-678-7246
